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[CherylA]

Hi Everyone, thanks for having me - first post on here. I'll apologise in advance because it's a long one!
My name is Cheryl, I'm 57 and had my last period back in September 2017 - so a good five years past the menopause. Up until the last 14 months or so, I thought I'd done pretty well; yes there were the flushes but although there were 20 or so a day at their worst, it was bearable. I did notice an increase in my anxiety levels but nothing intolerable.
Come late 2021, my sleep was beginning to be disrupted. No issues dropping off but night time waking and struggling to get back to sleep again. At first, it was maybe once a week but increasing in frequency and since last August, it's more or less every night: 3:00am wake-ups and can't get back off at all
I'm exhausted! I still work full time as a lab technician, my shift is 07:30 - 16:00 and I also exercise, keeping silly hours really to fit my training in around work and home, so though the week, I get up at 04:45 so I can get to the pool for a swim prior to my shift on Mondays, Tuesdays and Thursdays then on Wednesdays and Fridays, I do some meditation and stretches instead. Monday and Wednesday evenings, I go for a six mile Nordic walk when I arrive home, which takes me around 1 1/2 hours and on Friday afternoon (I finish at lunchtime on Fridays - nice!) I go for a seven mile Nordic walk. On Sundays, my husband and I go off hillwalking for three or four hours, so I SHOULD be sleeping...but I'm not!
I went on continuous combined HRT at the back end of October, Evorel 50 patches and Utrogestan 100 tablets in the hope it would sort out my disrupted sleep - but it doesn't seem to be working. The Evorel were switched to FemSeven 50 patches due to supply issues in January.
I know they say it can take three months before seeing a difference but it's been just over now and my sleep isn't improving.
As well as a good vitamin and mineral tablet, I also take zinc citrate, evening primrose oil, Vitamin D3 and on the recommendation of my osteopath, magnesium, one in the morning and one after my evening meal (I did try magnesium spray but found it didn't agree with my skin) but it's got to the stage I'm now dreading going to bed.
I don't have my phone in the bedroom and don't watch telly in bed - I go to bed at 10:00pm and read for a few minutes (nothing heavy or violent - I'm soft!) and as I say, no trouble falling asleep but if I wake up at 2:00 am for a pee, I can generally get back off, at least till around 4-4:30 am but if it's 3:00am or after, it's like PING!!!! Wide awake and that's it! Even happening with Nytol 
Work are being good with me (I actually fell asleep during a meeting two weeks ago ) but both they and the pharmacist have advised me to ring the doctors yet again - and I have mixed experiences with them to the extent I'm considering changing my practice. I DON'T feel depressed, by the way, but honestly think I'm suffering burnout but I got a somewhat negative reaction from my doctor when I suggested it - she just advised to to re-start my exercise routine to get the endorphins flowing: I'd just come down with my umpteenth cold / respiratory virus that year, something that's been happening every four to six weeks (several blood tests have ruled out anything sinister there)
Can anyone offer any hope or repsite? I honestly thought HRT was going to be the miracle cure for this but nothing I'm reading or hearing is giving me much hope to be honest.
Thanks for your understanding.

[Flossieteacake]

Hello Cheryl and welcome to the forum. Insomnia is truly awful and sadly often one of the last menopause symptom's to improve. You will find many threads on here with women reporting the same as you. I understand how exhausting and stressful it is not to get a decent sleep. Do not worry because this will improve it just is one of those things that can take time.

I notice you mentioned the HRT you are taking but you did not say if you are taking anything for vaginal atrophy. This is something that is vital to treat as soon as possible and treated with localised oestrogen. You getting up to go to the loo at night can also be caused by VA. You may already know what this is so I apologise if you already do. I just wanted to mention it as the sooner this is treated the better.

I know what you mean about expecting to feel great on HRT as we hear so many stories in the media were celebrities feel wonderful and full of energy. This has not been my experience so you are not alone there. I feel menopause is a journey and we have to take it slowly and be patient with ourselves. I understand this is difficult for you as you have a very active lifestyle. Allow yourself time to find the right HRT dose and for your body to adjust.

It is good you have found us as you will always have support on here.

[sheila99]

 
Your sleep pattern is the same as mine was in peri and for me it was cured by hrt though it did take 3 months. Have you seen any change at all since you started it? It's possible you're still oestrogen deficient and could benefit form a higher dose. The other possibility is utrogeston. Although it helps most people sleep better for others it has the opposite effect. You could rule that out by using a sequi routine for a couple of months to see if you're any different on the oestrogen only phase (utro is 200mg x 12 days, days 15-26, and you should get a bleed) or you could try a different type of progestin.

[CherylA]

Thanks for your kind replies, ladies.
Flossieteacake, no, nothing for vaginal atrophy - I didn’t know that was linked to night time visits!
To be honest, I’ve started drinking more before I go to bed as I find if I wake up for a wee before 2am, I drop back off again quite easily, although I still end up waking up around 4-4:30am but it’s better and more bearable than 3am!
Sheila, not keen on getting bleeds again to be honest after over five years without!
I’m actually waiting for a call back from the doctor this afternoon. Am I in order asking for a female hormone count? Both my osteopath and supportive HR lady said to ask for one but as you all know, some gp’s are better than others (even the female ones!).
As I say, not at all depressed - other than the prospect that this is “it” for the rest of my life 🙄 - just frustrated, and exhausted. I honestly think it’s burn out as everything else seems to fit - but not sleeping well is obviously not helping! xxx

[Flossieteacake]

Thanks for your kind replies, ladies.
Flossieteacake, no, nothing for vaginal atrophy - I didn’t know that was linked to night time visits!
To be honest, I’ve started drinking more before I go to bed as I find if I wake up for a wee before 2am, I drop back off again quite easily, although I still end up waking up around 4-4:30am but it’s better and more bearable than 3am!
Sheila, not keen on getting bleeds again to be honest after over five years without!
I’m actually waiting for a call back from the doctor this afternoon. Am I in order asking for a female hormone count? Both my osteopath and supportive HR lady said to ask for one but as you all know, some gp’s are better than others (even the female ones!).
As I say, not at all depressed - other than the prospect that this is “it” for the rest of my life 🙄 - just frustrated, and exhausted. I honestly think it’s burn out as everything else seems to fit - but not sleeping well is obviously not helping! xxx

There is no harm in asking for a blood count. I would also ask for vagninal atrophy treatment. Vagifem is a pessary and Ovestin is a cream. Some women are lucky and their GPs will prescribe both. I hope the call goes well.

[CherylA]

Well I got nowhere with the gp…
She (yes…) said we all have issues sleeping from time to time (I know this..!) and that if HRT was going to sort it, it would have done by now (just over 3 1/2 months in).
All she could suggest was a low dose antidepressant (she did say one beginning with “S” but I can’t remember what it was called).
So now seriously wondering if the whole HRT thing is worth the effort of trying to speak to a doctor when you need a review, finding out there’s a shortage of your meds etc. if it’s not doing what you hoped. 
I’ve just ordered a sh*tload of Astragandwa off my herbalist in the hope that will work  . I’ve also had al chat with my lovely hubby: he’s a blooming gem and I’m so lucky to have him on board.
So…do I or don’t I go down the antidepressant route.? I’d rather not to be honest but…you know?
Thanks for all your support and reading me venting off x

[Flossieteacake]

Well I got nowhere with the gp…
She (yes…) said we all have issues sleeping from time to time (I know this..!) and that if HRT was going to sort it, it would have done by now (just over 3 1/2 months in).
All she could suggest was a low dose antidepressant (she did say one beginning with “S” but I can’t remember what it was called).
So now seriously wondering if the whole HRT thing is worth the effort of trying to speak to a doctor when you need a review, finding out there’s a shortage of your meds etc. if it’s not doing what you hoped. 
I’ve just ordered a sh*tload of Astragandwa off my herbalist in the hope that will work  . I’ve also had al chat with my lovely hubby: he’s a blooming gem and I’m so lucky to have him on board.
So…do I or don’t I go down the antidepressant route.? I’d rather not to be honest but…you know?
Thanks for all your support and reading me venting off x

What an uneducated GP. I am guessing they suggested sertraline as this is their go to choice. I would not take an antidepressant because you are not depressed. HRT does not always help with sleep in just the few months you have been taking it for. I think it took me over a year before my sleep improved.

You could ask to be referred to an NHS menopause clinic. The waiting list is about one year but at least they understand HRT unlike this GP.

I can understand you feel it is too much hassle being on HRT due to reviews and having to speak to uneducated GPs but you will never know if the HRT will improve your sleep. I suspect your insomnia is hormonal related and sadly only HRT will be able to help with that. On the other hand if you feel you want to try without HRT then this is understandable.

I am so pleased your husband is so supportive and understanding. That really helps.

[CherylA]

Yes, setraline! That was it. Thanks for reminding me x

[sheila99]

You could get your levels tested privately. It's unusual to have been on hrt for 3 months and not seen any change so perhaps you aren't absorbing it very well.

[discogirl]

Hi CherylA,

I'm so sorry you're having a tough time with sleep. I'm 4 yrs post meno, had the nights sweats and flushes and really didn't bother me; however last year I developed unilateral tinnitus, insomnia and anxiety. Even when the tinnitus went, as my estrogen levels increased the insomnia persisted.

I started hrt in august last year, I'm now on gel and utrogestan; my sleep now is about 5 to 6 hours, it is broken sleep but at least I'm getting some sleep. I just keep focused on the fact that I slept well before and I can sleep well again.

My advice would be to give the hrt time to work; also make time for yourself just to relax, to do nothing, just to let your brain relax if you can.

I really hope things improve, all the very best xxx

[Gnatty]

Just to reiterate really what Sheila has already said, I suspect you need more oestrogen. The fact you can fall asleep ok but then wake up is classic low oestrogen.

[CherylA]

Thanks once again for your advice and support.
I’ve made the decision to change my health centre (been considering it for a while to be honest) and also to persist with the HRT for now. I don’t think 3 1/2 months is long enough to be honest so will give it a go till I’m due to run out in July.
It’s weird isn’t it? You somehow come to believe that once you’re “out the other side,” you’ve got it all behind you and sail on blissfully into the rest of your life without a care! Ha! As I say, I felt I was lucky compared to what many of you have experienced and what many go through but it’s not really hit me till I’ve been post-meno for over four years.
I’ve had a good natter with my hubby too (now I AM lucky there!) and we’ve come up with a few things between us.
Daft as it sounds, I’ve started drinking more in the evening (not alcohol 😂) as it seems that if I wake up needing the bathroom around 2am or before, I feel like I’ve been asleep for hours and can easily drift back off but 3:00am and after seem to be the witching hours for me.
Thanks for your support and suggestions and wishing you all well on your own journeys xxx

[Flossieteacake]

I think it is a very good thing you are changing to a different health centre. I hope you can find more support and understanding there.