HRT for insomnia

[Rzim]

I have been prescribed this for insomnia and been on a patch and Progesterone for about 6 weeks now (already have a coil fitted.)

Not seeing much improvement in my sleep. Just wondering if there's any point in me continuing with HRT bearing in mind that I'm 49 and will probably need it soonish anyway! Are there any downsides of being on it (apart from trying to get it in the first place!)

Many thx x

I’m in similar position, horrendous insomnia is my main problem. I’ve been on it for 4 weeks with little improvement. I’m going to keep going til 8weeks then ask for increased oestrogen if it’s still the same.

Insomnia was one of my reasons for starting on HRT. Maybe you might think soon about an increase in oestrogen dose, if your symptom/s continue to be unresolved?

Thx all - I am very inpatient!! X

Slightly weird @Rzim why are you taking progesterone if you already have a Mirena coil?

The reason you may feel HRT is not working is you are over-loading on progesterone.

Does your Dr not know that the coil gives the progesterone part of HRT?

You don't need MORE progesterone if you coil is under 4 years old.

That's helpful - maybe I don't need the progesterone pill then? I'll do some research!! X

Don't bother with the research. Your GP is wrong. it's shocking really.
This is very basic HRT info!

Many women (on this forum) use the Mirena coil and patches or gel.

Assume you are using Utrogestan?

Just stop taking it. But also talk to your GP because God knows how many other women are being mis-prescribed!

As I said, if your coil is new (not more than 4-5 years) it can be part of HRT. if it's older than that, you get a new one!

This is from GP notebook- training manual for GPs.

women may use a Mirena 52 mg LNG-IUS with estrogen for up to 5 years for endometrial protection as part of an HRT regimen. Women using Mirena for this purpose must have the device changed every 5 years

OP didn’t specify whether IUS or IUD. If it’s a copper coil or older Mirena then she needs oral/transdermal progesterone too.

One would hope the GP could see in her records what type of coil she has and has prescribed accordingly.

Many thx for this advice I really appreciate it x

I went on HRT because of insomnia and I’m around four months in. I started feeling a tiny difference after around three weeks and now my sleep is much less interrupted. I love that previous gel!

I agree @Sidge but @Rzim hasn't contradicted me when I said what happens IF someone has a Mirena.

I assumed therefore that it is a Mirena, especially as she said have been prescribed this for insomnia and been on a patch and Progesterone for about 6 weeks now (already have a coil fitted.)

Which suggests it's a Mirena, otherwise why mention it at all?

@Rzim maybe you can clarify if it's a copper (non hormonal) coil or the mirena?

One would hope... you'd be shocked at how many times GPs do not check records and this scenario has been posted on here zillions of times! @Sidge

I have the Mirena coil.
On the advice of you lovely people I have emailed my doctor and will see what they say!! X

@JinglingHellsBells that’s very true!

Also there’s a lot of old Mirenas out there, and women who don’t know when it was fitted or had it fitted in a CASH clinic so no record of insertion in their GP records. Safer then to add prog just in case if it truly can’t be dated 😬

Record keeping and attention to dates is crucial!

Cross posted with @Rzim

If you have a Mirena inserted less than 5 years ago you don’t need oral progesterone - just oestrogen. What dose patch do you have? If you started on a 50 and no improvement with symptoms in 8-12 weeks I’d increase it.

If you have a Mirena inserted less than 5 years ago you don’t need oral progesterone - just oestrogen.

As I pasted from the GP Notebook (online training!) last night.

Clearly her GP hasn't wised up.

I'm on patches Estraderm 50.

My Coil is only about 2 years old.

Good idea to increase the dose if I don't notice any changes in my sleep.

Any downside of being on HRT?

I still think my insomnia is partly due to Long Covid - or maybe Long Covid brought on the Menopause! X

@JinglingHellsBells MN was so glitchy last night I didn’t even see most of the responses on this thread until this morning!

OPs GP is obviously not clued up… worrying.

Many many thx I have now had a clarification from my GP and you are quite right - I DO NOT need the progesterone!! So fingers crossed my sleep may be sorted by the oestrogen only! X

Good luck! I hope your GP was suitably shamefaced. Why didn't she know you had a Mirena?

Is it hot flushes/night sweats keeping you awake? the Estrogen should help with that. I sleep like a rock when I take progesterone for part of my cycle, but not nearly so deeply on the estrogen only part.

@Totheweekend, at what point were you certain that the hrt had improved the insomnia? It’s such a long time waiting when improvement isn’t quick! At 4 months do you feel “normal” like pre menopause insomnia days?

No, I don't have any hot flushes yet - just wake up at 1-2am and then awake for a few hours!!

@HairyKitty after a month I was feeling very hopeful that good things were happening. Now I no longer have the random attacks of feelings of dread, no hot flushes and my sleep is pretty damned good. Not as good as when I was younger but some nights I don’t stir which I find incredible. I must be so much nicer to live with now 😀.
@Rzim I started out with the insomnia problems and hot flushes only joined the party quite a few months later.

(I just checked and I stopped bothering to log my sleep in the balance app about two months ago, so by then everything must have been much much better)