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[buffy26]

Hello ladies

Hoping someone can relate to this. I am 61 and on HRT for just over 2 years. I had minimal day hot flushes in peri, and the odd night of overheating but nothing like now.
 I have been a slow absorber of both the patches and the gel with last two lots of bloods reading just 312 when on 3 pumps. Ive since increased to 4 pumps of Estrogel and 1 Utrogestan 10 months ago. Apart from the early bleeds when starting, things eventually settled and I have not bled with the last lot of incrementally increased dosages. I also have VA and need to use Vagifem every night, lowering the dosage even by missing a couple of nights causes a rapid re- occurrence of the condition.

My main issue now and for the last year every night to wake up with my sheets really damp and whatever bed clothes I wear, they are the same. if I am wearing PJs, they are damp right down to the ankle. I have been trying to monitor this to see if there is a pattern emerging. The dampness appears in the early hours around 4am. I am not covered in visible dripping sweat or anything, the skin just feels clammy to touch everywhere. It must be significant enough to cause this.  I have switched to linen sheets, I have no duvet now as thats too much. Tried sleeping without nightwear too. Even in Winter this was happening. Does this happen to anyone else like this, all over the body or are menopause type night sweats more localised? I know we are all different but it would be good to know others experiences of how the night sweats occur.  I am concerned this could be something else. My GP who is registered as a GPWSI in Menopause said that she is reluctant to increase me to 5 pumps as a blood result of 312 is regarded as the normal range.

Grateful for any advice or shared experiences!

[Sereia]

Hello Buffy, sorry to hear about your suffering. I thought I'll share what happened with me so you can have some reference. Hopefully the more experienced/knowledgeable ladies will share their inputs also. I've been on hrt for about two years, and was on 5/6 pumps of Oestrogel daily. I felt okay. I wasn't as observant about my own body though. Then a few months ago (sorry can't recall exactly when) I noticed I had very bad hot flushes daily, late afternoon/early evening; as well as night sweats with pj soaked. I normally feel cold a lot and wouldn't sweat at all while sleeping. This went on so I finally made an appointment with my GP, who suggested straight away that I change to patches. I was prescribed Evorel 100. This was about a month ago. The night sweats are gone and my hot flushes eased too.
I was curious why I had symptoms breaking through on Oestrogel and found this wonderful forum, and read about the problem re the formula and dosage of the "new bottle."
Everything made sense! I filled a yellow card, while feeling angry at the fact that so many women were put through unnecessary suffering as the result of Besins' failed products.
The only obvious thing I noticed with the patch is that I am really bloated and feeling uncomfortable as if I'm having constipation, which has never been a problem for me.
Hope this helps and good luck!
Sereia

[buffy26]

Thank you for sharing your experience.
Prior to the gel I was on Evorel, but it was not successful as I wasn't absorbing it with the patches rolling off all the time

I checked the batch of the gel with the pharmacist and he reasurred me the batches I had over a period of time were all sound.
 :)Im going to switch to only am application
To see if this makes a difference before I go back to the specialist for a review

I've not experienced bloating with Hrt or bowel changes, have you found anyone else who has experienced the same?
It's such an individual picture for us all and so hard to follow a regime with any confidence. Good luck too and thank you again

[sheila99]

There can be a big difference between normal range and the level an individual needs to feel good on. You have uncontrolled symptoms so you need more oestrogen. If your gp won't prescribe more you can ask for a referral to a meno clinic who can. Or see someone privately. I had the same problem with evorel patches but find estrodot are fine. I get more from oestrogel and estradot than I did from evorel.

[buffy26]

I agree with you Sheila99 I need to have a review with a private specialist, they seem to have a more open mind on going over the guidelines
I have had some blood results come in recently that are being looked into for something else now, so will wait and see if this could be related to the night sweats and then once I have answers there I will get back to focusing on the estrogen levels.

Thank you

[Wrensong]

Hi Buffy26, you say the night sweats started around a year ago, but I'm not clear whether you only began Utrogestan 10 months ago (i.e. around the same time) & were maybe on a different progestogen prior to that?

I am 61 and on HRT for just over 2 years. I had minimal day hot flushes in peri, and the odd night of overheating but nothing like now.
I have been a slow absorber of both the patches and the gel with last two lots of bloods reading just 312 when on 3 pumps. Ive since increased to 4 pumps of Estrogel and 1 Utrogestan 10 months ago . . . and for the last year every night to wake up with my sheets really damp.

Reason for asking is that progesterone increases body temperature & some of us find Utrogestan makes us extremely hot at night.  I found it was the worst of the prog range for this effect but all progestogens other than Dydrogesterone (in the oral Femoston range) are said to act in this way to some extent.  As the others have suggested, sufficient replacement oestradiol should mitigate the effect.
Wx

[Wrensong]

Sereia 

[buffy26]

Hi Wren, thanks for your points
 I started utrogestan and Estrogel around October 22, gradually increasing from 2 pumps to 4 but remaining on just one Utrogestan tablet. The sweats were not to this level at that point, infrequent and less noticeable with not much dampness of bed clothes and sheets. I used to feel a little damp patch across the chest only but now its the whole body. Prior to that I was on a combined patch, with a lot of breakthrough bleeding. Its difficult to establish what is going on now, where to point the finger. I remain very achey and the brain fog is not good either. Its weird because when I very first started HRT I was staggered at the turnaround feeling like a new woman so quickly, but I had been existing on literally zero hormones for years so it was like a shot of adrenaline to the body. I feel I want to have more bloods done to get a proper view as I am also navigating autoimmune issues as well. It all feels complex and difficult how to navigate the hormones as symptoms cross over if that makes sense.
I know bloods are not meant to be the correct way to manage things, its our symptoms but it does help to know if we are absorbing sufficiently in line with the dosages

[Wrensong]

Hi Buffy, thanks for the clarification.  OK, so the increase in night sweats didn't coincide with starting Utrogestan.  That's good in a way, as I presume you'd want to continue on Utrogestan for the prog component of your regimen, it being considered better for us than the synthetics.


I'm also in my early 60s, on long term HRT & battling v persistent overheating at night with really troblesome insomnia & feel v unwell with the whole package.

If the night sweats started as you increased your oestradiol dose I wonder whether in fact higher levels could be too much for your body at this age?   Sweating as part of a stress response to too high a dose.  Being 3 decades hypothyroid has taught me that hormonal meds are very much goldilocks & for some of us they can be a devil to get right.

If you have an autoimmune condition (as I do) could underlying inflammation be a factor for you?  I agree that can make for a complex picture that's difficult to interpret.

Yes absolutely, bloods postmenopause to show how well we are absorbing can be helpful if symptoms are not well controlled & testing over past couple of years has shown I'm now getting frustratingly v erratic absorption compared with a few years ago.

I hope you manage to find out what's behind it so you can get it sorted soon.
Wx

[Wrensong]

Meant to say re your query about the sweats affecting more than just head & chest area - yes, my overheating at night has always affected the whole body, right from start of peri, a decade+ before starting HRT.  I don't sweat though (under any circs  by day or night), I just get overwhelmingly hot & visibly v flushed, heart often races with an intense fight or flight type adrenalin/cortisol response that feels horrendous  & wakes me right up.  Because of the lack of sweating I can't cool down easily, so the overheating episodes last a long time, often making it difficult to get back to sleep easily, if at all.  And yes, they happen every night.

[Jillyboo]

I'm in my late 60s now and have been on HRT for over a decade. All I can say is menopause robbed me of my body thermostat! I am frequently far too hot and especially in bed.  Progesterone definitely contributes to my overheating, therefore I have never taken it daily,opting to remain on a cycle.

Socialising with other women of a similar age you soon notice there are several of us in the same boat. None of us now tolerate hot weather and all complain of night-time overheating. I don't necessarily believe it's totally HRT related.

My main way of coping is to have a wide selection of bedding - duvets from 2 to 7 togs but nothing heavier! I've got very good at judging which one to use on which night just by the temperature in my room when I go to bed! Happily I don't share my bed with anyone - that would just be too much to bear.

[Wrensong]

Yes Jillyboo, busted thermostat in a nutshell 
Like you, I've amassed a vast range of bedding down to 1-tog duvets & have often tried to sleep under just a sheet.  I never get above 4-tog duvet even in mid winter.  I also sleep with the window open when that's possible & keep hot water bottles in the bottom of the fridge all day to take up with me at night when need be.  I also can't tolerate hot weather any more & long gone are the days when we holidayed in the Med.

Again like you I opted for cylical HRT long postmenopause to minmise progestogen exposure.

I don't personally know any other women - family or friends, on HRT or not, who have contiuned to have nightsweats every night year round.  They've been stubbornly resistant despite various doses of oestrogen over past 9 years & working my way through the entire range of progestogens, in latter years on a long cycle.  So still v much a work in progress.
Wx

[buffy26]

Hi Buffy, thanks for the clarification.  OK, so the increase in night sweats didn't coincide with starting Utrogestan.  That's good in a way, as I presume you'd want to continue on Utrogestan for the prog component of your regimen, it being considered better for us than the synthetics.


I'm also in my early 60s, on long term HRT & battling v persistent overheating at night with really troblesome insomnia & feel v unwell with the whole package.

If the night sweats started as you increased your oestradiol dose I wonder whether in fact higher levels could be too much for your body at this age?   Sweating as part of a stress response to too high a dose.  Being 3 decades hypothyroid has taught me that hormonal meds are very much goldilocks & for some of us they can be a devil to get right.

If you have an autoimmune condition (as I do) could underlying inflammation be a factor for you?  I agree that can make for a complex picture that's difficult to interpret.

Yes absolutely, bloods postmenopause to show how well we are absorbing can be helpful if symptoms are not well controlled & testing over past couple of years has shown I'm now getting frustratingly v erratic absorption compared with a few years ago.

I hope you manage to find out what's behind it so you can get it sorted soon.
Wx

oh gosh Wrensong you sound so like me with the long term sleep issues, to the point where I walked around in a stupor and couldnt handle driving, to racing heart and being so stiff and achey. I seem to tolerate progesterone fine which is a relief as we need that to protect us, yet the pill was a no no for me, I used to get ratty and huge hard boobs whilst taking it! My last blood test showed 320 for estrogen on 4 pumps, therefore I wonder if I am taking too much?  For the insomnia, nothing worked, I tried everything. I even was sent to have a cortisol and adrenal test to find out why. all fine. Melatonin was hit and miss and then I was offered a tiny 10ml dose of Amytriptiline, Bingo. I now sleep 7 hours, some of it broken as I wake up a lot shivering from the damp bedding but once I sort that out I can get back to sleep for a decent amount of time, with Deep and Rem sleep in equal measures. I tried to cut back to every other night and I didnt sleep properly so I know thats the magic pill for me.
I am just worried something is going on that is not related to hormones that is causing the sweats, with some strange blood results the other day I have been a bit worried. One was the inflammatory markers creeping up out of range. I have had on and off diagnosing with rheumatology, trying to piece together my symptoms so time will tell, I had no idea that could be a reason.

Sorry for the longgggg old tale of woes!

Im grateful for you sharing all this, and also sorry you are suffering still. We soldier on as always, but if you could get some decent sleep it would be great. I dont know if you have done all the usual sleep strategies, if you have you could always ask for a small supply of the Amytriptiline to see if that nails it!

[buffy26]

I'm in my late 60s now and have been on HRT for over a decade. All I can say is menopause robbed me of my body thermostat! I am frequently far too hot and especially in bed.  Progesterone definitely contributes to my overheating, therefore I have never taken it daily,opting to remain on a cycle.

Socialising with other women of a similar age you soon notice there are several of us in the same boat. None of us now tolerate hot weather and all complain of night-time overheating. I don't necessarily believe it's totally HRT related.

My main way of coping is to have a wide selection of bedding - duvets from 2 to 7 togs but nothing heavier! I've got very good at judging which one to use on which night just by the temperature in my room when I go to bed! Happily I don't share my bed with anyone - that would just be too much to bear.

What we have to endure Jillyboo I know! I like linen, I cant even bear a duvet inside the cover so I have a kind of double linen thing going on, its cooling and also doesnt feel so damp so quick. Then I wake up cold, needing to drag a separate duvet to feel comfortable again. Also sleep alone, I am a nightmare with all the tossing and turning, my hair is like a birds nest when I get up, its quite a piece of art

[Wrensong]

Buffy

My last blood test showed 320 for estrogen on 4 pumps, therefore I wonder if I am taking too much?

Impossible for me to say, but I just wondered as you said the night sweats coincided with your upping the dose of gel.  The serum level we feel good on is very individual & not everyone needs a lot to feel their best.  And it will change to some extent from test to test, but I've recently been getting differences of around 300 pmol/L from one test to the next & at times lower results on higher doses, suggesting much more erratic absorption than I was getting in the past, when I had somewhat better nights.

Often it's not being on enough oestrogen that's behind night sweats as you'll see frequently mentioned on the forum, but as like me you are in your 60s & don't feel good on quite a high dose of gel, perhaps a little less rather than more might just be what you need at this age.  My thinking was, being on too much for your individual needs could be causing something of a stress response that's not helpful for sleep.

Like you I've had referrals to Rheumatology in recent years & the jury's still out on that, but I also have v longstanding autoimmune thyroid disease.  If your inflammatory markers are a bit raised do you have a Rheumatology review coming up to discuss that?  It might only be temporary, so please don't worry about my querying inflammation as possible cause of the sweats.

Yes, I've been through the entire sleep tool kit over the years & we're pretty much at a loss as to know where to go now.  Melatonin doesn't help me either & actually made the overheating package worse.  I looked into possible interactions & found to my dismay it can mess with oestrogen levels.

Like you, I also had cortisol tested some years ago to no avail.

Good suggestion the Amitriptyline, thank you, but frustratingly it exacerbates other conditions I have.  That said, I've been thinking of asking for another trial as it's some years since I last tried it & you never know.  I need to wait to see how the latest change of HRT pans out first.

Please don't apologise for telling it like it is - we can't help each other on here if we don't have a reasonable amount of detail & this is a safe space for offloading where no one judges us & there's a lot of understanding support.  Your post wasn't at all long; you should see some of mine - almost guaranteed to put anyone to sleep!
Wx

P.S. few more quick thoughts - I'm sure you will have considered/tried these but just in case . . .

1) splitting your dose of gel a.m & p.m?
2) Having a look at diet to be sure you're eating in a way most conducive to blood sugar stability.  If it drops too low overnight that can be one cause of night sweats.
3) Although with continued use, gels, like other transdermal methods are supposed to form a reservoir in subcutaneous fat to promote consistent levels, I've repeatedly found I do worse on gels than on patches.  If Evorel didn't suit you, Estradot might, as I think Sheila suggested.  Bloods showed I used to get more consistent levels from Estradot some years ago than I have more recently on Evorel.