me off it as even at this dose I am up all night.

[Aroundtheworldandback]

Been on Eatradiol for 5 years at a high dose of 3 squirts because of my severe symptoms. I’m now 50 and dreading my consultant saying the party’s over and it’s time to come off.

Even on HRT I’m going to sleep then waking an hour later and not sleeping all night - so cannot imagine what I’d be like without it. Up to what age is it safe to carry on taking it, does anything me know?

*sorry- does anybody know?

I think that's your personal decision when you want to stop hrt. You can evaluate the quality of your life and your risks. For me there is no life without hrt. I m 42, I just cannot function without hrt. If you are healthy and willing to accept the risks why you should to come off?

As Emerald says. It's your choice. There is no time limit. Use it till you die if you want to. You had an early meno if you have used HRT since 45. You should use it to 50-52 at least anyway.
Have you thought about dropping the dose? Maybe 3 pumps is too much and making you 'hyper' at night...just a thought.
What are you using as he progestogen part?

Have you looked at your sleep hygiene, foods and drink (no caffeine from early afternoon, no booze nr bedtime, no TV and screen work late at night - see you posted at almost midnight!) Are you getting enough exercise? I'd advise you look at your lifestyle and think of HRT as part of the package to help, but you might need to make other changes too.

Thanks both, I realise it’s my choice. I have a Mirena, no caffeine pm, work out and eat healthily. I have done everything I can.

Was so symptomatic at 45 that despite tests showing repeatedly throughout one month that I was not in peri, I still had flushes and no sleep.

What helps me sleep now a little and might help other mumsnetters is 3 melatonin tablets every night, usually only prescribed to children for sleeping disorders. They make me feel groggy unlike ustrogestan which I’ve tried.

Polly it hasn’t occurred to me that the 2 pumps at night could be making me hyper; I was under the impression that oestrogen had a relaxing effect.

My mum still has flushes mid 70’s so perhaps it’s in the genes

Sorry, meant that the melatonin tablets do NOT make me feel groggy!

No, estrogen doesn't have a relaxing effect at all. It controls flushes and lots of other symptoms. In a normal, fertile cycle pre-meno, it's progesterone that relaxes muscles.

Have you tried sleep hygiene :
No screentime for 2 hours before bed
No alcohol at dinner
No caffeine (cut out completely)
No exercise in the evenings
Calm, decluttered environment in the bedroom- no TV.
Warm bath
Lavender oil
Magnesium supplement (relaxes muscles)

Why not try 1 pump gel morning and 1 at night- whatever time you normally use it?

Thanks so much Polly, I’ve tried most of the sleep hygiene you mention bar magnesium which I will try. All this makes no difference though as I fall asleep easily but wake an hour later.

I’m relieved that I’ve started a period which means I can put down my dire sleep last week to that and hopefully things will be better for a couple of weeks. Too frightened to go down to 2 pumps! Seeing consultant soon so will be interesting to see what she advises. Thanks again so much.

I've always thought of estrogen as the feel good, energising hormone. I use 2 pumps- well, more like 1.5 - but some years ago went up to 3 just now and then (maybe for a few days at a time) to control night sweats.

You have nothing to lose (just sleep) by cutting back on the dose for a week or so. You could ask your consultant to do a blood test to check your estrogen levels, just in case you aren't absorbing much of the gel. Unlikely but worth a go.

Where do you put it and when? The leaflet says either upper arms (outer edge and shoulders) or inner thighs. Don't rub it in, just smooth it on enough to spread it and leave to dry. Don't use strong shower gels or anything on your skin first, don't shower or swim for an hour afterwards, don't apply it on top of body lotion.

Blood results vary as to how much oestrogen one’s own body is producing at any given time aside from the gel, so I’m reticent to start with that unless the consultant insists- which she probably will! I apply it to inner thighs, never moisturise that area for that reason.

Maybe when hormones settle down after the menopause one has the option of a very small constant dose of oestrogen to top up the feel good factor.

I have switched to premarin after trying estradiol in all its forms. It just didn’t cut it for me - premarin has been a game changer for me.

I'm 56 and on kliovance 1 mg tablets which are marvellous, my GP says I can stay on them until I'm at least 60 and I have no menopausal symptoms at all. Kliovance 1 mg is the lowest does but I can have more if I want.
I have no intention of stopping until I finish work at 67 as my menopause was horrible, no sleep, bad tempered, no concentration. I am normal now and intend staying this way.

I didn't realise you were still in peri . However, it's still worthwhile checking how much you are absorbing because IF you have your own hormones, the 3 pumps may be too much. Put it another way- if you are ovulating and producing estrogen, you wouldn't need 3 pumps. Another option is to get rid of the Mirena and go onto a sequi regime. The hormones from the Mirena do get into your bloodstream, so you are in effect on a conti dose. Might be worth trying sequi with a cycle, just to see how you go- so, Oestrogel plus either Norethisterone 12 days a cycle or Utrogestan.

TBH- 2nd thoughts!- if you were in peri at 45, the likelihood is that 5 yrs on you are post menopause. Do you have any signs of PMS / ovulation? Once peri is over, you are 'in menopause' for the rest of your life. Menopause (means 'no periods' ) never ends- just some of the symptoms get less in some women, but other long term effects of loss of estrogen - bone density falls, heart disease risks increase , pelvic atrophy- keep on going, without HRT.

Thanks Polly, not in menopause yet as currently have the period from hell! Perhaps some people are more sensitive to the symptoms than others.

Who knows how many years after meno to stay on hrt.. I guess whatever the answer, it’s probably at the lowest dose at which you can function normally.

It's quite rare to have heavy periods after using the Mirena for years. Is it due for replacement? Have you asked your gynae for an opinion on this?

I've had the menopause for years have tried all the herbal stuff but nothing worked, my sweats r driving me mad up all night and day, doctor put me on Elleste solo mx40, its been a week now and because of all the sweating the come over , really getting me down any advise would be helpful thank u

How can u keep the patch on as with all the sweating it keeps coming of

I know it’s rare- just my luck have had very light periods since Mirena fitted (had scan to show all was well and in place) but this is the heaviest- not due to be changed yet.

Karenoc have you considered Oestragel? Polly has a wealth of experience and has so kindly advised me, with any luck she’ll be able to advise you too.

Have you thought about ditching the Mirena and using a sequi type of HRT Around? These are just my ramblings....but some women do find that constant progestogen in sequi does 'negate' the good effects of estrogen. I know that the Mirena is supposed to be localised but someone told me that it did get into the bloodstream, in an amount equal to a low dose HRT conti pill. It seems odd that you need 3 pumps of gel BUT the Mirena isn't controlling the bleeding. Obviously the more gel you use, the higher the chance of heavier bleeding because higher estrogen levels make the lining thicker.

Makes total sense re Mirena leading to bleeds with the 3 pumps but it’s usually light so doesn’t bother me. I’m not sure though how decreasing my dose would help though, when I’m flushing and up right through the night. I think it’s time for a blood test...