started on HRT - need support

[Thomasina2505]

Hi Everyone
I'm new here and I'm glad I found this site. I have been having serious insomnia which started rather suddenly- have only been able to sleep with pills which I've had enough of as they give me awful side effects. Have been given HRT Ellest 1mg as blood tests showed i'm menopausal (I'm nearly 50) and am wondering if other women who have had perimenopausal sleep problems found that they improved substantially with the HRT. I'd be grateful for any support as I'm at the end of my tether!
Also, have you been able to tolerate HRT fairly well?
Many thanks.

[PollyPerky]

Hopefully, you should find it works! It was the 2nd main reason I started using it- the first was hot flushes. I found a difference in about a week. You might want to - medium term- think about changing from pills to patches or gel. These are known as transdermal and are safer, fewer side effects and are recommended by NICE recently as being safer.
GPs sometimes don't offer them as first choice partly because they are slightly more 'complicated' to prescribe due to varying doses being available and some GPs are not quite up to speed on HRT. There is nothing to stop you learning about the different types and asking though!
Sorry if this is more info than you need at this stage! Yes, I've tolerated it very well and used it for 7 years. I am intending to stay on it until I am very old, all being well.

[Thomasina2505]

Thank you so much for the reply, PollyPerky. No information is too much at this stage. Have only started the process of finding out about it as it all sprung on me quite suddenly although the signs were there for a while.
I am feeling a bit anxious with the tablets and have stomach cramps. So, yes, perhaps the patches will be a better option. It's hard that everything takes so long when you need a quick solution but i guess this isn't one of those occasions.
Really glad it's working for you. Thank you again.

[TheyreMadITellYouMaaaad]

HRT has made an unimaginable difference to my and my family's well-being! I didn't even realise that my poor sleep was menopausal, and the improvement on HRT was a delightful surprise.

I use patches. I've tried gel, but it wasn't the right thing for me. GP preferred me to use a transdermal HRT, as she said the dose would be lower and the side-effects less.

It can take a few weeks to show improvement. IIRC I noticed a difference after about a month, and continued improvement for about 3m.

[KilburnOriginal]

Hi, I've been Peri since ds was born in 2009 , I was 40. I'd managed with menoserene for about 3 years, but my last period was in August and I've noticed a steady increase in symptoms since. It got to the point where I'd have cheerfully murdered some one a few weeks ago. I decided I needed more help and saw my GP. We both agreed to try me in hrt, I've been on Evorel Sequi patches for just over a week. The night sweats and hot flushes diminished almost immediately, meaning my sleep is improving. Im not as 'angry' but that needs to improve more hopefully with time. I've also noticed an improvement in my hair and skin, not as dry. Fingers crossed HRT will work for us! Might be worth considering patches as they don't affect your stomach.

[Thomasina2505]

Thank you very much for all your replies. It really helps to know about other women's experiences. I started throwing up violently (not a pretty picture, I know) after taking my 2nd and 3rd tablet of Elleste duo so I definitely need to go back to my GP and ask for patches. I'm still having periods though more erratically. Apart from crazy insomnia (no sleep what-so-ever I don't have many other symptoms, or they are so mild i hardly notice them. I pray that the right combination of treatment comes my way as I am off sick due due to the sleep problems and feel like an emotional wreck. Anyone else experienced this extreme lack of sleep? I am not able to fall asleep because I get adrenaline rushes as I am about to drop off. No hot flushes to blame either...
Very grateful for your comments.
x

[PollyPerky]

You might have found without HRT that your symptoms become worse and flushes are part of that. Not all symptoms start at the same time.
My main symptoms were insomnia- unable to drop off and I used to go to sleep in under a minute! I don't know what an adrenaline surge feels like - have heard the term used on forums, not sure if that's what people use when they mean 'wide awake', but my sleep pattern did change hugely.

I did have hourly flushes though too.

[Thomasina2505]

I call adrenaline rushes or surges when you get a sort of flutter in your stomach as when you get a sudden fright and you get a pounding heart that lasts ages and may not even settle. After a few rounds of this, trying to fall asleep, you get to be wide awake even if to start with you were sleepy. From what you say, Polly it sounds as if other women have mentioned it in other forums? I'm glad it's not just me...

Any good sites to research HRT patches, creams, etc? I'd be interested to read about the NICE recommendations.
With thanks
R.x

[dementedma]

I am 52 and started in HRT (Prempack) last year. Hot flushes stopped almost immediately and sleep improved. I was suffering terribly from UTIs though and someone on here recommended I also take oestrogen vaginally twice a week and this has made a difference to the UTIs and the "shrivelling" of below stairs.
Only downside is I have gained some weight around my middle but I also have a pretty unhealthy lifestyle and don't exercise, so could probably offset this is I really tried!

[PollyPerky]

There is a list of all HRT on the website Menopause Matters but it doesn't list the pros and cons; it's just a list of what is available.

You will also find links to NICE on the MM Home page, but tbh it's easily findable if you put the words into a search engine.

There are links to it on this forum so again, do a search on this site and it ought to come up.

[Thomasina2505]

Thanks Polly; found it. I'm really mad at my GP who put me on tablets knowing that I'm sensitive to medication and have a dodgy digestive system. Why oh why didn't she give me patches - and she should be aware of the NICE guidelines favouring patches anyway. Thanks for the tip. I can see I have much to learn. Read everything on menopause matters. Really good to start but I would like more info on the different forms of each hormone.

Has anyone tried a combination of estrogen patches and the more natural progesterone (Dydragesterone or micronised progesterone) as a gel? Or even if there's a combination of both of these? The progesterone above is supposedly better as least testosterone related.

Thanks again for all info and support.

[Follyfoot]

I'm on patches too, much prefer them to tablets. My GP told me there is research ongoing which may show that patches have fewer of the more serious side effects that HRT tablets carry. Sleeping lots better, hope its the same for you.

[PollyPerky]

My GP told me there is research ongoing which may show that patches have fewer of the more serious side effects that HRT tablets carry

The research has been done years ago. Typical GP!
This is why NICE suggests transdermal- lower risk of stroke and blood clots.
It's been known about for years- at least 7, when my consultant prescribed transdermal for me.

[PollyPerky]

Thomasina
Lots of us use gel and Utrogestan. There are lots of comments about this on Menopause Matters forum.

Dydrogesterone is not an androgen- related (testosterone) type.

You can't get progesterone as a gel if that's what you mean. You can get Utrogestan as capsules.

[LifeIsGoodish]

Thomasina, what you're calling adrenaline surge are more commonly known as panic attacks and palpitations. (Far prefer your label, though! More positive and less scarily emotive.) Most definitely a peri-memo symptom, and, for me, the most distressing ones.

[Thomasina2505]

Thank you so much for all the replies and suggestions. I assume that by "gel" you mean Estrogel? I understand that Esterogel and Utrogestan are bio-identical and that's better. Do they have to be prescribed separately?

I'm getting no where speaking to a GP at the moment. The ones I normally see don't have appointments until next week and meanwhile i'm still having horrendous sleep problems and having to take sleeping pills as nothing else send me off to sleep. I think this will kill me somehow or drive me mad. feeling really anxious about dependency on the pills...

Thinking about getting referred to a consultant. Anyone has a good experience of a good Gynecologist in the North West? I'm prepared to go privately if it means starting to sort this out quicker!

And my adrenaline surges are not like panic attacks - I know what those are like but this is different. It's just a jolt in my stomach followed by a racing heart but without the emotional component of the panic attack It's seems an entirely physical thing that happens as I am dropping off to sleep. Weird!

Thanks for the comments. Take care, everyone.

[PollyPerky]

You have to get Oestrogel and Utrogestan as 2 separate products . It doesn't really affect me re. NHS because I see a private consultant so pay for my own HRT anyway.
I don't know of anyone in the NW but if you go to the Menopause Matters site there is a list of specialists on the menu. It's not all encompassing (mine isn't there!) but the other route is to select a private hospital local to you and search their website for gynaes- and choose 1 who is able to deal with meno.

The jolt you describe when falling off to sleep- I don't think this is anything to do with meno. I can't be sure but I've heard lots of people describe this feeling- MEN and women! It's part of the muscles relaxing. I've experienced it all my life, off and on, though not very often.

[Thomasina2505]

hi
Have been using Evorel sequi patches for a few days now and had a bit of nausea and dizziness to start with but since yesterday started vomiting just like I did with the pills. Is this likely a side effect and has any one experienced it with the patches?

Still no positive effect on my sleep or anxiety and GP now not prescribing any more tablets. He seems to think people can get by with no sleep what so ever which is what happens to me presently without a sleep aid. Actually I think I'm more edgy on the HRT and anxiety has increased, which I hoped would all be relieved by treatment. But it could also be a result of no sleep, I guess. Any shares on this? Many thanks

[PollyPerky]

Sorry to hear you are feeling nauseous. It's not unlikely because the higher oestrogen levels are akin to what you'd have if pregnant (though much lower!) so it's almost like morning sickness. I had this nauseous feeling for a few days when first using gel but the way I managed it was to reduce the dose and then split it into 2 doses- morning and bedtime- which worked wonders and I've done that now for 7 years.

Is your GP reluctant to prescribe Oestrogel rather than patches? Gel is really fantastic because you have full control over how much to use - anything from half a measure to 4 full ones.

If you are a 50mcgs patch that is medium dose and may just be a bit too high for you- you can get lower doses. But if you could change to gel it might be better.

[KilburnOriginal]

I'm on Evorel Sequi , in my 3rd week so on the conti patches now. I've not had any adverse side effects, in fact I feel things have improved. I'm a bit edgy the last few days but not sure if it's the switch to the conti patch or the fact my son has had me up at the crack of dawn the last few days.
Maybe hrt doesn't suit you, have you taken the pill in the past? Might be worth persevering for 2 months to see if it settles down.

[PollyPerky]

Replacing oestrogen shouldn't cause side effects because it's simply putting back what we have naturally before meno. The reason for side effects is usually too high a dose or too high too soon. It's also a much smaller dose than in the Pill.

[Thomasina2505]

Hi! Thanks for the replies. I feel like giving up straight away, as had another sleepless night and am feeling really rough. I have ME on top of everything else, so not a pretty picture. I'm sick in the morning but then feel like I could keep going all day despite lack of sleep and exhausted. Not my usual self at all.Feeling very downhearted about it. I thought it would be easier and I see that it can be for some women. Will try and speak to GP this week. Thanks again.

[PollyPerky]

Try to stick with it. It is normal to experience some feelings of nausea with higher levels of oestrogen; you could either try a lower dose. Estradot patches (oestrogen only so you'd need a progestogen for 12 days a month too) come in 25 mcgs and 37.5 mcgs.
They do say give all HRT 3 months trial- hard I'm sure if you are actually throwing up, but my feeling from my own experience is it's better to start with a low dose and build up over a few weeks.