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[StrictlyFan]

Hello Ladies

During my wonderful journey in to Menopause (note the sarcasm  ) I have been plagued by 2 major symptoms: Insomnia and crushing fatigue that comes out of nowhere and leaves me housebound for at least a couple of days. I have been on Oetrogel (2 pumps) and Utrogestran 1 tablet at night for at least 2 years and it has intermittently helped with the insomnia, it hasn't really helped with the fatigue.

Over the past years, I have had the usual NHS blood tests and they all come back normal. I have a good diet (mainly plant based and I take a Vitamin D K2 spray).

I'm currently trialing 3 pumps of Oetrogel (two in the morning and one in the afternoon). This seems to have really helped with the insomnia. I  now wake up at 5 am and can usually get back to sleep. As opposed to waking up at 2 am then 3 am then 4 am with a little light sleep until 7 am. However, the fatigue has not really gone away. This is having a big impact on my life as I would love to go back to work and have a normal existence. This has also had a big impact on my confidence, as I would love to book a holiday with my husband, but daren't do that in case I feel very ill and it becomes a complete waste of money.

I have a GP appointment booked next week. She apparently has menopause training, according to the lady at reception.

Do I ask to change my hrt regiime? With all the upheaval of new side effects.
Do I ask for testosterone? Does this help with energy and sleep?

Sorry for the rant! It can feel a very lonely place when you are trying to figure out why I'm plagued by these 2 symptoms.

Thank you for listening.

[CLKD]

I remember my Mum switching off the stove at tea-time, sitting down suddenly and falling asleep for hours. 

If the new regime is working then stick with it. 

Symptoms can also be caused by low VitD levels and thyroid function issues.  Let us know how you get on!

[SundayGirl]

Eating a plant based diet can leave you with vitamin deficiencies, especially the B vitamins, and low iron.

Before altering an HRT regime that you are comfortable with, ask your GP for bloods to check vitamin levels. Also an iron panel and ferritin to check for anaemia.

[StrictlyFan]

Thank you CLKD and SundayGirl for your responses!

When I say I'm plant based, I should have stated that I'm mainly plant based, but I do have meat and fish occasionally.
I had my bloods tested last November and my B12 was 646: Serum Iron levels 146 ug/L: TSH level 3.30 According to my GP, they are all in the healthy range.

I have been plagued with crushing fatigue since my menopause journey began. I have had countless blood tests and they all come back normal, which is really fustrating . I must be the only person hoping a blood test would come back abnormal, just so that I could at least treat it with some sort of medication and move on with my life

[Dotty]

Hi I suffered with total exhaustion. I literally couldn’t do anything. This changed once I was on the right dosage of HRT. I had to be on 4 pumps of Oestrogel before I saw any improvement.

[SundayGirl]

I know lots of people are going to say - she's at it again  - but please keep an eye on your thyroid function. A TSH of 3.3 is towards the upper end of the usual NHS range and some people will be experiencing some hypo symptoms with that sort of level. (Tiredness, insomnia and fatigue etc)

As Dotty says, it may also be worth trying a little more oestrogel rather than switching to something different.

[CLKD]

I would up the oestrogel ........... also keeping a. mood/food/symptom diary may be useful.

U go [Sunday] Girl - many aren't aware of the very poor care that those with potential thyroid disfunction get !

[sheila99]

My insomnia which followed the same pattern as yours (get to sleep OK, then wake up in the small hours and can't get to sleep again) was due to insufficient oestrogen. As it's improved on 3 pumps it seems likely that yours is too. I would try 2 or 3 cycles of sequi instead of taking utro every night (200mg days 15-26) and see if you're any different on oestrogen only. For most people utro helps with sleep but for me it gives me very interrupted sleep and left me feeling like a zombie all day.

[StrictlyFan]

Thank you ladies for taking the time to reply. It is much appreciated.

Dotty - I'm probably looking at upping my Oestrogel to 4 pumps if 3 does nothing to improve my symptoms. I think it would be wise to do this after my GP appointment this week. I have seen your previous posts and I feel we seem to have very similar symptoms, but I just can't quite get to grips with mine.

CLKD - Yep, I'm definitely going to keep a close eye on my food/mood etc

Jules - I believe my symptoms really kicked in after my periods stopped. I was 47 at the time and I'm 54 now. It started with terrible nausea internal shakes, insomnia and of course fatigue. I don't feel this all kicked off after a virus, but I take your point it could be CFS/ME, although I'm not sure where the virus comes into it.

Shella99 - I will ask my GP about going sequi, although given that I have been post menopausal for so long, I worry about changing my progesterone intake during the month and having endomentrium build-up. I might ask if there is a different progesterone I could swap it with.

I'm really hoping this new GP may help me get to the bottom of these symptoms, as I have the added "blessing" that I have Osteoporosis in my spine and I really need to keep up with my weight baring exercises. Sometimes the fatigue really stops me from even going for a walk and other times really quite low and I can get on with things.

[Dotty]

I’d go for 4 pumps before changing anything else.

[sheila99]

I wasn't suggesting you use sequi permanently, just to trial it to find out if utro is the problem, if it is you can try alternative progestogens. You can use sequi in meno if you choose to though the nhs don't like it much. They told me there's a slightly higher risk of endometrial cancer but they agreed to it because of my intolerance of utrogeston. I'm another who thinks 4 pumps would be the best starting point.

[StrictlyFan]

Thanks Dotty - I think 4 pumps might be the way forward. I will probably look at doing that after I have given the 3 pumps a while to bed in. I do believe the lack of energy is my body craving the extra oestrogel.

Sheila99 - I think you maybe onto something here. The progesterone is probably (not sure without proof) one that is giving me a problem with the waking in the night. Although, knowing myself I'm a bit of a scatterbrain, not sure if I would be organised enough take  (200mg days 15-26). I just know I would forget and end up getting in a real mess. I might try taking the progesterone earlier in the day so that it's probably out of my system (albeit not completely) by the time I go to bed. Then, if for some miracle I get a full night's sleep, I know it's the progesterone that is waking me up.

[CLKD]

Scatterbrain or not: 1 can find ways to take medication on a regular basis.  Whilst it is a person decision, all medication should be used as prescribed otherwise the body won't know if it's flying a bike or riding a kite ;-). Keeping a mood/food/symptom diary can help to discuss with the GP/Nurse Practitioner, then deciding whether hikes need to be made to suit individual symptoms.

[sheila99]

I tried taking it earlier (10am) and although it made sleep a little bit better it was nowhere near as good as no utro at all. It made no difference at all to feeling wiped out all day. Completely up to you of course but imo it isn't enough to prove if utro either is or isn't the problem. I would suggest you don't do it at the same time as increasing oestrogen though, you need to which change causes which effect.

[StrictlyFan]

Just wanted to give an update on yesterday's GP appointment.

When I explained my symptoms to her (crushing fatigue/exhaustion & terrible insomnia) and told her I had upped my Oestrogel to 3 pumps and nightly tablet of progesterone. She said that she was very hesitant to increase my dosage to 4 pumps as that would expose me to higher risk of endometrium cancer. For the record I have never had any form of cancer. She has instead referred me to my local menopause clinic (at Addenbrooke's hospital, goodness knows how long the waiting list is for an appointment.) and given me 14 days  worth of sleeping pills. On the positive side (if there even is one....) she has organised blood tests to verify my hormone levels including Testosterone, as well as a full panel of the thyroid. There is also I whole other raft of blood markers (bone profile/H1bac/Ferritin etc) I have had these before and they have all come back normal.

Ladies, I have no idea where to go with this??? I will be very interested to see the levels of my various hormones, as well as how my Thyroid is behaving. Until then I can just continue with the current HRT routine and keep putting in life style measures as in good diet and stress management, with a bit of gentle exercise.

Any thoughts would be greatly appreciated.