My dr regards insomnia as a big issue in itself because lack of sleep ruins the immune system and also affects blood sugar etc - which in turn can lead to diabetes. Insomnia has short and long term health consequences. This is from the Mayo clinic on chronic insomnia:
Complications of insomnia may include:
-Lower performance on the job or at school
-Slowed reaction time while driving and a higher risk of accidents
-Mental health disorders, such as depression, an anxiety disorder or substance abuse
-Increased risk and severity of long-term diseases or conditions, such as high blood pressure and heart disease
Without periods and associated fluctuations, would this continue?
IME, yes. It's loss of estrogen that causes the symptoms, not simply the fluctuation. My symptoms didn't start until my periods were more or less over, at 53.
Just as an example of how a specialist who really understands HRT can help- I was started on estrogen-only for 2 months, to get the dose right. Then I added in a short course of progesterone to initiate a bleed, which is necessary until you are 12 months post menopause.
I then went onto what they call 'long cycle' HRT which means the progesterone phase is not as often as every 4th week, but it's also being monitored.
Your average GP is not able to offer these options - no training and can't work outside the licensed regimes.
Obviously some women are fine on a pack of tablets, like Femoston, or a patch and progesterone.
But all I'm saying is that if you found something didn't suit you, there are many ways of tweaking the dose and the kinds of products, and often women don't appreciate this is possible.