To Hrt or not Hrt, that is the question...

[Sapphiretrueblue]

I'm losing my mind dealing with awful sleepiness. I've seen doctors and private specialists - all fine including oestrogen etc but I know that's not how peri is diagnosed.

This started last summer along with nausea after a really stressful period but it went away for months and reared its head again this summer. Brain fog persisted though, forgetting words etc. Both times these symptoms started around the start of a period. I've got so worried about it not shifting that it's no doubt not helping.

I can get up and take the kids to school then have to have a power nap before working then have to have another one at lunch and feel like I'm spending my days fighting sleep. It's really getting me down. Endocrinologist said to lose weight which I already know I need to do and cut down carbs and sugar. The week before and during my period I am so groggy and exhausted I feel like I'm on drugs. My periods are regular but they have changed.I'm 46. Just feel so broken. I'm scared to try hrt (which my doc was happy to prescribe) as I've heard so many stories about the progesterone making people sleepy. I can't cope with more of that.

Has hrt helped anyone on the tiredness side? My body doesn't feel weak/fatigued but want to sleep all the time.

My GP prescribed citalopram, an antidepressant, for the sleeplessness and night-time hot flushes and it worked. If you are already taking it for depression it doesn't work, apparently.

Thanks. Sleeplessness isn't my issue though. Awful sleepiness instead! Argh!

I’m post meno by 2 years. Have not taken anything hrt wise. Be wary of blaming everything on meno.

I sleep fine mostly but if not I’ll take an anti histamine or Nytol herbal.

What autoimmune tests have you had? I’m thinking thyroid, lupus, Addisons, anaemia - not all those are done as standard; particularly an early morning cortisol (Addisons / adrenal insufficiency). If you’ve done ALL of those screenings and checked the results yourself (not just the doctor saying normal - you need the results and to google/ check online) then I would try HRT. (I have all those autoimmune issues and more….)!! With the progesterone part of HRT it only makes you sleepy just before bed - you take it (utrogestan) at night so it shouldn’t make you even sleepier during the day as the effect will wear off by then.

Had your thyroid levels checked?

Can I suggest a thyroid check ?

I kept fiddling with my HRT trying to make it work again in a kind of tunnel vision of “if something is wrong it must meno related”. A whole summer wasted.

It was my bloody thyroid coming to join the hormone party.

My initial results indicated potential sub-clinical hypothyroidism. The scan show a nodule on one side and the other side has shrunk a bit, but no scary stuff. No autoimmune antibodies showed up in tests. Iron & Vit D too low (despite regular intake of sardines and appropriate offal, which were eaten in the name of vitamins, not delight at the menu) But other than that I was disgustingly healthy.

But I felt like somebody had taken my Energizer Bunny batteries out and swapped for a couple of mostly dead ones left in the junk drawer.

Thyroid meds, one week in, slight improvements. Then I’ll have to work out how to untweak the HRT I’ve been messing with trying to feel human again.

It’s worth a test just to save you time wondering why HRT isn’t helping with ALL the symptoms you’re having a hard time with.

I'm scared to try hrt (which my doc was happy to prescribe) as I've heard so many stories about the progesterone making people sleepy. I can't cope with more of that.

@Sapphiretrueblue You just need to give HRT a try and see how it feels. Don't base your choice on something that affects some women.

Not sure how much you know about HRT but you need two hormones- estrogen and progestogen. There are different types of progesterone.

Utrogestan (micronised progesterone)
Dydrogesterone (In Femoston which is a tablet form)
Norethisterone (in patches and tablets)
Mirena coil (a different type of progestogen.)

Sorry for the lecture!

The point is, that although many drs are now prescribing Utrogestan, automatically, not all women use that or get on with it.

For young women like you in peri, Femoston tablets are a good choice, or the Mirena coil + estrogen gel.

You can try a few types and see how you go.

Presumably if you have been told to lose weight, you've been tested for diabetes? That can cause tiredness. Have you been checked out?

Progesterone doesn’t make me sleepy at all. I wish it did. I use utrogestan btw.

Hi OP, I DO find the progesterone makes me sleepy.

I first tried utrogestan which made me feel sick and in some kind of daze the next day (plus very depressed).

I've now switched to the mirena coil. Which for the first three months made me feel sick with tiredness. I still feel excessively tired now, even though the initial burst of serious tiredness has worn off a bit. This is despite sleeping for 6 or 7 hrs without waking up most nights. I feel ever more tired.

Sometimes I go for a nap in my car at lunchtime. I am also taking testosterone which I'm hoping will start giving a bigger burst of energy soon.

I'm hoping it's all going to get better with time as the mirena loses its kick.

I did tell the GP how tired I was once the mirena went in and she told me to get some more rest 🙄

I am also still ovulating underneath too so once a month the exhaustion increases further!

BUT I think I am very sensitive to progesterone. Very sensitive. I sometimes wonder how much happier I would be without my ovaries and uterus!

Thank you all lovely ladies for taking the time to respond.

To answer your question, I've been tested for diabetes, thyroid, cortisol, all the iron, vit b, d etc and all in good shape, so pretty sure it's peri. I saw a private endocrinologist as GP wasn't thorough enough. I have borderline raised insulin (have PCOS) but very steady glucose levels, so I know I need to lose weight/cut so many carbs/reduce sugar drastically to feel better.

I think this sleepiness must be related to peri as it gets extra bad and I get mega groggy leading up to and during period. Us ladies have it tough! I don't feel weak or fatigued in my body at all though.

Those of you struggling with the progesterone side, I really hope it eases up for you soon and provides relief.