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[shrosphirelass]

Can anyone shed any light? I always had PMT and one of the issues was insomnia in the week / 10 days  running up to my period, often feeling generally wired. I am now on sequi HRT and get the same issues during the progesterone phase. Having read many posts on this site, it seems that many of you feel more groggy and tired during the progesterone phase and some sleep better. If this is the case what could my issue be?

[shrosphirelass]

Thanks Stellajane, I'm 57 and on evorel sequi. I was peri last year what I started on HRT but am guessing I'm at menopause from recurring symptoms which may be caused by my natural reduced estrogen. I've never tried any other types of HRT, not advised to take pills due to headache and digestive peri issues.

I did start to experiment with a 5 week cycle (my natural cycle was always longer, around 6 weeks) as felt better on the estrogen part, but with the shortages of HRT daren't continue with this as would run out of estrogen. Is a 2 month cycle safe? How does this work? My GP is happy for me to have yearly scans as I have a small cyst that needs monitoring.

I also thought about changing HRT, which I talked to GP about but with the shortages and the fact I managed to get 6 months supply he advised me to carry on with it in the short term and hopefully when more options become available I can the change if need be. I did wonder if I'd be better on a conti regime, to stop fluctuations, but I guess I may then end up feeling rubbish all the time!

I agree about the sleep, I try not to worry about it and try not set my self up to fail. The worse thing is it makes me very headachey which makes it hard to function.

[Wrensong]

In the decade leading up to menopause proper when I was not on HRT, the worst symptoms for me came in the 10-12 days leading up to a bleed, however long the cycle.  These were increased number & intensity of flushes & night sweats, ectopics at their worst & my pre-existing pain related insomnia also became much worse - just seemed too alert for sleep despite feeling exhausted by day.  On some nights, close to a bleed, I would have no sleep at all.  I felt almost permanently too hot, anxious & wired.  The same happens to me with Utrogestan postmenopause, to the extent I that I can't tolerate it.  I can feel a similar reaction to the MPA phase of my current sequi combo, but as I'm on such a low dose, this is less marked & therefore bearable.   So like Stella, I would say you are reacting to the Norethisterone in Evorel Sequi, or suffering from the way its effects oppose oestrogen.  Over the years I have read reports of other women on here also feeling wired & hot on Utrogestan, so not everyone feels sedated on progesterone.

Are you hypothyroid on replacement by any chance?  I ask because exogenous thyroid hormone is said to increase sensitivity to progesterone.
Wx

[shrosphirelass]

Sounds like me wrensong. No, I'm not hypothyroid. Dr was conviced I was hyperthyroid as I was so manic and have lost weight, but tests came back fine. I've always seemed to be sensitive to progesterone, got regular awful hormonal headaches leading up to a period. I also had post natal depression which they seemed to think was progesterone related, though 30 years ago I was given progesterone injections for that! I'm worried utrogestan would be as bad, even though its body identical and would have to try it vaginially due to the headaches, but concerned about the iritation as like many others I have dryness issues. Have thought about a mirena to even things out but I don't think they are recommended for people who are sensitive to progesterone and am too scared to risk it. I'm hoping to try femseven when it's available again as I know it's a different kind of progesterone and perhaps try a longer cycle when HRT is more avaialable and I get to go to the menopause clinic. It's just coping in the meantime. Roll on next week when I'm back to estrogen only!

[Wrensong]

Stellajane - I thought the progesterone was potentiating thyroid hormone - I felt scarily hyper on Utrogestan in many ways & searched to find whether my intuition was correct.  I did find that documented some years ago but when I raised it with medics got no comment.

More recently came across the article that said thyroid hormone increases sensitivity to progesterone, so I now don't know whether both happens or just the one!  Whatever it is, I think being on thyroid meds complicates the situation, though I wouldn't be without them of course!  I thought I remembered you were also on thyroid meds.
Wx

[Wrensong]

Shropshirelass, yes that's just it - progesterone seems to have very similar effects to being hyperthyroid or overtreated on replacement thyroid hormones - hence my asking whether you were hypothyroid (& therefore on thyroxine) as I find the combination complicates menopause treatment.  Like you, I lost weight when the "hyper" type symptoms were at their worst which added to worries that they could be due to being on too much thyroid hormone rather than menopause.  A confusing & frightening time.

Unfortunately Utrogestan seems like poison to me - I think it's simply too strong as I was OK on the Norethisterone in Evorel Conti though maybe only because I absorbed it poorly, so perhaps got as little prog from it as I did oestrogen!

I've tried Utro both ways & it has the same extreme effects for me, though I could tolerate it longer on the highest dose of oestrogen I ever tried.  I also get the bladder irritation from using it vaginally. 

Like you, I didn't want to risk having a Mirena inserted & have to wait for removal if I felt bad on it.  As you say you can try the Levonorgestrel it contains with more control when FemSeven comes back onto the market.  I may well do that too.

I'm also not able to tinker with my HRT at present though need to for better symptom control.  Awaiting surgery, so need to taper off soon to minimize clotting risk, rather than increase as symptoms suggest I should.

I do hope you get something more satisfactory sorted out - it's horrible to have that dread of progesterone coming up every cycle.
Wx

[shrosphirelass]

Thanks both.

Good look with tapering off Wrensong, I don't envy you but it's got to be done and hopefully short term x

[Wrensong]

Thank you.
Wx

[Hurdity]

shropshirelass - it seems that progesterone can have both effects. For example - while I am taking it I get more and more foggy-headed and lethargic (worse some months than others), sometimes a migraine, and most definitely absolutely dead in the mornings - even more than usual ( I do get very bad morning tiredness). However at the same time - it irritates my bladder so that I have to get up to empty it at least once sometime tiwce, and in the hours leading up to waking for that I have very restless sleep and vivid dreams - so some might say they feel wired. However I am sure it is due to the bladder thing - trying to wake me so that I don't sleep so deeply and I keep half-waking and trying to pretend I don't need to get up, when I really do, so then go back to (half) sleep again fitfully until eventually I have to give in to it and get up!!! That's just my experience on it - always so glad when the 12 days is over!

Hurdity x