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[Penguin]

Hi
Getting really bad nightmares since starting utrogestan these past few days. I've had vivid dreams since starting but these are something else, they play into my absolute worst fears and are seemingly driven by whatever I'm anxious about.
Does anyone have any suggestion as to how to prevent them, even if it's only old wives tales, I'll try pretty much anything. I don't want to go to sleep tonight and am sat here in tears as last night's one (which also seemed to last the whole night ) has upset me so much.
Do all progesterone cause thus or is it just utrogestan?

[Wrensong]

Hi Penguin, so sorry to know about the nightmares.  I get these a lot so I know just how bad they feel.  They can be caused by overheating so I wonder whether you feel the Utrogestan is making you too hot?  Progesterone raises body temperature & there was a study I read of (sorry don't have a link) that found nightmares in premenopausal women are more common in the luteal phase of the cycle when progesterone is high.  I found that all progestogens exacerbated my sleep problems & Utrogestan was the very worst for this.  The only progestogen said not to increase body temp is Dydrogesterone (in the Femoston range), but overheating may not be the cause for you.  I try to keep the bedroom as cool as possible, use lightweight bedding (we have several 1-tog duvets) & have a glass of water beside the bed for when I wake too hot.  I hope you managed some good, untroubled sleep last night 
Wx

[CLKD]

Awful.  As a child I would have bad dreams about wolves 

Since taking regular ADs my dreams have been busy: the brain takes something from the News of the day and grabs a person from waaaay back who I haven't thought about for years.  Then runs with them!  Not particularly bad but I wake feeling knackered!   I would agree that it's as Wrensong suggests.

[Penguin]

Hi Wrensong, thamos for your reply. It was last night that was the worst night actually, its been getting progressively worse since starting the utrogestan on Sunday night. I do get massively overheated when taking progrsterone, more so since starting hrt although I always felt hotter at night during luteal phase even with just my natural cycle. According to my fitbit my body temp goes up at least one degree too so you are right to make that connection, thank you, I hadn't thought of it.
I'll try cooling down the room some more, I moved back from just a sheet to a 1 tog duvet at the weekend which was probably a mistake. I'd be better off too cold than too hot then if the overheating is contributing to the nightmares.
I suppose I could try taking the utrogestan in the morning like some ladies do, it certainly hasn't helped my sleep this month taking it at night.
Honestly if this continues I am just going to stop everything at the end of this utrogestan stage and try to increase my estrogen natural with Phytoestrogens. It didn't work before but perhaps I need to try harder.

[Penguin]

Awful.  As a child I would have bad dreams about wolves 

Since taking regular ADs my dreams have been busy: the brain takes something from the News of the day and grabs a person from waaaay back who I haven't thought about for years.  Then runs with them!  Not particularly bad but I wake feeling knackered!   I would agree that it's as Wrensong suggests.

So I am also taking citalopram which is probably exacerbating it all. Yes, exactly as you describe, thats what happens. Lots of people from my past, and then some awful interactions with people from my present, like my lovely hubby who'd never dream of treating me like he did in my nightmare. Plus ones where my worst (and whatever most recent) health fear comes true, which then shakes me for the whole following day.

[AngelaH]

Progesterone raises body temperature & there was a study I read of (sorry don't have a link) that found nightmares in premenopausal women are more common in the luteal phase of the cycle when progesterone is high.

When I was in peri I had nightmares, severe night sweats and I constantly felt hot due to low progesterone level in my body and all those symptoms were successfully treated with progesterone. From my point of view it’s all about balance between different hormones, but not just about one certain hormone.

[Penguin]

Progesterone raises body temperature & there was a study I read of (sorry don't have a link) that found nightmares in premenopausal women are more common in the luteal phase of the cycle when progesterone is high.

When I was in peri I had nightmares, severe night sweats and I constantly felt hot due to low progesterone level in my body and all those symptoms were successfully treated with progesterone. From my point of view it’s all about balance between different hormones, but not just about one certain hormone.

Thanks AngelaH. It has only started since starting back on the utrogestan though and I am on the full 200mg with only one pump of estrogel, so I think surely it must be unlikely my progesterone is too low? I do agree with you that it is about balance between the hormones though, and I have added an extra half pump of gel this morning as I'm worried my estrogen may well be low in comparison to progrsterone.  GP won't let me lower the dose though.
Can I ask what type of progesterone you used please? I'm willing to try another type. Wrensong mentions dydrogrsterone above.

[Wrensong]

Penguin

I'd be better off too cold than too hot then if the overheating is contributing to the nightmares.

I have to make sure not to go to bed too warm, so I don't shower or exercise too close to bedtime & we also moved main meal of the day from evening to lunch, though not practical for some people I know.

If you are only on one pump of gel (25mcg patch equiv) with 200mg Utro, I agree the balance may be wrong.  Are you still in perimenopause?

Another thing that can cause nightmares is blood sugar dropping too low overnight, so perhaps something to think about.

Honestly if this continues I am just going to stop everything at the end of this utrogestan stage and try to increase my estrogen natural with Phytoestrogens. It didn't work before but perhaps I need to try harder.

Please don't beat yourself up, this can be a very challenging stage of life & we are all doing our best in a trial & error situation.
Wx

[Penguin]

Penguin

I'd be better off too cold than too hot then if the overheating is contributing to the nightmares.

I have to make sure not to go to bed too warm, so I don't shower or exercise too close to bedtime & we also moved main meal of the day from evening to lunch, though not practical for some people I know.

If you are only on one pump of gel (25mcg patch equiv) with 200mg Utro, I agree the balance may be wrong.  Are you still in perimeonoause?

Another thing that can cause nightmares is blood sugar dropping too low overnight, so perhaps something to think about.

Honestly if this continues I am just going to stop everything at the end of this utrogestan stage and try to increase my estrogen natural with Phytoestrogens. It didn't work before but perhaps I need to try harder.

Please don't beat yourself up, this can be a very challenging stage of life & we are all doing our best in a trial & error situation.
Wx

Thanks, this is all very helpful. So I didn't eat dinner last night as we'd had a big lunch out, so all I had at 7pm ish was a banana and a few Brazil nuts,  perhaps not enough to stop low blood sugar?

Yes, still in perimenopause and I get my withdrawal bleed 2-3 days after stopping the utrogesran and its like a normal period. Before starting hrt at the end of last year, my periods were 26-31 days apart but very light. I started hrt for anxiety, hot flushes and dryness (eyelids would stick to eyes overnight!) even though I hadn't yet missed a period. Do you think it sounds like I need to increase the estrogel?

Thank you for your kind words. I am hard on myself as feel like I have been trying for years to deal with hormone imbalance and sort my increasingly worse anxiety out. Tried natural for a good two years before giving up and starting citalopram a year ago and then hrt after Christmas. I can't seem to get it quite right.

[AngelaH]

Thanks AngelaH. It has only started since starting back on the utrogestan though and I am on the full 200mg with only one pump of estrogel, so I think surely it must be unlikely my progesterone is too low? I do agree with you that it is about balance between the hormones though, and I have added an extra half pump of gel this morning as I'm worried my estrogen may well be low in comparison to progrsterone.  GP won't let me lower the dose though.
Can I ask what type of progesterone you used please? I'm willing to try another type. Wrensong mentions dydrogrsterone above.
[/quote]



Penguin I am now struggling with the similar problems as you I am on gel too, on very low dose 1/4 of 1 pamp (GP prescribed me 2 pamp, but it near killed me) because if I increase the dose it makes me feel anxious, ill and very hot! Sometimes I think my body just rejects estrogen, like I don’t need it, I don’t really know myself. I have Mirena coil for 4 years, it sorted all my nightmares out in my peri, but now it’s coming to the end and I think it doesn’t balance estrogen anymore in my body, it is still enough for my womb protection, but not enough to go to blood stream and take a part in balancing estrogen like it did before. I tried Ultrogestan too, it made me feel ill. For some  reason my body tolerates synthetic progesterone in coil much better than Ultrogestan. So I am in the middle of nowhere, but I am seriously thinking I need to work out my progesterone first (because I had problems with it before in peri) and then I can try to add estrogen. If it all is not going to work for me then I don’t know what to do next,I can’t look inside my body and see what a real problem is. 

So sorry Penguin I am not much help for you, but you are not the only one who has this problem, 200 Ultrogestan it is high dose, but Ultrogestan definitely not for everyone.

[Wrensong]

Penguin

So I didn't eat dinner last night as we'd had a big lunch out, so all I had at 7pm ish was a banana and a few Brazil nuts,  perhaps not enough to stop low blood sugar?

Maybe not.  Blood sugar stability can be affected during menopause & it's really worth looking into & making any changes you feel might be beneficial.  The evening meal issue can be tricky.  Eating too late or too much means metabolism is fired up, making us too hot for restful sleep & a big glycaemic load from getting the carb/protein/fat balance wrong can mean we produce a lot of insulin in response that can then take the blood sugar down a bit too much.  You could maybe experiment & see what works best for you?

Do you think it sounds like I need to increase the estrogel?

I'm sorry but it's really difficult to be sure in peri, but one pump is low dose & though I know 200mg is the advised Utro dose for a sequential regimen, it's a big hit for anyone who doesn't feel well on Utro & may just be overpowering if you are not producing much oestrogen yourself.

Penguin, please try to remember none of the difficulty we get at menopause is our fault.  Hormones have very powerful effects as we all know & we can only do our best with the tools available to us.  As things stand, the range is not wide enough to make this easy for everyone.  We need a better choice of doses for progesterone & possibly for someone to crack the issue of producing a stable transdermal form of it, as well as NHS testosterone products designed for women instead of faffing about with estimating pea sized blobs of way too powerful male formulations or feeling we have to go private for Androfeme.

Like you, I tried for a long time (more than a decade) without HRT & then had another 15 months off it 5 years into postmenopause.  For some of us it can be a struggle for sure, but this is a great forum for support, so please don't be alone with what you are going through.  There is always someone here who understands.
Wx

[AngelaH]

Mirena has a very little dose of progesterone, the main function of it is to prevent pregnancy, not even to balance estrogen in peri or meno, but in peri it worked perfectly for me, though I had sever symptoms of low progesterone. So 200 Ultrogestan is definitely too much. GPs don’t know what they are doing. 1 year ago I was prescribed 75 Evorel patches and 100 Ultrogestan on top of my Mirena, this combination sent me straight to the Space. Next morning I could not able to get out of bed, whole World was moving around me, I found myself in the centre of Universe and I could not stop it!

[Penguin]

Penguin

So I didn't eat dinner last night as we'd had a big lunch out, so all I had at 7pm ish was a banana and a few Brazil nuts,  perhaps not enough to stop low blood sugar?

Maybe not.  Blood sugar stability can be affected during menopause & it's really worth looking into & making any changes you feel might be beneficial.  The evening meal issue can be tricky.  Eating too late or too much means metabolism is fired up, making us too hot for restful sleep & a big glycaemic load from getting the carb/protein/fat balance wrong can mean we produce a lot of insulin in response that can then take the blood sugar down a bit too much.  You could maybe experiment & see what works best for you?

Do you think it sounds like I need to increase the estrogel?

I'm sorry but it's really difficult to be sure in peri, but one pump is low dose & though I know 200mg is the advised Utro dose for a sequential regimen, it's a big hit for anyone who doesn't feel well on Utro & may just be overpowering if you are not producing much oestrogen yourself.

Penguin, please try to remember none of the difficulty we get at menopause is our fault.  Hormones have very powerful effects as we all know & we can only do our best with the tools available to us.  As things stand, the range is not wide enough to make this easy for everyone.  We need a better choice of doses for progesterone & possibly for someone to crack the issue of producing a stable transdermal form of it, as well as NHS testosterone products designed for women instead of faffing about with estimating pea sized blobs of way too powerful male formulations or feeling we have to go private for Androfeme.

Like you, I tried for a long time (more than a decade) without HRT & then had another 15 months off it 5 years into postmenopause.  For some of us it can be a struggle for sure, but this is a great forum for support, so please don't be alone with what you are going through.  There is always someone here who understands.
Wx

Thank you so much. I'll definitely try eating more this evening but not a big dinner and perhaps take a snack up to bed for when I wake in the night. Blood sugar levels havd precuously effected me (I get hangry very easily).

Since these messages this morning I have been on the phone to the GP surgery and managed to get an appointment for tomorrow with the doctor I always see, and who is really helpful in managing my anxiety. I think I just need to say that I've tried 8 months and something now isn't working and how can he help me work out what it is, either with testing or letting me try another way of doing the utrogestan or a different progesterone. I was also wondering if taking it in the morning when I first wake up would help reduce the nightmares as there'd be less in my system by bedtime,  but my hubby says I should wait and discuss that with the doctor tomorrow.

Either way I can't go on as I am. I've been crying all morning about my latest health anxiety 'symptom' , which I know I've caused by prodding and poking my breasts too much, but which still scares the shit out of me 🤷‍♂️

[Penguin]

Mirena has a very little dose of progesterone, the main function of it is to prevent pregnancy, not even to balance estrogen in peri or meno, but in peri it worked perfectly for me, though I have sever symptoms of low progesterone. So 200 Ultrogestan is definitely too much. GPs don’t know what they are doing. 1 year ago I was prescribed 75 Evorel patches and 100 Ultrogestan on top of my Mirena, this combination sent me straight to the Space. Next morning I could not able to get out of bed, whole World was moving around me, I found myself in the centre of Universe and I could not stop it!

Gosh that sounds horrible. Yes a mirena has been suggested to me before as  way to manage the extreme pms I used to get. I'm concerned about how difficult it seems to be to get the nhs to remove them when they cause problems. There are ladies on here having that issue at the moment and I'd hate to be stuck with it. Seeing GP tomorrow now though, so hopefully he'll have some suggestions.

[Wrensong]

Oh Penguin, bless you.  Good to know you have an appt with an understanding GP for tomorrow.  Yes, maybe put morning Utro dosing to him if you'd like to try that & want his approval.

We've all been there with the poking & prodding when HA makes us nuts.

Good too that you're aware of how blood sugar issues affect you, as nutrition's something you can experiment with to help yourself feel more in control.

Let us know how you get on with the GP & I hope you have a much better night tonight.
Wx