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[Berto77]

I am 47 and have been on HRT for 4 years. I am on Evoral 75 and Utrogestan 100 x 2 12 nights a month. In the past few weeks I have developed very bad acute insomnia, I think it is a vicious cycle of not sleeping, high cortisol leading to more poor sleep and so it goes. Prior to this I have typically been a good sleeper. I absolutely cannot function on the 3 or 4 hours sleep a night I have been getting its massively affecting my work, mood and relationship. I have tried adding an extra bit of estrogen to no avail and the Nytol the diphenhydramine containing one only worked for one night. I can fall asleep ok but when I wake at 3 or 4 thats it I'm awake. I do practice good sleep habits, the bed room is cool and dark, I wear blue blocking glasses, I don't drink caffeine only decaff tea, I exercise, I don't drink alcohol ever, veggie wholefood diet, I have been trying breathing exercises and meditations but they only seem to wind me up even more, I can feel my heart rate go up when I do box breathing and get this tension in my solar plexus area.

I have bought some expensive sleep reset tablets from H&B today and will try them tonight and I am getting some myo inositol delivered tomorrow.

Anyone else have any tips? I am not convinced it is lack of estrogen but perhaps more due to raised cortisol which may in itself be due to peri. Please help me before I lose my mind!

[CLKD]

Cortisol is I believe the waking hormone as well as keeping us alert when necessary.  Then we get into the cycle of 'will I sleep/not tonight' ...... I had this for several years until I accepted that I survived. This was however different to the intense tiredness that arrived with peri due to busy, involved dreams leaving me knackered each morning.  No pleasing me!

Do U have a go2bed routine to relax, i.e. turning off gadgets etc.?  I often fall asleep in the bath 

[joziel]

I have sadly intense experience with insomnia. (Last night was awake till 4am, then managed to sleep till 9.40am.) I have every possible sleep issue in rotation, it seems.

For me, it helped loads to get my estrogen up to around 800pmol. This is quite high and as I don't absorb very well it took a high dose. I'm on 300mcg Estradot and 6 pumps of gel at night.

Increasing it 'just a little bit' would have done nothing for me. I'd suggest beginning with a blood test to see what your current levels are and whether you have room to increase at all. Your dr should easily support an increase to 100. But you might need a lot more than that and that would need you to go private.

The other thing you can try is having some peanut butter (or any fat) with your utrogestan. This helps you to absorb it even better and creates more GABA and sedative effects in the brain.

Lastly, the only supplement I've found which really does help lower cortisol effectively, is Seriphos.

I've been through months of 2-3 hours of sleep and it is life changing (in a bad way). I get inner tremors at night, my heart beats fast and harder than usual, I get hypnic jerks which startle me awake and I can either spend hours lying awake just not feeling tired (whilst my brain literally hurts because it wants to sleep) or I wake up like you at 4am and can't go back to sleep. I also have frequent wakings at night and not much deep sleep (Apple Watch).

[DottyD68]

Have you tried :-
-Magnesium supplements? Capsules and/or Oil?
- Sleepy tea? There are a number of different combinations which usually include Camomile.
-Acupuncture?

[SundayGirl]

I've always gone through phases of not sleeping well for as long as I can remember and over the years I've learned that worrying about it makes things worse.
Now I don't get stressed about it and go with the flow. When your body needs sleep, you'll sleep. 

[sheila99]

My insomnia was due to oestrogen deficiency so that would be where I would start. Do you find any difference when you're on utro? For most people it's a sedative and it helps sleep but there are some people (like me) for whom it has the opposite effect.

[StrictlyFan]

Joziel - I could have written your post word for word. The insomnia for me has been terrible from the start and I'm 6 years post menopause.

I have a blood test booked for tomorow, as I manged to get an appointment with a GP who would allow this. Although it wasn't easy, I'm hoping to see just where my Estrogen levels are. I'm currently on 3 pumps of Oestrogel and 1 Untro at night. I have not tried the peanut butter trick. I will definitely give that a go tonight.

In terms of supplements, I think I have most of my local Holland & Barrett stock in my bathroom cabinet 

[flo69]

Depending on where you live, you could try some cannabis edibles?

I couldn't sleep throughout my 40s, then started vaping cannabis at night, something I'd not had in decades, it works an absolute treat.

[joziel]

Strictly, whatever your E results are, you can try increasing. It should be easy to do 4 pumps of gel, that's still within the max licensed dose. But you should also consider going private to trial higher.

Because it's not just about results being 'okay' according to your NHS GP. My understanding is that these are neurological symptoms of the menopause and they can take quite high E doses to fix, we think because the brain doesn't uptake E very efficiently. So you can have decent doses in your serum but be deficient in the brain... Dr Lisa Mosconi is doing some great research into estrogen and the brain, but we're not quite there yet in understanding all this.

[Berto77]

Thanks everyone, I am taking magnesium for a month prior to insomnia setting in and I am trying sleepy tea, and bought some supplements with ashwagnada which seem to be helping as sleep has increased now.

I would have to go private to get more estrogen I think as I am in the UK. My GP is very anti-hrt and was very against me going from 50 Evorel Patches to 75 Evoral Patches, telling me that I would have to start thinking of coming off it, that i can't stay on it forever, that I'm only making it worse for myself and so on. My GP is a woman a couple of years older than me and for some reason is very opposed to HRT.

I think even if you go private for an increased dose most GP's here are now refusing shared care for everything and private health care is an expense I can't afford.

I do have some cbd oil but I am not sure how much difference it makes really.

I usually use utro vaginally and I am back on it now for the next week or so and it does help somewhat.

I am throwing everything at this blue blockers and so on and it is currently a bit better. I think I need one of those special pillows as I think hip pain at night is causing me to not fall back asleep, that was the case last night anyway.

Thank you everyone for the advise I will try it all!

[joziel]

Berto, you really can't accept that standard of care - because you pay your taxes (presumably!) and are entitled to adequate health care. And what you've just said there is outdated and inadequate.

1. You do not need to go private to increase your estrogen over 75. You can easily go up to 100 with your GP. If your particular GP won't do this, change GP practice. find a new GP. You are going to need someone who will be a partner with you through all this as you get older, not someone with outdated information.

2. You do not need to 'start thinking of coming off it'. You can stay on it until you die, even if you live to 100. (Which you will be more likely to do, on HRT, but let's not go there.) So you can in fact stay on it forever.

Your GP is just going to be an obstacle to you receiving adequate care with all this, and you are entitled to better. Change GP.

[Berto77]

Thank you Joziel, I appreciate that. The nurses at the practice are great and my practice also once acted quickly to get me treatment that probably saved my life so they are good in general but the GP is poor on HRT. I will look into other local practices.

[valm]

Hey,
Totally feel you… I’m 50 and going through the same thing. I’m doing all the “right” stuff too — no caffeine, cool dark room, exercise, no alcohol — and still waking up at 3 or 4am like clockwork. So frustrating.

I’m starting to think it’s not just about estrogen either — maybe cortisol is the real issue. I’ve seen some women mention adaptogenic mushrooms like reishi or lion’s mane. Supposedly they help with stress and nervous system balance. Haven’t tried them yet but I’m curious.

Anyway, just wanted to say you’re not alone. 💛

[joziel]

Cortisol happens in response to low estrogen. The hypothalamus detects that estrogen is low so adrenal hormones and cortisol are increased to try to compensate, because the body can't run on nothing....

If you have adequate estrogen (and progesterone) the same response isn't triggered. The problem is that most providers starve women of enough estrogen and keep them on tiny doses because of misplaced fear. There is more estrogen in the combined contraceptive pill than there is in all licensed doses of HRT. Yet providers will unblinkingly prescribe combined pills (with synthetic hormones) and then act as if a decent dose of HRT is harmful.

It is total chop logic.

[valm]

Hey, 
Totally feel you… I’m 50 and going through the same thing. I’m doing all the “right” stuff too — no caffeine, cool dark room, exercise, no alcohol — and still waking up at 3 or 4am like clockwork. So frustrating.

I’m starting to think it’s not just about estrogen either — maybe cortisol is the real issue. I’ve seen some women mention adaptogenic mushrooms like reishi or lion’s mane. Supposedly they help with stress and nervous system balance. Haven’t tried them yet but I’m curious.

I found this page on menopause and insomnia super helpful — it gives a few practical angles I hadn’t considered.

Anyway, just wanted to say you’re not alone. 💛


Anyway, just wanted to say you’re not alone. 💛