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[elliephant]

Hello everybody

I'm Ellie. I went into a medically induced menopause, aged 35, in 2019, after cancer treatment. I'm on daily doses of estrogel (4 pumps), utrogestan 200mg, and testogel (one 'pea sized' amount).

Reaching out for advice on sleep, which is a problem for me - 

I have tried cooling mats, I'm mindful of what I eat before bed (e.g., camomile tea, a banana), I try to exercise (although my body isn't what it was, so short 20 mins jogs)

Nevertheless, I usually wake up, hot (not sweating) and uncomfortable, at about 2am. I get up. Read for an hour. Then sleep again in spurts until morning. It's exhausting. I really miss a full night's sleep.

Recently, I have been struggling with these weird - hard to describe - 'shakes' isn't quite the right word...almost nauseating, sort of vibrating.

...my oncologist considers me 'cancer-free'. Scans all come back clear.

I feel like I've exhausted all input from my GP/ and menopause specialist appointments are short on the ground.

I am so tired. The insomnia/poor sleep has been going on for a year, or so.

Any thoughts/advice/tips would be much appreciated.

THANK YOU

[CLKD]

The waking hormone 'cortisol' can be troublesome in the early hours.

Some describe those internal tremor like symptoms.  Insomnia can be caused by hot/cold flushes; getting up to P; getting hungry ........ if you are able to catch up with sleep in the day, do so ;-).   Insomnia can become a Catch22 situation, in that we worry about not getting to sleep or waking in the night ........ acceptance can help.  That 1 can have the odd night of broken sleep.  I know that if I have a couple of nights when my brain is racing, I'll eventually catch up and it won't affect my work - which was my main concern!  I always coped.



   So pleased that your scans etc. have come back clean.  Your oncologist must be pleased too.  Who is prescribing your HRT? 

[Wrensong]

Hello Ellie 

So sorry to know you've had a difficult time of it in recent years, but it's great that your oncologist has given you the all clear. 

I usually wake up, hot (not sweating) and uncomfortable, at about 2am. I get up. Read for an hour. Then sleep again in spurts until morning. It's exhausting. I really miss a full night's sleep.

I would not want to suggest changes to your medication which will be best discussed with those specialists who know your history, but as a very poor sleeper myself I really feel for you.  I wonder whether your GP could arrange for a menopause clinic to see you as a priority case as you will already have been through a lot & it's important that you are able to sleep as well as possible.

I just want to mention that although many women find Utrogestan sedating & sleep well on it for that reason, some of us really don't.  I found it very badly exacerbated my pre-existing sleep problems & one reason for this is that progesterone increases body temperature.  So I wonder whether the Utrogestan could be making you too hot to sleep well.  You say you are taking 200mg daily so I take you mean continuously rather than cyclically & that there is good reason for your taking it on that basis?  If so it's quite a hefty dose to take every day but presumably because you are on 4 pumps of Oestrogel?  It might also be helpful to know how well you are absorbing the oestrogen & testosterone as if your doses are not right for you this could be contributing to your difficult sleep.

I can't comment on the vibrating shakes you describe as I haven't experienced those, but many women have posted about what they sometimes describe as internal tremors, so hopefully someone else can help you with that.  You might like to try using the search box if not.

I would try to talk to your GP about how the sleep issues are affecting you & ask him/her to arrange for you to see a menopause specialist as soon as possible if he/she cannot help further.  I do hope you manage to make some progress.
Wx

[Gnatty]

Just wanted to add that it may be you need to increase your oestrogel and testosterone.. I found I needed 5 pumps after oophorectomy and increased the tube of testim so it lasts 7 days rather than 10. I would see a Meno specialist. I see someone at Newson health and they have been really helpful. My oestrogen levels are around 600 and the reason we recently increased the testim was because my FAI levels were 1.1. Apparently anything less than 2 is considered low.

[Hopeful]

Hello Ellie
Sorry to say I don’t have any advice but just want to say that I am exactly the same the waking after 3 hours sleep feeling hot,but not really night sweats, and the internal tremors are so awful. I am postmeno but things seem to fluctuate everyday 
Do you eat the banana close to bedtime? As the advice is to take the utro on an empty stomach.
I have a meno appointment in a week, will get back with any advice I get. hope you get some help soon
Helen

[elliephant]

I just want to mention that although many women find Utrogestan sedating & sleep well on it for that reason, some of us really don't.

- I didn't realise that. It was specifically prescribed to help with sleep. I take it continuously. initially it wasn't prescribed at all as I have had a hysterectomy. I do remember that it helped with sleep at first, but these effects have since disappeared.

It might also be helpful to know how well you are absorbing the oestrogen & testosterone as if your doses are not right for you this could be contributing to your difficult sleep.

- I have been asking this question for a while: How well is it being absorbed? My bloods are normal, but there are no FSH etc. levels to compare to, so I'm not sure what my normal levels were before menopause.

You might like to try using the search box if not.

- Done, thank you. Nice to know I'm not alone with this weird one. Best description found - "it's like a swallowed a mobile that's permanently on vibrate". haha

arrange for you to see a menopause specialist as soon as possible if he/she cannot help further.  I do hope you manage to make some progress

- been referred. Long, long waiting list. I know that private is an option...

Thank you - hope you're having a good w.e

[CLKD]

Keep us up to date!

[elliephant]

I see someone at Newson health and they have been really helpful.

I have been thinking about Newsom. - It's an investment, but interesting read about your experiences after the oophorectomy. I presumed 4 pumps was the limit. Was it her/one of her team that recommended you increase?

Thank you

[elliephant]

I have a meno appointment in a week, will get back with any advice I get. hope you get some help soon
Helen

- That's incredibly kind of you. THANK YOU.
Yes - I eat magnesium etc rich food 2 or 3 hours before taking the utro'.

[Gnatty]

Yes it was one of her team. If you think that 4 pumps is max for people with ovaries, and even that isn't always the case, then it stands to reason that those of us without could well need more. Likewise with testosterone.

[Wrensong]

Yes Ellie, Utrogestan is known for its sedative properties & many women do find it helpful for sleep but progesterone also raises body temperature.  Utrogestan makes me hellishly hot, so if you are consistently too hot at night & on a high continuous dose, this could be something to think about.  If there is no medical reason for you to continue with a progestogen (e.g. cervix removed, no history of endometriosis) then presumably you have scope to reduce the dose or stop altogether if that does prove to be the cause of your poor sleep.

Again, could also be that your oestrogen &/or testosterone are not at the right dose for you, so yes, testing might help you find your best fit sooner rather than later.  Also important, especially as you are so young, to ensure good levels for cardiovascular & bone health & as you've been prescribed 4 pumps of Oestrogel I'm assuming there's no reason for your doctors to want to keep your replacement to a minimum.

If you are  thinking of a private consultation, I'm another past Newson patient post-BSO & found the doctor I saw very helpful, generous with her time at first appointment, which was backed up by a really comprehensive clinic letter outlining her recommendations to my GP.  For a chance of an early appointment, if you are in a position to do so, you could ask to be considered for a cancellation.
Wx

[marge]

Shakes, internal tremors, were my worst meno symptom by far. It sparked off health anxiety which is another can of worms

[cazza]

My biggest meno symptom is insomnia its horrible, I sometimes struggle to fall asleep then when I do wake constantly like Im waking myself up or I can go all night without sleep then feel horrible the next day and working full time I always worry I won't cope.Ive started to take magnesium to see if that helps so fingers crossed.I have not had the tremors you describe so can't comment but my friend had them and she said they where awful fingers crossed you will find something that helps x

[elliephant]

Thanks everybody. sorry I took so long to get back to say thank you.

Very encouraging to hear about the newsome practice again. i think I will see about booking an appt'/and good tip re. asking about a cancellation.
this week I'm knackered and have just slept 5 hours during the day - which isn't as fun as it sounds. I keep bouncing from INSOMNIA to SLEEP. I feel a bit fed up with this cocktail of symptoms, atm.

Will contact dr newsome tomorrow. i'll let you guys know how I get on with that - for anyone interested/considering booking a consultation for themselves...

[Marchlove]

Hi Elliphant
Sorry to hear you’ve feeling so grim.
I have two thoughts. The first is regarding you tremors. It could be an electrolyte imbalance, bananas are very high in potassium so it might be throwing your sodium out whack. Do you feel dizzy as well? Get your Gp to check your electrolytes and you could cut out the bananas to see it it makes a difference. You need magnesium at night to help with sleep. Zinc would also be of great benefit for sleep latency.
Also, I wonder it your cortisol circadian rhythm is causing problems. High cortisol at night but low during the day. ZRT lab do a home cortisol test which involves taking 4 saliva tests during the course of the day. Very easy to do.
I had quite bad tremors a few years ago and worked with a naturopath to correct the above and my tremors completely resolved.
It’s a lot to take on board for you but hopefully you will get to the bottom of it all with the right help. xx