I have already posted a couple of times up-thread but want to flag something to you all in case it may be relevant to you. I have experienced 7 years of intermittent, what I thought was unexplained, insomnia (I asked my GP to check back in my notes to see how long it had been going on). Last week, a new friend used the term “progesterone intolerance” when I was complaining to her about my insomnia. This always returns with a vengeance when I am taking the progesterone element of my HRT (which I started in Jan 2020) but never during the estrogel-only phase of my monthly medication. I had never heard the term before and apologies if you already have and have already ruled this out as a potential cause of your insomnia - if this is the case, the rest of my post will of no interest to you.
In an effort to try to sleep as well during the progesterone-only phase of my HRT as the Estrogel phase, my GP suggested that I try a Mirena coil as this would not only deliver the progesterone element I needed locally (and therefore supposedly should be less prone to side effects than progesterone taken orally) but also provide me with a treatment for my heavy periods and some (most likely redundant!) contraceptive protection at my age. Win-win I thought.
Since having the coil inserted last week I have experienced the worst insomnia I have ever had - broken sleep with 2/3 night wakings limiting sleep to less than 4/5 hours every night. It started the very evening that the coil was put in. Over the counter sleeping pills do not touch it and my GP prescribed sleeping pills (in case this was a teething period as my body adjusted to the coil) now provide me with only 2 hours sleep before I re-awaken. I think the insomnia is getting worse the longer the coil is in.
If I had to describe the feeling in my head, I would say that I cannot sleep at night as my mind is racing - butterflying if you will, across a variety of different subjects - all of them popping into my mind fleetingly even though my head is heavy (itchy even!) with sleep in the front part of my brain (behind my forehead). It feels as though something is overriding my sleep function no matter how tired I am. Meantime, during the day, I cannot hold any information in my brain for longer than seconds - human goldfish! Even reading a newspaper article is beyond me, never mind a whole book - Full Stepford-Wife (only without the grooming).
I suspect that I am progesterone intolerant (as my friend is) and have been doing some research. It is believed that about 20% of women are progesterone intolerant to some degree. Some women are intolerant to their own progesterone. They can experience serious PMS symptoms and possibly are at a greater risk of post-natal depression. Others are intolerant of progesterone dosages in hormonal contraception and HRT, whether administered orally or by implant, irrespective of whether they have had PMS or PND before. This brings me back to my medical notes. I have just discovered that about 6 months after I was moved onto the progesterone-only contraceptive pill (as I was experiencing heavy periods and had been taking the combined contraceptive pill since my late teens), I first complained of insomnia. However, this was an insidious, creeping up of insomnia so I did not associate its onset with the progesterone pill and, more importantly, neither did my GP.
My coil is being taken out this afternoon and I hope that I will regain my ability to sleep during my estrogel-only phases of my cycle. I will cross the bridge of whether I can solve my insomnia during the progesterone phase once I’ve caught up on some sleep!
I am not suggesting that your insomnia is caused by progesterone intolerance, merely that it might be. I am also certainly not suggesting that you immediately stop taking any progesterone-based contraception or HRT - you need to speak to your doctor first. However, I am flagging that this could be a potential cause of your insomnia. I am also wondering if not everyone has so immediate a reaction to the progesterone as I have experienced with the coil and that its effects may be more insidious. I have double-checked the leaflet given to me when the Mirena was inserted and absolutely no mention of insomnia is made as a potential side effect - brilliant.
You may want to take a look at:
www.researchgate.net/publication/13933740_Progestogen_intolerance_and_compliance_with_HRT_in_menopausal_women
www.mumsnet.com/Talk/family_planning/2758092-Mirena-Depression-Five-Fucking-years-of-my-life-AIBU-to-have-the-rage?pg=10
www.chelwest.nhs.uk/services/womens-health-services/gynaecology-services/menopause-and-pms-clinics/links/ProgestogenandProgesteroneRegimensinHRT130518AGREED.pdf
www.studd.co.uk/dep_women.php (I have never spoken to anyone at this clinic but my friend used it). Tab down to the very bottom of the page for the section on progesterone intolerance