Can’t sleep without progesterone

[SweetWilliam77]

Hi everyone, just looking for a bit of advice.

I started HRT back in the summer last year, and have been getting on ok with the Evorel patches during the progesterone weeks. I feel good, sleep good, life is good. Then I have to do the oestrogen only weeks and my life falls apart - because I simply cannot sleep without the progesterone. I’ve tried to up or down the oestrogen, but nothing works except giving me progesterone. There’s a couple of issues, the doctor doesn’t seem to want to give me continuous progesterone because I still have periods (I’m 48). Second, I also seem to develop progesterone intolerance if I continue for more than 2 weeks straight on the patches, but I’ve read that synthetic progesterone can have that effect so I’m considering swapping to oestrogen gel and then take progesterone vaginally. I cannot take any tablets due to severe drug intolerance to anything that goes via my stomach so that’s not an option. I also cannot have the coil because the risk with my drug intolerance generally is too high and I can’t just ‘take it out’ like I can rip a patch off my thigh in the middle of the night.

I’ve got my review appointment tomorrow.

Has anyone on here been allowed continuous progesterone while still having periods?

It’s clearly different here in Canada. I’m 52, still having periods and I’ve been on progesterone tablets for the last year.

Oh that’s interesting @MooseBeTimeForSnow, can I ask what dose you take for continuous?

yes and for the same reason! Switched from sequential to continuous at my 3 month review in about November and things are immeasurably better. I didn’t go in suggesting it, my advanced nurse practitioner suggested it. I’m on gel and have also added a teeny bit extra- so two pumps and a pea sized blob and I’d say the two together have done the trick. I do notice when I have a run of forgetting my multivitamin and magnesium- seem to sleep worse then but the HRT is the game changer, the supplements play a supporting role! I am still having regular periods on this regime but as they’re every 4 weeks (so far, only a couple of cycles in) I’m assuming it’s ok- will mention it when I request my repeat prescription. I figure that I’m still having the drop in my own hormones that triggers the period which wouldn’t happen post-menopause.

@TwinklyStarfish so you were allowed continuous too, strange, I will have to dig deeper into why they won’t let me have it tomorrow! Your gel must be oestrogen, so how do you take your progesterone? Is it the micronised tablets?

Yes oestrogen gel and the micronised progesterone tablets, orally, but as you suggested, some people take it vaginally. I did try to find some info about starting continuous so soon after starting HRT, and whilst still having periods but don’t think I came up with much. I’ll have another look and see if I can find anything you can take to your appointment as evidence!

@TwinklyStarfishdo you take 100 or 200 mg every day? I’ve read something about the dose having to be smaller for continuous

@TwinklyStarfish are you older than me btw? I’m wondering if being still in my 40s is what stops them giving it to me, but maybe not…

My doctor put me on continuous progesterone because I'm still having very heavy periods at 55.
I'm on a tablet called Duphaston and I take two 10mg tablets a day. It's been 80 days since my last period. I also use oestrogel. I am still having bouts of insomnia cyclically but I do feel less exhausted.

I’m 46 (and a half…) and on 100mg progesterone every day no breaks. You’re right, it’s 100mg for continuous and 200 for sequential, unless your oestrogen dose is high and then they up the progesterone too.

I’m on 100mg continuous progesterone with the gel.

Couldn’t manage without it for decent sleep, I would however like to try and reduce the progesterone dose if that’s even possible.

I am currently down to a pea sized blob of gel having experimented all the way up to three full pumps and back down again.

I’m on one pump of gel and continuous utrogesten. I’m 46 but am post hysterectomy so maybe why?

I have just requested a trial of increasing my 100 mg progesterone to 200mg each night to see if it helps with insomnia, which was approved. I’m also on 3 pumps of gel (I do two in the morning and one at night - helps keep the night sweats away). I also add an extra pump if I feel my anxiety increasing - doctor said this was also fine. I’m 48 still having periods.

@TwinklyStarfish ah yes, so it is 100 - which is what I thought, I’ve tried 100 vaginally as can’t sleep unless I take 200, I doubt they agree to that. I’m on Evorel 50 which works well for me on the oestrogen side of things.

@walledgarden6 that’s interesting, we are the same age and still periods, my appointment is later this afternoon so fingers crossed they approve it, I just cannot live any longer without sleep !

@socks1107 yes I imagine post hysterectomy they don’t question it

@stayathomegardener what’s the reason for wanting to reduce the dose, is it side effects?

They don't generally do continuous until you're post menopause because it can sometimes cause irregular bleeding. But it's perfectly fine to take it that way if it's easier for your system to handle.

It's also very individual - apparently some women actually do better on a higher dose of progesterone which seems counter intuitive as you'd expect it to worsen side effects.

@YourShiningAutumnOceanCrashing yes that’s exactly it, but 6 - 7 months down the line and I’m still fighting to get continuous. Fingers crossed for today’s appointment! 🤞🏼

Sorry, I didn't read the thread because I don't have the capacity (no sleep at all last night 😞) so apologies if it had already been discussed. Fingers crossed for today!

@YourShiningAutumnOceanCrashing oh I’m sorry to hear that, I know all there is about living with zero sleep - it is the pits!! About your note about the higher dose progesterone, I think I might be one of them as 100 did nothing for my sleep!

I moved to a version of continuous in mid 40s but gynae said that I was still having bleeds on sequential, she would put me on 25 days a month. I had a bleed around that point but unfortunately as I also had some irregular bleeds it was too early to be on continuous and I was moved back to sequential.

They also can put you on continuous and then do regular scans to keep an eye on things. They are basically concerned about thickening of the endometrial lining as I understand it.

@Wonderbug81 so 25 days on progesterone, and then how long a break - 7 days?

@Wonderbug81 it’s actually the opposite though, progesterone is there to prevent lining overgrowth (according to Google)

I cant offer any advice as im the opposite, I have to have my progesterone in the mornings because it makes me wired!!! I only started hrt recently and cant wait for my 2 week break from it