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[CS24]

Hi all,

I have been taking HRT on a low dose for a year to help with minor sleep issues and anxiety. I was on 2 pumps of gel and progesterone. My doctor realised that I was a poor absorber and increased my oestrogen to a 100 patch.  My oestrogen levels still would not increase beyond 150. I didn’t have any major symptoms.

Eventually he recommended I go to a private clinic that was more specialised who put me on a massive dose of oestrogen - 100 esdradot patch and 6 pumps of gel, 100 progesterone. And 2 little balls of testosterone. At first it helped and I felt really good but after a few weeks I felt awful. My sleep deteriorated very quickly. I kept getting weird dreams,  woke several times though out the night and felt like I wasn’t really sleeping.

I had my bloods done and my oestrogen levels had jumped from 170
to 788. I consequently reduced my oestrogen as I thought my sleep issue might be oestrogen dominance.

I went down to a 50 patch and 2 pumps of oestrogen but they increased my progesterone to 200mg. Now my sleep is worse and I only get 2/3 hours sleep.
I wake feeling very shakey.

I am so at a loss as to why my sleep is so bad. My doctor thinks it’s oestrogen dominance and the fact I have changed my HRT dose so many times. I think my body dislikes the progesterone.

I had hoped to see an improvement since reducing everything but I haven’t yet.

Has anyone experienced similar problems? Also How long does it take for your hormone and symptoms to balance back out after reducing oestrogen due to oestrogen dominance, or changes to dosages or reducing progesterone? I am
Just so fed up with not sleeping.

Thanks

[Dramy3]

Do you use the testosterone at night? I found that perked me up and made sleep worse. Switched to the morning and it helped a lot.

I also use promethazine every once in a while to help get my sleep back on track.

Good luck!

[bombsh3ll]

That's a massive sudden drop in estrogen from 100mcg patch and 6 pumps to 50mcg and 2 pumps.

I would have kept the 100mcg patch and maybe gone down to 3 pumps and re-tested in a couple of months.

I agree taking the testosterone in the morning is more physiological.

Changing one thing at a time and then giving it a  few weeks to settle and reassess is best, unless you find something absolutely intolerable.

There are also multiple other options for endometrial protection if you don't feel micronised progesterone suits you.

I've struggled with insomnia at every stage of life and for me I don't believe this is related to my ovarian hormones, so whilst I couldn't possibly know what is causing yours I just wanted to add that once you are optimised hormonally, if you still have insomnia there are other treatments that are effective - I take low dose mirtazapine off label for sleep.

[CS24]

Thanks. Yes I take the testosterone in the morning. What I don’t understand is I was fine for 2/3 months and it’s the last 2 months that have changed.

I have never had issues with sleep and hence why I think it is making me feel worse and I am struggling.

I am not sure if the issue is:
1. Too much oestrogen as I was feeling great when my levels were around 200/250 but awful as it increase to 778. Does it take weeks/months to rebalance?
2. The constant changing of my dose. My doctor thinks I have changed it so much that I just need to stick with something and let my body adjust?
3. Challenge with progesterone and the increased dose.

Can it really take weeks and months for your body to adjust?

[Dramy3]

So sorry you’re struggling with sleep—that made everything so much worse for me when trying to get the HRT regimen right. Sleep is a basic foundation for health so I’d go to your GP to ask for a short course of something to help you sleep while your hormones adjust (there are multiple options). It will give your body a break and let it calm down a bit. Try not to alter your HRT doses until at least 6 weeks (12 is better). And like it says above, only alter 1 thing at a time. I made that mistake and it took ages to figure out what the problem was.

Hang in there, it gets better 🩵

[sheila99]

Insomnia is often oestrogen deficiency but progesterone can be the culprit too. I'd be tempted to try a couple of months of sequi (or just come off it, probably safe for 3-4 weeks) and see if you're any different. Might be worth a blood test too to see where your oestrogen levels are now.

[CLKD]

 

[CS24]

Thanks Dramy3. I agree that maybe letting things settle is right. I am just so exhausted and it just feels miserable when you have 2 young kids and a job that you love and don’t want to lose.

Does it really take 6-12 weeks for everything to settle? I have gone back to the dose I was on before it all started to go bad.

[Gingat]

How are you now?  Have things settled down a little? x

[blu22]

I've struggled with insomnia at every stage of life and for me I don't believe this is related to my ovarian hormones, so whilst I couldn't possibly know what is causing yours I just wanted to add that once you are optimised hormonally, if you still have insomnia there are other treatments that are effective - I take low dose mirtazapine off label for sleep.

Hi, I've been prescribed low dose mirtazapine by a doc. Brief history: I'm almost 47 (uterus intact), started low dose HRT last year (Femoston 1/10) but then after six months my sleep got disrupted again (6 hours of sleep and then I was fully awake, couldn't go back to sleep and couldn't nap) so they upped the dosage to 2 mg E (Femoston 2/10). Then (after about 4 months of using Femoston 2/10) for the past few weeks my sleep quality has been worse again. This time I could sleep long and nap, but the sleep quality was always bad (kinda like my brain kept on being on overdrive). The doc (different doc) thought it wasn't perimeno this time, so I've started low dose mirtazapine (1/4 of a 15 mg tablet) since Wed. I've been sleeping about 11-12 hours each night, but the sleep quality is still bad. Dunno if it's because I've been sleeping so badly for 3 weeks prior to this or what? I'm also sluggish and the brain fog is at times kinda bad, but I was thinking maybe it's because my body's still adjusting to the Mirtazapine as well? How long does it take for you to feel the full benefit of Mirtazapine? I googled Mirtazapine and it seems one shouldn't stop using it cold turkey. I wonder if you've been on Mirtazapine regularly or is it OK to take it at random times?

FYI, I have another doc's appointment 'coz the doc sent me off to the lab for some blood tests. We shall see how it goes.