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[Elaine90]

Background- definitive surgery due to severe endometriosis, 2016 (hysterectomy, oophorectomy, bowel resection...). No HRT. Developed several health problems due to long term hormone deficiency. Saw a private gynae and was prescribed Oestrogel with Utrogestan and Testogel (also tried evorel conti.)
In combination, they have helped in many ways - stronger, more energetic, more confident, no more dry eyes and so on. Without the HRT I felt about 90. But, it causes terrible insomnia. 2 to 3 hours sleep at most. Sometimes none at all. I just feel wide awake.
Oestrogel alone is no use as it makes me more anxious and makes my dry eyes worse, the progesterone and testosterone are the most useful for energy, mood, eyes, but are the ones messing with my sleep cycle.
Over the past 10 months, I have tried different doses, different timings, different methods of application, to no avail.
The gynae says that tablets cause more side effects than the trans-dermals, but I can't continue like this.

I was wondering if any of you had tried tablets after gels/patches and if so, what did you use and did it work out for you?

Thanks

[sheila99]

Utrogeston disrupts my sleep too. I take it in the morning now and my sleep is OK.

[Mary G]

Before switching to a different form of HRT, why don't you try melatonin?  If you take 3mg about an hour before going to bed, it will probably help.

[Elaine90]

Thanks for the replies.
Unfortunately I already  take them in the morning and it doesn't help as they stay in my system too long.
I've also tried melatonin and that doesn't help either. ( also tried 5-HTP, l-tryptophan, numerous sleep remedies)
Hence wondering about something else

[Mary G]

You obviously get on well with your HRT regime apart from the insomnia so you might have to consider taking a low dose antidepressant off label.  At a low 10 or 25mg dose, antidepressants don't actually work as antidepressants and are prescribed for sleep, pain, IBS and migraine prevention.

I can tell you that amitriptyline and its sister noretriptyline would give you a full night's sleep!

Definitely worth a try I think.

[Wrensong]

I also found progesterone badly exacerbated insomnia.  I second Mary G's suggestion of a low dose, sedative type antidepressant trial.  Mirtazapine can be very helpful for sleep, with a caution that it can mess with thyroid status if you are hypothyroid.  Usual starting dose is 15mg but it can be halved to try @ 7.5mg & has been shown to help sleep more at lower doses than higher.
Wx

P.S. meant to say that I found amitriptyline worsened dry eyes, mouth etc & it is a known side effect of that class of drugs, so as you already have dry eyes perhaps just bear that in mind.  May not be a problem for you at the low dose Mary G has suggested.  Mirtazapine also has dry eyes listed as a side effect (sorry), but I don't remember it worsening mine when I tried it @ 7.5mg.  I think it's pretty much trial & error as to how we react & there's not much in the tool kit as regards insomnia remedies.

[Wrensong]

Mary G do you find your eyes are OK on amitriptyline/nortriptyline & it doesn't give you dry mouth?
Wx

[Elaine90]

Thanks so much for the replies.
I've looked into amitriptyline before as one of the reasons I started HRT was severe burning mouth syndrome following a dental procedure and low dose amitriptyline is one of the treatments. I was put off by the list of adverse effects and I already had a somewhat dry mouth and eyes, so was afraid of trying, but might have to do so at some point as the HRT didn't fix this.
I was really hoping to be able to get an alternative HRT which doesn't cause insomnia and ideally simplify the regime as I find it a pain already. (Eg being sensitive to small fluctuations,  I need to split the oestrogel dose over the day also the testogel is so concentrated that it's hard to dose accurately enough)

[Wrensong]

Elaine90, if you have no contraindications to oral HRT I wonder whether the Femoston range might suit you better.  The dydrogesterone it contains is well tolerated by some women.  I coped better with that progestogen than Utrogestan or any of the other progestogens.

I'm in a similar situation to you having had BSO several years ago, chronically dry eyes, mouth etc & relentless insomnia whatever I do with HRT, so I feel your frustration.
Wx

[discogirl]

Hi Elaine90

Sorry for sounding thick but just wondered if you had a hysterectomy in 2016 what is the reason your taking progesterone.

[Elaine90]

Hi, thanks for the replies
Wrensong - I'll look into femostan
Discogirl - The main reason for progesterone is I that had severe endometriosis, which grows with oestrogen.
Although I had surgery, mine had spread beyond the pelvic cavity to the diaphragm (which can't be operated on). Also, it's very difficult to get it all, even in the pelvic area, so there's a risk of regrowth with oestrogen only.
I also found it made me feel calmer, whereas oestrogen only makes me feel rather anxious.

[Scampidoodle]

Interesting re the anxiety as I’m
On oestrogen but with Mirena. I’ve had Mirena for years but since the addition of a tiny dose of oestrogen I feel a jittery anxiety. So might have to add a v small dose of progesterone on top.

[discogirl]

Hi, thanks for the replies
Wrensong - I'll look into femostan
Discogirl - The main reason for progesterone is I that had severe endometriosis, which grows with oestrogen.
Although I had surgery, mine had spread beyond the pelvic cavity to the diaphragm (which can't be operated on). Also, it's very difficult to get it all, even in the pelvic area, so there's a risk of regrowth with oestrogen only.
I also found it made me feel calmer, whereas oestrogen only makes me feel rather anxious.

Thanks for explaining that.

I really hope you find a solution soon.

take care xxxx

[Mary G]

Wrensong, I have never suffered from a dry mouth or dry eyes with either amitriptyline or noretriptyline.  It might be because of the low dose ie 25mg. 

Elaine90, I almost suggested Femoston myself but you said you are happy with your current regime.  However I do agree with Wrensong, it would be worth a try and it contains a very well tolerated form of progesterone.

[Wrensong]

That's good Mary G, that you don't find them at all drying at low dose.
Wx