I am 45 and peri menopausal, also got osteoporosis. last oestrogen levels 269 on 2.5 pumps so increased to 3 pumps estrogel, taking utro 100mg vaginally at night as feel lousy as prog intolerant. I take the estrogel at night too. I was on 2 pumps a few months ago. Since increasing the oestrogel I have noticed my sleep is much worse, waking about 4am and feeling a bit jittery. The sleep was a problem prior to starting HRT. I still get VA and have low libido and occ night sweats, joint aches and achy muscles. I will try the oestrogel in the morning instead. I did read someone else found it made them wake early. I do regular meditationa and yoga and eat well and no alcohol (which makes me sleep badly sadly!). I think my energy levels are slightly better with the oestrogen, just feel a bit wired. I seem to remember i felt like this when i started it but was told by HRT nurse that it wasnt due to the oestrogen. I will persist with it but any thoughts appreciated!