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[sev70]

Hello everyone!

I have been on several different HRT over the past 6 years, but the latest one (Tibolone / Livial), which I had been on before and worked wonders, doesn't seem to work so well anymore. I have PROFUSE night sweats on it every single night. It goes through my nighty, the sheet and the duvet and mattress are soaked in the early morning.

I wake up about 4 times a night to change myself and use an electric heater placed at the level of my bed to dry and warm myself up throughout the night.

As anyone experienced that and what did you do?

I have been on Tibolone for nearly a year now.

Any input will be greatly appreciated.

Thanks

[Dancinggirl]

Hi sev70 - These bad sweats are possibly not menopause sweats and if you have been back on the Tibolone for at least 4 weeks then the nights sweats should have settled by now.  I wonder if your thyroid is the problem??? If HRT is not reducing the sweats then it's worth popping back to the GP to have other tests.  DG x

[sev70]

Hello dancinggirl and thank you for your reply.

I have had thyroid checked, liver and kidney function, full blood count, inflammation markers and all came back absolutely normal, except a slight elevation in white cells count. This is caused by a kidney infection for which I am taking antibiotics.

The tests were done this month but I have been back on Tibolone for 8 months now and the sweating started about 6 months ago.

It is getting worst though.

And my GP has NOT A CLUE about menopause. He has been using me as a human Guinea pig for 6 years now, hence The reason for my question on here...

I just don't understand...

[Dancinggirl]

I don't know what to suggest really, however, if your white cell count is even slightly raised that might indicate ongoing infection which would make one sweat at night.  If you are getting regular kidney infections due to UTIs and on ABs then this could also be contributing factor.
There have been some threads on MM that cover UTIs and the fact that many women are given regular short term ABs for the infection (even if no infection is detected) which then results in the ABs becoming ineffectual, so ongoing burning and UTI symptoms persist.  It has been mentioned that this routine treatment of a 3 day course of ABs for UTIs is actually making things worse and doesn't actually clear any infection as it is often necessary to have a longer course of ABs to truly get rid of the infection.
Bladder atrophy/disfunction often goes side by side with vaginal atrophy and sometimes local oestrogen e.g. Vagifem alongside systemic HRT would be beneficial as this might break the cycle of constant UTIs and the need for ABs.
I would ask for the referral to a meno clinic for gynae to further advice.
BTW you need to remind me how old you are and where you are in your meno journey?  Dg x

[matildamouse]

I was on Tibolone for about 4 months and it worked EXCELLENT initially. My hot flushes and night sweats totally stopped. My issue was a significant increase in facial hair and slight spotting which became minimal as time went on. I also found that my night sweats returned in my last month...slowly but surely. I stopped taking it due to the facial hair issue.

I read a while ago the return of flushes and sweats while on HRT might have something to do with the estrogen and progesterone receptors becoming "deaf" again for the effect of the medication. (can not remember the exact details now sorry!) Tibolone is quite an unique form of HRT as it is a man made steroid mimicking the effects of our hormones to give menopausal symptom relief.

You might need to consider another form of HRT all together if it has to do with the receptors.

[sev70]

I don't know what to suggest really, however, if your white cell count is even slightly raised that might indicate ongoing infection which would make one sweat at night.  If you are getting regular kidney infections due to UTIs and on ABs then this could also be contributing factor.
There have been some threads on MM that cover UTIs and the fact that many women are given regular short term ABs for the infection (even if no infection is detected) which then results in the ABs becoming ineffectual, so ongoing burning and UTI symptoms persist.  It has been mentioned that this routine treatment of a 3 day course of ABs for UTIs is actually making things worse and doesn't actually clear any infection as it is often necessary to have a longer course of ABs to truly get rid of the infection.
Bladder atrophy/disfunction often goes side by side with vaginal atrophy and sometimes local oestrogen e.g. Vagifem alongside systemic HRT would be beneficial as this might break the cycle of constant UTIs and the need for ABs.
I would ask for the referral to a meno clinic for gynae to further advice.
BTW you need to remind me how old you are and where you are in your meno journey?  Dg x

Thank you very much dancing girl! I am 45. Diagnosed early memo at 39.

I know very well about ABs for UTIs because I have been plagued with UTIs all my life. I have to get urethral dilation every few years. I hadn't taken AB for 15 years but this time, my kidney hurt too much so I relented.

Usually, it comes back with a bacteria which is best treated with penicillin, but I am seriously allergic to it and the alternatives don't really destroy the bacteria completely either so as I said, I usually bare the pain, which I have had less and less over the years anyway thanks to the dilation.

Sometimes it comes back with proteins and white cells in it. Either way, I don't get treated for that.

No menopause clinic over in my neck of the woods. I've already fought for that and the best I got was a 3 seconds appointment at gynea hospital. No test, nothing. So that's that.

[Dancinggirl]

sev70 - I still think it is odd that you are just getting terrible sweats at night - are you getting flushes during the day??? If you haven't been able to have the right ABs for the kidney infection then maybe the infection is still going on - I assume with your past history you must be under a consultant urologist? Maybe a referral to see the urologist for further advice would be advisable.
I also wonder if, now you are further into post meno, you may need a stronger dose of HRT.  Have you considered having a Mirena so you can then use oestrogen as either gel or patch as this would allow you to use a higher dose of oestrogen which, at your age, you may need?  Dg x

[Mary G]

sev70, I think your problem is lack of oestrogen, pure and simple.  Tibolone might have worked before but if your own levels of oestrogen have dropped then it might not be working anymore.  I think you need to move to a bio identical, transdermal form of HRT.  I am on Oestrogel and it is fantastic.

You sound like you are really suffering and I think you need to see a hormone specialist like Professor Studd.  It will cost money but if he can get you on the right medication it is money well spent.  You could spend years (like I did) trying to find the right solution elsewhere.  Professor Studd is an expert on all things hormonal and specialises in PMS, PND,the menopause and HRT.

I had a dodgy thermostat and excess sweating for years and it really got me down.  No oral HRT worked and the patches were useless because they did not deliver enough oestrogen and it was only when I went onto the oestrogen gel that my thermostat got back to normal and the sweating stopped. 

Don't put up with it, you don't have to. 

[Hurdity]

Hi sev70

I agree with Mary G and others that if your sweats have been investigated and there is no other reason for them eg infection etc - then it is because the dose of oestrogen is too low and I would look to changing your HRT type. You did mention having tried other types and I wonder what they were?

However in my view there is no need to go privately, and also patches have always worked perfectly well for me and for many women who use them. Having considered the different options it is up to you to decide which method you want to use - and there are advantages and disadvantages of each - just a matter of preference!

Also you can get bio-identical HRT ie estradiol ( tablet, patch or gel) + progesterone (Utrogestan) on NHS through your local GP - you just need to find out who in your practice is good with HRT, do your homework, and ask for what you want - and if they don't prescribe it, change doctor. No woman needs to go to the expense of a private consultation.

But I agree with Mary G and Stellajane - don't put up with it (the sweats) if a change in HRT will help.

Hurdity x