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?

@Megifer what type do you take? Continuous synthetic progesterone does that to me (i.e the Evorel Conti patch on every day) - it’s quite a common intolerance to synthetic progesterone (as far as I know) but can probably be similar with the body identical stuff too. If you only started recently it might ‘settle’ though, it takes quite a long time for the body to adjust to the new HRT regime

I take the micronosed type, 200mg and 2 pumps of gel.

The side effects from the progesterone when i started that at night after being on the gel for 2 weeks were instant. I didnt sleep more than 2 hours, 30 mins a time, for 4-5 nights. That was the only side effect really. Switched to taking it in the mornings and ive been better, still a bit wired but thats fine in the day!

I tested taking 1 in the morning and 1 at about 4pm and same again - no sleep that night!

Have been keeping a diary for my review. I have a fairly decent GP who said based on my symptoms (suspected later stages of peri) id be better on the gel as I can adjust it myself when needed so im half expecting her to say maybe try 3 pumps of gel which might balance out the progesterone from what ive read. Or maybe not. Who knows with this crap 🤪

@Megifer. Ah yes that makes sense, 2 pumps (as far I understand it) is quite low with a 200 mg dose of progesterone. I’m on Evorel 50 which equates to about 4 pumps of oestrogen gel. It’s a nightmare isn’t it, but once you’ve got your dosage right, you’ll be fine. I’m taking my HRT to my grave with me, that much I know!! 😆

I take progesterone continuously, still have periods. I take 100mg a day instead of 200 when on cyclical. I use oestrogel too.

I’m 41 and have 200 Utrogestan daily. The consultant and GP were both fine with me switching to continuous after 12 months on HRT - they said you’ll almost always have periods/withdrawal bleeds on a cyclical regime so can’t use that as evidence you’ll have irregular bleeding on a continuous regime.

@WashableVelvet interesting that you were allowed 200! At this stage I don’t mind having irregular bleeds really, all I want is to sleep. I’ll find out today at my appointment 🤞🏼

@WashableVelvet can I ask what were the reasons for you, to take 200 mg progesterone every day? Was it insomnia too or something else?

Oooh this is interesting and a bit of a coincidence given what I said not long ago.

So my cycle is up the wall anyway, either very long or very short so I started the progesterone at who knows what point in my cycle as it could have been months before I came on to wait for the day 15 thing.

I came on yesterday, have 2 days of the 2 week progesterone left. No worries i assumed it would all be up the wall at first as theyve been all over the place for the last 2 years.

Took my progesterone about an hour ago as normal and I dont feel wired, I feel REALLY spacey and mellow, like the side effect you hear about!

This is so weird!! 🤣 I just laugh now at it all 😀 I really want to lie down but im delivering a presentation to 30 people in an hour 😬 this will be interesting.

No, I dislike the progesterone but get a lot fewer side effects on continuous and apparently that’s the continuous-regime dose for the amount of estrogen I use. On cyclical it would be 300.

@Megifer oh hahaha there you go, mellow is the way forward! Good luck with your presentation!! 😆

I had the same problem but have started taking magnesium on the weeks I am progesterone free it’s not perfect but it does seem to help!

Sorry they use a 28 day cycle so 3 days off.

I was told to take mine before bed rather than in the morning?

Yes but continuous can have adverse affects on this if moved too soon to it e.g. irregular bleeding etc. Like I said even with bleeding I believe some consultants are comfortable with it but may require regular scans to share there's no issues with the lining.

Thats the norm but that didnt agree with me at all, it kept me wide awake and i looked like id been dug up, and I saw on another forum that can be pretty common (its just some GPs dont believe it!) so some women prefer taking it in the morning which had been going great for me, until today 😬

Am putting today down to coming on after another 40+ day cycle so hormones are a bit haywire anyway 😩

I’m almost 55 and still having periods every month. I take two weekly progesterone. Last year, the GP suggested I try the continuous progesterone on account of I’m an old crone, which led me to bleed constantly for about four months. Obviously I changed back. It doesn’t have a huge impact on my sleep either way. I have split my oestrogel across morning and night though. I think that helps.

It’s just personal to me, I recently had all my genetics tested and have an increased rick of breast cancer due to not metabolising oestrogen well.

I would like to see if hrt worked for me at a lower level all round as I think the alternative of not sleeping is worse overall than the hrt risk.

Hope your appointment went well.

@stayathomegardener sounds sensible! I’d love to know where you have a test like that done?

I’ve now had my appointment, and been prescribed Evorel Conti continuous. She said that there’s an unknown about the efficacy of taking the micronised progesterone vaginally, and therefore a possible risk of endometrial something - cancer I guess. I explained that I seem to develop an intolerance to the synthetic progesterone after the initial 2 weeks, but the Conti is currently the only thing they’re prepared to try. I have no choice but to give it my best, but from experience I end up ripping the patch off in despair… If this doesn’t work I think I’ll go private

I'm not in the UK, so I see my doctor privately anyway. I still had to go to a menopause specialist, my gp kept saying my hormones were fine and as I was still getting periods, I couldn't be on HRT. The new doctor said the usual blood tests are not reliable indicators of hormone level, and not only prescribed me HRT, but also identified low vitamin D and B12 levels. Having attended a work organized webinar about menopause, I found that a lot of women there also found their gps unhelpful or unaware of all the options for HRT.

Could you try the Mirena coil for progesterone? It’s always in there

@Theonlywayicanloveyou because the Mirena is too risky with my drug intolerance. If I need it out I can’t wait for several weeks to get it out

Sorry for the late reply. I have two different 100mg pills. One is quick release, the other is slower. So I usually take one of each. One to get to sleep and the other to keep me there. I could take two of the same.

@SweetWilliam77I receive my prescription via my nhs gp but see a private menopause specialist for advice or tests as and when, she has no issues with my splitting my care, I thought it unwise to mention to my gp though.

The genetic testing is widely available now I spent £350 ish. Very illuminating.