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[AngelaH]

If you can't sleep on the progesterone phase, you might be having a paradoxical reaction to progesterone.

I never had a paradoxical reaction on progesterone in my life. Do you really believe it can appear suddenly at the age of 53? 

[rferdi]

It’s all about balance and not about certain hormone. In peri my body was losing progesterone faster than estrogen and that caused imbalance between 2 hormones. Adding progesterone put my hormones back to normal balance. In that case progesterone stopped all my peri symptoms including insomnia.

Hi AngelaH, So you didn't need to take any estradiol during peri, and progesterone alone took care of all your symptoms, that's something I heard some menopause doctors say (all in favour of HRT). I was very curious to see if that would be helpful for me, so I tried taking Utrogestan alone 100mg for a month, back in June, but I didn't notice any help other than the improvement in insomnia.

Maybe I should've tried it for longer, but then I found this gynaecologist who convinced me to add the estradiol and do cyclical. I tried it and it did help quite a bit the first 3 wks or so but now I'm not sure as some days are better than others (for example today's not a good day).

I agree it's about balance, I can't wait to find mine. I think perimenopause is a lot more difficult to treat and get the proper balance because of the wild hormonal fluctuations, especially of estradiol. I guess menopause should be easier, since you don't make E or P anymore. Testosterone in my case I'm very much looking forward to it going much lower, as I've had too much of it my whole life because of PCOS, and have been on medication for years to decrease levels of it.

[joziel]

You said that 'too much P can cause insomnia'. I don't know if there's any evidence of that.... beyond your personal experience. It's not something I've heard of anywhere else. Too much P tends to have the opposite effect and leave women feeling very sedated.

I also tried P alone, rferdi, and it did nothing for my night time symptoms.

The increase in estrogen is doing great for me at the moment. Last night I slept till 7.30am and had good relaxed deep sleep and dreams, like I haven't had for the last 3.5 years. It's such a relief. I'm on 125mcg patch and 10 pumps of gel and will be increasing the patch to 150mcg this Friday.

[AngelaH]

You said that 'too much P can cause insomnia'. I don't know if there's any evidence of that.... beyond your personal experience. It's not something I've heard of anywhere else. Too much P tends to have the opposite effect and leave women feeling very sedated.

I also tried P alone, rferdi, and it did nothing for my night time symptoms.

The increase in estrogen is doing great for me at the moment. Last night I slept till 7.30am and had good relaxed deep sleep and dreams, like I haven't had for the last 3.5 years. It's such a relief. I'm on 125mcg patch and 10 pumps of gel and will be increasing the patch to 150mcg this Friday.

You said It's not something I've heard of anywhere else. Too much P tends to have the opposite effect and leave women feeling very sedated. But the same time you have to lift up your estrogen level to make yourself sleep!!! Sex hormones work together, it’s a right balance between them which makes us feel great or feel ill. It’s not about numbers on the blood tests, probably your progesterone level is not high in numbers, but it may be high for that amount of estrogen that you have in the body. So by lifting your estrogen up you bring your balance close to right and you can sleep. Another thing I can think about, the body can use progesterone to make cortisol. If we experience stress during day, the body will make cortisol at night and by the very early hours in the morning it will keep the body awake. When it comes to sex hormones everything becomes too complicated and that is much more than “estrogen is happy hormone” and “progesterone is sleepy one”, and some people even call progesterone as a devil hormone.

[AngelaH]

Hi AngelaH, So you didn't need to take any estradiol during peri, and progesterone alone took care of all your symptoms, that's something I heard some menopause doctors say (all in favour of HRT). I was very curious to see if that would be helpful for me, so I tried taking Utrogestan alone 100mg for a month, back in June, but I didn't notice any help other than the improvement in insomnia.

I agree it's about balance, I can't wait to find mine. I think perimenopause is a lot more difficult to treat and get the proper balance because of the wild hormonal fluctuations, especially of estradiol. I guess menopause should be easier, since you don't make E or P anymore. Testosterone in my case I'm very much looking forward to it going much lower, as I've had too much of it my whole life because of PCOS, and have been on medication for years to decrease levels of it.

I believe I have quite long history of low progesterone in my body. Symptoms like hot flashes and itchy skin, as well as a weak bladder I started experiencing in my 30s. But GPs never suggested hormonal imbalance was responsible for that, and never suggested to check progesterone. In peri things went even more worse, more and more symptoms appeared, they made my life hell, but not for long, because I started heavy bleeding I was fitted with Mirena coil (no estrogen added) and this is how I realised that low progesterone caused all my symptoms through my 30s and 40s. Mirena stopped all symptoms just overnight and I had my happy life back for next 2 years until I reached menopause. Unfortunately meno and post meno symptoms appeared and now is not so easy for me to find that “magic” treatment. When my hormones reached the floor level I started feeling really ill. Transdermal HRT made my symptoms worse for more than a year. Now I am on Tibolone and this first time since I started HRT when I am starting feeling better.

But we all are different, probably meno and post meno will help you feel better after so many years struggling with hormonal imbalances in your body.

I don’t think personally Utrogestan is suitable for progesterone treatment, the doses are too much for that. You will have to adjust estrogen levels for it. It is designed to do heavy job for uterus. For therapeutic effects the body needs much lower doses, from my point of view and from my experience.

[joziel]

" It’s not about numbers on the blood tests, probably your progesterone level is not high in numbers, but it may be high for that amount of estrogen that you have in the body. So by lifting your estrogen up you bring your balance close to right and you can sleep. Another thing I can think about, the body can use progesterone to make cortisol. If we experience stress during day, the body will make cortisol at night and by the very early hours in the morning it will keep the body awake."

I think you missed the part where I said I've tried zero progesterone, 100, 200, 300 and 400mgs and had exactly the same symptoms and no change in them.

It is not about progesterone at all for me. It is about estrogen and getting estrogen high enough.

Forget about any ratio or whatever, it is debatable whether there is such a thing needed (beyond protecting the uterus).

[AngelaH]

I think you missed the part where I said I've tried zero progesterone, 100, 200, 300 and 400mgs and had exactly the same symptoms and no change in them.

Forget about any ratio or whatever, it is debatable whether there is such a thing needed (beyond protecting the uterus).

You mentioned somewhere you didn’t have problems with sleep before you started HRT.

I can’t forget about ratio or whatever because putting the hormones in right  ratio in peri made me  completely symptoms free, I was back to  my normal life. Any medical professional will tell you that meno symptoms are all about wrong balance. This is why not everyone has them at first place.

Anyway, joziel, I wish you the best and good luck with your treatment. 

[joziel]

I didn't have problems with sleep before. But the hormonal (estrogen) fluctuations which started when I stopped desogestrel and began HRT caused this.

[AngelaH]

You mixed up hormonal balance in your body by doing that. I wish I knew that “magic formula”, which suits everyone, but even NHS and scientists can’t help us. 

[joziel]

There is no magic formula, only trial and error for each of us at the moment.

We don't even understand why things work the way they do. We should be clear on the level of uncertainty.

There is nothing to suggest that it was about 'hormonal balance', rather than fluctuating estrogen - able to fluctuate because I stopped the desogestrel.

[rferdi]

I also tried P alone, rferdi, and it did nothing for my night time symptoms.

The increase in estrogen is doing great for me at the moment. Last night I slept till 7.30am and had good relaxed deep sleep and dreams, like I haven't had for the last 3.5 years. It's such a relief. I'm on 125mcg patch and 10 pumps of gel and will be increasing the patch to 150mcg this Friday.

Glad you're getting so well with the increase. I wonder if you wait 2-3 months before you make any changes to your dose, and do you not get any symptoms each time you do change something?

[rferdi]

Angela H yes we're all so different and can react so differently even with the same treatment. I do hope meno & post meno is an easier time for me. I'm glad that you've started feeling better with Tibolone.

I don’t think personally Utrogestan is suitable for progesterone treatment, the doses are too much for that. You will have to adjust estrogen levels for it. It is designed to do heavy job for uterus. For therapeutic effects the body needs much lower doses, from my point of view and from my experience.

I'm interested to know what progesterone product did you use during your peri years that helped you so much, and at what dosage, if you don't mind sharing.

[joziel]

I no longer wait 2-3 months, no. Experience with all this has shown me that I notice the effects of an increase within 2 weeks. I also know that I don't absorb well and I have a ways to go, to get my estrogen into the ballpark we want it to be at.

It's now reached the point, after doing this slowly for years, that I am 3 years into this and still haven't got it where it needs to be - so by this point I would rather overshoot and come back down to find the point where symptoms return, than spend so long dialling it up and suffering in the meantime. But as I get higher I will wait longer between increases because I'm likely to be approaching where I need to be.

Even my Newson meno doctor has told me I can increase every 4 weeks.

Things didn't stay as great as they began a couple of weeks ago. There has been a definite improvement generally - but still not even one single normal night of sleep. Interestingly, I'm getting more night sweats - I think because I now am sleeping deeper, that I'm not aware I'm getting hot until I get sweaty. Before, my sleep was so crap and light I would wake up and throw the covers off when I got hot. I also am quite chilled when I first get into bed, with cold feet and just feeling cold. I have a hot water bottle on my feet(!). Then I'll wake up in the night, sweating.

I increased my dose again today to 150mcg patch. Still on 10 pumps of gel (well, 6 pumps of gel and 2 sachets of Sandrena). I don't think the Sandrena does anything and I couldn't absorb above 6 pumps going by bloods - so I'm probably on 6 pumps of gel. I will stay on this dose a full month.

[Seasidegirl]

@joziel

I also don't wait 3 to 6 months to assess changed - I think it's one of those NHS fallacies designed to reduce patient demand!   

I do seem to absorb well (fingers crossed that continues)and can feel the benefit or not of any change fairly swiftly.   

I am carefully making progesterone changes on a monthly basis.  Under suggestion from you lovely ladies I have increased my Oestrogen to see if that makes my progesterone days any better.   I started P last night so it's too early to assess,  previously I've struggled 5- 7 days in).

[rferdi]

After 3 years I can see why you do what you do joziel. I hope the new increase with the patch goes well. I'm an HRT newcomer but I can see it's a bit of a rollercoaster ride at least for now. My intention is to wait the two months to assess, I need to know more and to have more experience with how my body absorbs and reacts. Although bad days like today make me doubt sometimes I'll get to the two months before I try an increase in estradiol.