Tweaking HRT to aid sleep?

[TwinklyPeer]

Hi,
My worst peri symptom is insomnia. Mid-cycle I am getting 3-5 hours sleep for 4 or 5 days- I fall asleep quickly and deeply but wake up anxious and jittery and can’t get back to sleep. A few days into the progesterone things get better. It’s very clearly hormone related and seems to be the oestrogen drop off at that point of the cycle that triggers it. I know it’s only a few days a month but I’m finding the associated anxiety crippling.

After a false start of being prescribed anti-depressants, I’ve been on sequential HRT for 3 months (2 pumps oestrogel, 200mg micronised progesterone for 14 days). Lots of things have improved (lighter periods, hurrah!) but the pattern of insomnia remains. Our nurse practitioner (that runs the menopause clinic) suggested at my review that I change to continuous HRT but I’m only 46 and not been on HRT as long as is suggested before switching.
I know progesterone is calming and aids sleep, but has anyone seen a benefit from increasing oestrogen for sleep benefits? I wondering if anyone else has a similar pattern of insomnia and if so, what is your HRT regime is that helps?
Thanks for reading x

High dose magnesium can be helpful, although I feel I’ve reach my limit with that now so watching with interest. Total hysterectomy though, so oestrogen only here.

I do take magnesium bisglycinate but I find that taking it before bed makes me need the loo in the night. The other thing I sometimes use is passiflora tincture for the anxiety. The insomnia is so cyclical though that a hormone solution seems logical.

Hi OP.

I basically wasn't sleeping for years before HRT. I started taking it in January 2023 and by 2024 I was sleeping through the night again. This is my regime:

Mirena coil - this massively improved my sleep, whereas the Utrogestan made me feel like I'd been drugged, I don't notice the progesterone working from the coil.

100mcg oestrogen patch, I went up from 50 in 4 months as only the high dose stopped the sweats.

Testosterone.

Vaginal oestrogen cream - no longer need a wee a night. It's magic cream.

Magnesium Glycinate 450mcg elemental magnesium. Get a good one off amazon.

I can sleep through 6hrs usually, quite often 7 now. Without waking up.

Hi OP, my sleep was shot to pieces before HRT. I do sleep well during the progesterone part of my cycle, but outside of that I take two Fullnesium (magnesium blend), two sleep supplements with GABA (not sure if available, brand is Arrae) and it works a treat when combined with no caffeine 6 hours before bed.

Also, like a previous poster mentioned, vaginal oestrogen cream helps massively with bladder function for me overnight.

I know it works a treat, because I now have an Oura ring with detailed sleep stats. I’m so gutted I was gaslit for so long about being in perimenopause before being prescribed HRT – I thought that appalling sleep was just part of my life now. It doesn’t have to be.