Insomnia on progesterone phase of HRT?

[ramesesmaze]

I've been on HRT for 2 months, all good so far. However I've noticed that in both cycles, once I start the progesterone (utrogestan) I get terrible insomnia. I take the tablets first thing in the morning to try and mitigate this, but doesn't help.
Anyone else experienced this or have any advice?

Yes me too. But doesn't taking them in the daytime affect your cognition? I find they make me quite 'dopey' but still awake at night. They also made me very dizzy once, known side effect, when I took them an hour before bed- almost fell over! Now I take them very last thing before getting to bed.

Do you still get insomnia taking them at bedtime? My cognition is always a bit off these days so I'm not sure if it the progesterone or not! I've also noticed getting pretty bad tempered whilst on them. I read that women whose periods are irregular (me) can take 3 months of oestrogen then one progesterone for 12 days at the end of month 3. I might ask the GP. Have you heard of that @JinglingHellsBells? Also taking them vaginally, but mine are kind of plastic capsules rather than tablets iykwim so I don't know if that would work.

I read that women whose periods are irregular (me) can take 3 months of oestrogen then one progesterone for 12 days at the end of month 3. I might ask the GP

Yes, that's what I was prescribed but it was through a consultant and it's 'off licence' so not sure if a GP would be able to willing to do that.
I stopped in the end with such a long cycle as the bleeding was too much. Now do a long cycle but only usually 6-7 weeks not 12. Again, you are supposed to do this under supervision in case of any breakthrough bleeding that may need looking at.

Also taking them vaginally, but mine are kind of plastic capsules rather than tablets iykwim so I don't know if that would work

There is a only one type of Utrogestan- the capsules that are made from a type of jelly coating, It melts if you use them vaginally. I use it that way .

Do you still get insomnia taking them at bedtime? I tend to wake up after about 4 hrs sleep and feel hot and wide awake.

Ah thanks for that info. I'm only 2 months in, so I guess should give it another couple of months and see what happens. The other option of course is to get my progesterone through the Mirena coil. I'm a bit dubious as Women seem to either love it or hate it.

I must be a weird person because I get on really well with vaginal progesterone every other night. It helps me sleep. There’s a chance I’ll be put on some other form of progesterone depending on how a hysteroscopy and D&C goes next week. I’m going to put up a good case for letting me carry on with it!

Take magnesium glycinate and vitamin D12 (and k2 as well if affordable).

I found they made a huge difference

@Abraid2 what is the type of vaginal progesterone you have? I will ask my GP if this might help.
@RealityExistsInTheHumanMind I do take magnesium daily and also a multivitamin with iron that includes Vit D12. Will look into the k2.

It’s just Utrogestan. It’s not licensed this route but the gp I see privately told me to try this.

@ramesesmaze I think @Abraid2 is talking about utrogestan (there is no other type used vaginally.

@Abraid2 I guess you are using it on a continuous cycle of 100mgs every other night? I'm using 200mgs nightly, vaginally, for 10-12 days per cycle. I am low body weight (I don't mean I have an issue- am just small) so maybe it's just a lot for my system.

and it's only in the UK it's not licensed for vaginal use. In Europe, using it vaginally or even as a suppository, is the norm.

@ramesesmaze
Typo - should have been D3,

Can I suggest this one amazon.co.uk/gp/product/B07JCXK3HP/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1 D3]] Inexpensive £8 for a full year supply

Also Magnesium - the glycinate works better for sleep than other types but not cheap.

That's right, jingling, 100mg alternate nights and I am amazed at how well it suits me. I'm 62kg, 173cm tall, so perhaps I've just been lucky to have stumbled into the right kind of dose for my size.

I'm dreading them telling me it's going to have to be a Mirena or something else instead after my procedure! It works so well to send me to sleep at night. When I took it orally, every day (also 100mg) I had a rather nice sedated feeling all day long, which was pleasant but unhelpful when it came to getting any work done.

Thank you @RealityExistsInTheHumanMind, I'll have a look.
I'm at work now but if I post a picture later of my utrogestan tablets could you both tell me if it's ok to try vaginally? My are like a little bubble, white and like a sort of plastic (I know it's not plastic but looks like that!) rather than a flat tablet like a paracetamol iyswim. Difficult to describe!

Found a picture on the Internet

www.google.co.uk/search?q=utrogestan+tablets+picture+of+box&ie=UTF-8&oe=UTF-8&hl=en-gb&client=safari#imgrc=Uy0PVNLYJPyrXM

There is ONLY one sort available and what you have is what we have :)

Ah brilliant! I know I should ask the GP, and I will for next cycle, but what is the recommended dose generally for vaginal use?

@Abraid2 being thick here - just to clarify you take the utrogesan vaginally in the second part of the cycle, not through the whole cycle?

Whole cycle, alternate nights. I’m on continuously HRT as post-meno.

@ramesesmaze I really would not ask your GP.

If you read the previous threads, both me and Abraid have said that in the UK it's not licensed for vaginal use. However, meno specialists who are private can prescribe that way (mine does) and actually prefer that route as it's considered better.

Your GP is likely to have never heard of that way or say it's not licensed.

That makes sense, I won't ask the GP then. Could you advise on dose as I'm peri with irregular but heavy periods (prior to HRT anyway). It's not really giving medical advice (as such!) I will also do my own research. I will have a look at previous threads too. Thanks

You could try the menopausematters forums in case anyone there is at a similar stage of peri- and has been prescribed what your GP has given you and tweaked the utrogestan from oral to vaginal delivery?

I don't really know enough about the subject other than to say what I'm doing and why my doctor recommended it. :)

@ramesesmaze I am post meneopause but prefer to have a cycle, like women in peri, partly for fewer side effects from progesterone.

The dose is 200mgs x 12 days per month.

The same as you are doing now.

Some people have other variations BUT it is not licensed that way and not recommended. One reason is that with a lower dose of Utrogestan there is a small risk of hyperplasia. Women who have a private consultant can (usually) access a scan or whatever it needed if they have odd bleeding on individualised regimes, whereas that's harder with the NHS.

And also, it's not 'legal' for GPs to prescribe drugs in a way that is different to the prescribing guidance. They could be liable if someone sued them.

The dose is 200mgs x 12 days per month.

This is the dose for you, the same as you use it orally.

Other women using less, or less often, are under the care of private doctors who can work outside the prescribing guidelines, because they are using their own judgement and experience, and are not bound by NHS legalities.

Thanks @JinglingHellsBells