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[Sophiliqy]

I started HRT (utrogestan and the gel, just one pump) principally to lengthen my cycle because I had extremely heavy bleeding (around 400-500ml) every 20 days. It’s all been checked out and it’s fine, so I’m switching to the coil in a couple of weeks. The HRT is around 5 months in from starting and I am feeling incredible debilitating fatigue, and aimlessness - I am very fortunate to get 8 hours of good sleep a night. But I’ve even had a couple of nights where I’ve woken up at 8.30am (10 hours) and still felt groggy. Even before HRT I’d wake up at 4 but it didn’t bother me and I wasn’t this tired. I’m wondering whether when I have the coil fitted if I should come off the gel - am I right in thinking that if I don’t really need it and that this may be causing such fatigue? I am very conscious about nutrition, I do weights and some running, and my bloods including iron and ferritin levels are fine. I’ve had no other problems with menopause and apart from longer cycles and perhaps hair a bit thicker I feel no different than when I wasn’t on it.

[Flossieteacake]

Hello and welcome to the forum. Have you thought about trying to increase your oestrogen? One pump may not be enough for you. I personally have found lack of oestrogen to cause me to feel fatigue.

It is horrible not to get a decent sleep and something many of us are all too familiar with.

[sheila99]

IMO too it's more likely to be caused by too little oestrogen rather than too much. It might be better to get the oestrogen right before you throw the mirena into the mix too as once it's in you can't easily remove it to see what problems it might be causing.

[Sophiliqy]

Thanks for your responses - I get loads of sleep (too much!) and this type of fatigue has only started 4 months into taking Oestrogen. I wasn’t tired before and didn’t take it for fatigue. Maybe I’ll increase it to two pumps and see how that it. My recommended dose is 1-2.

[Wrensong]

Did you actually find out what your ferritin result was?  There's a very wide ref range (around 10-300) & if you were bleeding that heavily I wonder whether you are close to bottom of range.  It is possible to be low in ferritin & have a normal haemoglobin level & feel under par.  Also, I assume bloods included thyroid & if so, did you see the results with ref range?  What about Vit D & B12?

 
Wx

[Sophiliqy]

Yes I always have ferritin checked. I take iron supplements (hemaplex) which have been great. I have always been at lower end, been tested for last 10 years on and off. I take Vit D, not too sure about B12. Had thyroid checked throughly, fantastic nurse practitioner, I’m slap bang in the middle on everything. Nothing apart from the HRT has changed dramatically, as far as I know.

[Wrensong]

Good.  That's all reassuring.
Wx