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[ATB]

It made no difference to when I wake up, just that I wake up easier with more alertness. I don’t know why I thought you had trouble getting to sleep as you say you don’t!! Sorry. But you might like to try going to bed earlier. I see a lot of women saying they wake up at 5/5.30 now, I don’t know why that is? But I also really don’t seem to be able to sleep past 6am but often it’s 5. So now I take Utrogestan earlier and go to sleep early enough to get at least 7 good hours sleep, or 8 if I’m really lucky. Good sleep overall has helped my anxiety too. I switched from 10/11pm at night to by 6pm every night, exactly when depends when I eat, as ut needs to be 1 hour before food or 2 hours after.

[Tora]

Going to bed earlier helped me initially as getting proper sleep helped the anxiety/palps/heart thudding etc. I blocked all light from my bedroom and I don’t wake before 8am now.

[joziel]

It’s an interesting idea, if I go to bed earlier and still wake at 4am I’ll get more sleep for sure.

I don’t think I can take the utrogestan any earlier as it has to be 2 hours after food…

[ATB]

Or an hour before your evening meal ( at least 2 hours after lunch )

[joziel]

Do you think I should try taking the utrogestan vaginally??

I don't think I want to do that long-term (due to endo deposits being away from the vagina) but if I just did it for a couple of nights and immediately slept much better, it would be useful information and I might need to try a different progesterone.

I was just doing some Facebooking and found a few other people in FB groups who think their palpitations and anxiety during the night are caused by the utrogestan, not estrogen. Which gave me the idea...

Now would be a good time to try it as I'm also on Cerazette, which is suppressing the endo too. (Supposed to switch that for 200mg of utrogestan in 2 weeks time.)

[joziel]

An update on the palps...

Things have generally been going better although not perfect. Better meaning, it is happening much less often. But not 'never' yet.

Last night was bad again. Woke at 1.30am. My hands felt like rubber gloves someone had blown up and a bit 'pulse-y'. Dozed for a bit, couldn't fall into a deep sleep because I felt like I had the fluttery palps and was pulsing again - presumably with high blood pressure. It really sucks when it happens because I start to get anxious about it in a semi-awake state - which means I can't reason properly and tell myself it's all okay - and just get more anxious. I try not to wake fully because then I will never get back to sleep again.

I'm now at 4wks since the increase to 62.5. But as this still seemed to be happening occasionally even after 7wks at 50, I am not sure it's realistic to wait for it to completely stop before increasing again or I may never increase.

Going to see a new menopause friendly doctor this Friday so will see what she says. Slightly daunted that I have only 20mins to explain about 5hrs worth of things.

[joziel]

I just thought I'd update this in case it helps anyone who does a search on it later....

Menopause 'friendly' GP turned out to be menopause 'ignorant' GP, so won't be my GP 

She wasn't concerned about the heart palpitations unless I also fainted, collapsed, felt breathless or had chest pain. 

No mention of referral to cardiology. She did get a letter from the A&E doctor, who had advised a referral to cardiology - but she couldn't understand why he was advising that, given my ECG was normal and I didn't have any other worrying symptoms. So she just ignored it. She looked at my 7-day blood pressure record and said it looked totally fine.

I am going to see how things go. In a couple of weeks I will increase estrogen again, but only by moving from 62.5 to 68.75  (which is a 50 patch and three quarters of a 25 patch - I will get the ruler out and measure it in mm !)

Meanwhile things are pretty minimal at the moment. At night, lying in bed to go to sleep, I can hear my heart beating a LITTLE louder/harder than usual but nothing like it used to. I don't feel the pulsing/ throbbing hands very much at all. And I haven't had any palps for about 4-5 nights although I'm not kidding myself they've gone for good, especially if I increase estrogen.

[joziel]

Update: I am sooooo over waking at 5am on the dot for no apparent reason and feeling jittery and a bit throbb-y/pulse-y.

I am wondering if I should try some gel instead of patches, with the thinking that there would be a reducing of estrogen levels at night if I put gel on in the morning.

Whereas with the patches, perhaps I am just getting a constant high amount all the time and, for some reason, my body doesn't like that at night?? (Maybe naturally our estrogen levels are lower at night and the gel would help mimic that??)

I'm not going to rush to try this yet but am thinking about it. 

I had an idea that I could do an experiment - I change my patch on a Friday morning, so I could take the old patch off the night before and have a night with no patch on, and see if I sleep better before putting the new one on in the morning. If that works, then it might suggest that the gel in the morning would help...

ALSO: I don't understand why I am this sensitive to estrogen. I mean, natural levels during the month are all over the place in peaks and troughs and I haven't had any issues with symptoms like this earlier in life when not taking any hormones. Is this estrogen is body identical, why is it affecting me like this?!

[joziel]

HELP!! I slept so badly 2 nights ago, I was exhausted all day and had to go have a nap late afternoon yesterday (was a rubbish nap as the house was too loud to sleep properly). Couldn't work or keep my eyes open, after months like this.

I then had some good sleep last night from 11.30pm but again woke up at 6am. Feeling throbby and pulse-y and jittery. ARRRRRGGGGGGGG 

I seem to get rubbish sleep for a few nights and then am so exhausted that overwhelms me and I finally get some decent sleep - but still wake early between 4.30-6am. Sometimes (if I'm not too throbby or heart isn't beating hard) I can sleep lightly again a bit longer after that.

I just don't really know what to do with this or where to go with it.  I am stuck. I need HRT/estrogen. All my peri-symptoms have pretty much gone on it. (This sleep stuff was NOT a peri symptom!!) But on estrogen, this is what I'm dealing with after about 14-16wks. (I really hoped it would settle and go away.)

Doctors don't seem to care, once they have established I'm not having a heart attack and I don't have permanent high blood pressure (leaving aside these episodes of it in the mornings). I don't know if they realise quite how much this is affecting me.

I experienced similar when I was 21 and taking the combined pill for a few months, so I reckon it is my reaction to estrogen. (I don't know why, considering my own body produces this stuff and seems fine with what I produce!!)

I am supposed to be increasing to a 75 patch in 2 weeks time - there's no way I'm doing that, if I'm still having episodes of this right now because it's just going to get worse. So I now think I'm going to stay at 62.5 for the foreseeable. I might even need to come down to 50. But I'll try to do a finger**** blood test as I am at the moment before making a decision on that.

I spent an hour at 5am this morning trying to google research papers about the rate of absorption from the patch versus the gel, because one idea I had is to try the gel and to use it in the morning - with the hope that it is really wearing low by the time we get to 4-6am and therefore less likely to trigger this. But all the research papers I can find suggest that using the gel provides quite a constant steady supply of estrogen in the blood over 24hrs - so maybe that's not going to help either??? Does anyone know?? .    I know that some women split their gel morning and evening, for stability, so presumably it does wear off some?!

This Thursday night, I'm going to take off my 50 patch (leaving on my little 12.5 bit) and sleep without the 50 on. Because I'm due to change patch Friday morning. If I then have a good night on Thursday night, and sleep past 6am, it suggests lower estrogen levels at night might help and I could try the gel...

But if the gel doesn't reduce the amount of estrogen enough overnight, I can't be taking patches off every night and sticking them on again the next morning, can I?!

[joziel]

Update: I tried my little experiment last night - I removed the 50 patch around 9pm and kept on the little 12.5 half patch. I spent the night like that.

Well, it wasn't a normal pre-HRT totally perfect sleep night.    Still a little pulse-y and tingly in hands and feet and still waking at 6am - but some good sleep before that and able to doze after that and no awful palps.

So I'd say that in terms of how I am on HRT, it was a 'good' night - but it wasn't like sleep used to be before HRT either 

I will repeat the experiment on Monday and Fridays, which are patch change days, a couple more times.

[ATB]

Oh dear, this is such a hard journey for you. I had a similar thing as I’ve said where I was waking up at around 4, quite panicked. I lowered both estrogen ( had other symptoms of too high ) and my thyroid meds and stopped magnesium ( just to eliminate ) and about a month or so later it stopped. But it’s not scientific so I have no idea what stopped it. Why are hormones so darn difficult! It doesn’t seem right the female body is this complicated. Poor design if you ask me! It seems we are destined to try things out ourselves until we figure it out while trying to manage a normal life at the same time. You have my sympathies Joziel.

[joziel]

Thanks, yeah it sucks    I am investigating a low histamine diet at the moment, but also not sure it really applies to me. I don't have any itchy skin or hives or allergies in terms of skin reactions to things. And in terms of blood pressure, it mentions low blood pressure for histamine intolerance - and I have the opposite problem when I'm having an episode. I do have the palps of course, plus a drippy nose and watery eye and over-production of mucous especially after eating.

I guess it can't hurt to try the diet for a couple of weeks and see if it all stops though. It's just a pain because I like eating so many of the things that are supposed to be high histamine  I eat a lot of yoghurt and kefir and it seems I'd have to drop all that! I'm going to need to finish up some of the food I've got here before I can start it, as well as order in a few things.

I might also reduce my estrogen back to 50. The main reason I increased was that my blood estrogen was only 233nmol and I wanted to get a bit higher for bone protection. But I've been googling research and it seems quite mixed about how much you need for that, with some doctors saying a low dose is enough to protect you. Others want higher. Do we know?! Might start a new post.