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[Elizabeth69]

Hello,

I have been menopausal for a number of years but have struggled with some symptoms. Although the hot flushes are much better, sleep seems to be an intractable problem.

I started HRT about 3 months ago; initially a low dose of 25mg evorel (oestradiol patches), with 100mg utrogestan (continuous) - I asked Gp for this as I read utrogestan was helpful for sleep. I increased to 50mg about 3 weeks ago as my sleep hadn't improved. If anything it seems even worse; waking at 4 now whereas it was 5 before. I would like to try and stick with it if there is a possibility of improvement. I know it is all very personal but I wonder what other people have found most helpful sleep-wise and if it might just be the case that ageing has changed my sleep pattern and it is not fixable with hrt.
(I should say I have osteoporosis so there is another advantage to being on hrt but feel I may as well be on the lower dose if sleep not being helped with higher).

Thanks for your opinions,

Elizabeth

[Gilla999]

Everyone is of course different but for me the 3/4am insomnia is always from too low estrogen, without exception. (I read that when it is too low it affects the part of your brain that controls waking in the morning, which is why it happens).

Having said that, depending on your age, it is also known that as we get older our melatonin levels drop. I take a prescription melatonin every day (only available privately) which I've found useful.

Sleep is such an individual thing though, it can be hard to pin point!

[sheila99]

I think you need to give it longer on this dose. Mine was from low oestrogen and took the full 3 months to go. Utro didn't help me at all, makes me dopey all day but didn't help me sleep at night, I took it cyclically. I do think our sleep changes, as we get older too, I used to sleep through anything  now I wake easily.

[Elizabeth69]

Hello again, thanks for those...yes ageing does seem to change sleep, and maybe genetic as my sister experiencing the same.
Strangely I slept later this morning after mot taking utrogestan, which seems counter-intuitive, but I definitely feel brighter. Perhaps coincidence.
I did ask GP about melatonin but she said wouldn't prescribe...when you went private for this what kind of specialist was it?
Have an hrt review tomorrow so will speak to nurse to and maybe just have combined patch rather than faffing with utro, though curious about experimenting with missing it and seeing if it is having a negative effect on me (aware of need to take re. risk).

thanks,
Elizabeth

[HelloSam666]

I was actually prescribed melatonin slow release 2mg by my GP for insomnia. Unfortunately it did not work at all but i appreciate it can work well for a lot of people.

[Gilla999]

Yes Sam, I have Circadin too (brand name). As you said, it didn't help with hormonal insomnia, but I have found there is no sleeping pill of any kind (prescription or otherwise) that is strong enough to beat that (at least for me). I mentioned it more in case it was more of an age-related thing which I've read a lot about in older people.

Elizabeth, it was from my Psychiatrist (which I only ever needed to see I now know because I was going through the menopause!)

[HelloSam666]

I do agree with you Gill as I've tried so many but to no avail. I was so excited to try the Circardin thinking it would be a miracle cure especially reading so many positive reviews online for melatonin. I couldn't wait to try it the first evening. I persevered a few days with it but when i did get some sleep, had very vivid dreams / nightmares too. Suffice to say, I gave up within a week.

[Jane_w]

It's odd that the Dr won't prescribe melatonin.. I also had a low dose course of it via my GP some years ago when insomnia first reared its head in peri. Didn't help me at all which was disappointing as i really hoped it would ...the only thing that's fixed it for me is HRT (2 pumps gel & oral utro). Took about a week of hrt before I was sleeping again, which shocked me. I'm only 2yrs post meno but the insomnia felt permanent after 5yrs of very little sleep. Maybe as others have said it might just take a little patience to let everything kick in?

[Elizabeth69]

Hi
Well melatonin sounds a mixed bag too. My GP said it was only prescribed for older people and children I think (strange!).
Thanks for all your input...
Will persist with hrt anyway, though notice I am experiencing more nausea now on 50mg. E

[sheila99]

Someone on here bought melatonin from the states where it isn't a prescription drug. You could try that and get onto your gp again if it works.

[Jane_w]

Well now you mention it, after the not entirely successful effect of taking 2mg melatonin my hubby brought an over-the-counter bottle of 10mg of the stuff back from USA in pre-pandemic times and I took them for a while with patchy results. Sometimes they seemed to work other times not. The guidelines in UK are indeed for people over 55yrs but I was younger than that and my GP said it was preferable as first line treatment rather than sleeping pills ...which I also ended up being prescribed and which made me feel dreadful. Don't think I took more than on 3 or 4 occasions when I was utterly sleep deprived and desperate, then decided I'd rather be sleep deprived than feel so zonked out! Maybe its worth trying another GP if you can, to see if they are a bit more flexible?

[Ana21]

Hi Elizabeth69!

I take HRT and I've found it helpful for sleep, but daily exercise has had the greatest impact.  I start and end my day with movement.  Non-strenuous exercise in the evening improves the quality of my sleep.  If I skip my evening exercise, I find that I sleep less deeply.  Exercise reduces the level of stress hormones, adrenaline and cortisol, and stimulates the production of endorphins.  It's a nice way to relax and unwind at the end of the day.

It's a widely held belief that sleep quality can be improved by avoiding exercise in the evening, but a study in 2018 found that evening exercise helped people fall asleep faster and spend more time in deep sleep.  However, those who did high-intensity exercise, such as interval training, less than one hour before bedtime took longer to fall asleep and had poorer sleep quality.  Another study in 2020 found that moderate-intensity exercise in the evening does not impair sleep.  So it's okay to exercise in the evening, if you didn't get a chance during the day.

I also take melatonin when I need to adjust my sleep schedule.  Melatonin has a positive effect on bone density and strength, perhaps through synchronization of bone turnover.  Melatonin levels decrease with age and this decrease may play a role in the development of postmenopausal osteoporosis.  A study on peri-menopausal women taking 3 mg melatonin nightly for 6 months showed improvement in markers of bone turnover (decreased bone resorption, increased bone formation) resembling the bone turnover of pre-menopausal women.

Hope you find something that works for you.  Let us know.