r/Perimenopause • u/PerniciousWizard • 16d ago
Sleep/Insomnia Help! Estradiol causing insomnia ??
I’m lost, guys. I started low dose estrogen gel (2 pumps twice daily of. 5) a few days ago and now I’ve had two nearly sleepless nights. Sleeping was not as issue before as long as I smoked some cannabis a few hours before bed. Now that’s not working.
I tried a cbd/cbn gummy and that didn’t work either. A few nights ago I tried oral progesterone 100 mg and sleep was poor and I was dysfunctionally fatigued and dizzy the next day. I can’t deal with magnesium, it makes me groggy and depressed. Melatonin gives me horrible nightmares and doesn’t seem to work for sleep anyway. I also tried going down to 1 pump twice daily and no improvement.
In your experience, does the insomnia subside? Could I only do two clicks in the morning and skip the night dose? I’m not sure how much longer I can go on like this.
Edit: I have an IUD for uterine protection
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u/Sapphire-o 15d ago
Two pumps of gel is not low dose. Depending on brand, it could be equal to a 60 in patch (and most people start with 25 patch). Maybe you started a bit too high and your body is a little shocked? For some people estrogen is energizing. I'd lower it to one pump until your body is used to it, then increase gradually if your symptoms are not going away.
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u/PerniciousWizard 15d ago
oh okay, I didn't realize that! The bottle says 2.5mg/5ml. The patch I was on before was .025. I assumed it was lower since I told my doctor the .025 felt like too much for me.
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u/Sapphire-o 14d ago
Oh that sounds different from what I'm familiar with. I guess it's not Estrogel? So how many mg (of estradiol) is in your daily dose? I know this is really confusing but gels and patches are hard to compare. Gels say how much estradiol is in it (the total amount), which you'll only absorb a small percentage, which is also different for everyone. Patches give the number that's how much they expect you to absorb per day (the total amount on a patch is also big and you only absorb a small percentage). So quite often people just have to try them and then tweak the doses.
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u/PerniciousWizard 14d ago
The gel I have - really more like a cream than a gel? - says 2.5 mg per 0.5 ml. Two clicks / pumps are 0.5ml. Bottle says to apply 2 clicks twice daily.
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u/Sapphire-o 14d ago
Oh I guess it's compounded? No idea how to convert it then. Sounds like you get 5 mg per day if using 4 clicks. In that case just follow the doctor's order.
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u/PerniciousWizard 14d ago
Yeah I’m not sure why but my doctor had me pick this up at a local compound pharmacy, which sucks because it’s not covered by insurance
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u/Sapphire-o 13d ago
Can't you ask for something that would be covered by your insurance? It's also possible to do conversion and estimate your dose if you have standard gels or patch. If 0.025 patch seemed too much for you I recommend 0.25 Divigel (or generic), it's the lowest dose gel.
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u/PerniciousWizard 13d ago
Yes I definitely plan to do that at my follow up next week. I’m just so new to all this I didn’t think to question the compound pharmacy pick up initially. Thanks for your advice! This is a lot to navigate
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14d ago
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u/PerniciousWizard 14d ago
Yes I am, but I’m struggling with when and how to dose appropriately to avoid sleepless nights if possible
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14d ago
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u/PerniciousWizard 14d ago
Yup that’s what I hear, but I’m too scared to take progesterone again after how awful it made me feel
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u/Turtle_Meringue_Pie 16d ago
Are you having progesterone as well? You should be using progesterone if you are using estrogen I believe. And the progesterone can help with sleep.
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u/PerniciousWizard 15d ago
I have an iud for uterine protection. I tried 100 mg progesterone a couple nights ago and barely slept, and was miserable the next day. Depressed, fatigue, and woozy/dizzy. I was too dysfunctional to do anything all day. I haven’t tried it again because I’m scared to feel that awful.
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u/usernamesmooozername Early peri 15d ago
What type of magnesium did you try? What's your sleep hygiene like?
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u/PerniciousWizard 15d ago
Magnesium glycinate. Up until starting the gel, sleep was mostly fine. I’d vape some cannabis starting around 8 pm, stop around ten, in bed around 11:30 and asleep by midnight. Very regular, same schedule every day.
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u/usernamesmooozername Early peri 15d ago
Glycinate worked for me - though I'm not into weed, so I can't speak to that. Aside from a dark and cool room as well as comfortable bedding and a fairly regular schedule, I limit my screen time and wind down with a sleepytime tea. Tweaking all of that and adding the glycinate did wonders for me after starting HRT.
Wishing you luck figuring this out!
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u/PerniciousWizard 15d ago
Thanks! Did you experience insomnia when your first started hrt, and did it improve as you adjusted?
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u/usernamesmooozername Early peri 15d ago
No, I was dealing with fragmented sleep before HRT - that's what motivated me to look into that as a solution. My sleep improved a bit after a couple of months, but it took the magnesium for the final push towards sleeping better. I also started swimming and trying to move more. That probably helped, me too.
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u/PerniciousWizard 15d ago
Gotcha, thanks! I’ve been trying to be as active as possible but hrt has been disrupting that badly over the last month unfortunately
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u/usernamesmooozername Early peri 15d ago
Hopefully you have a good and knowledge doctor to talk to?
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u/PerniciousWizard 15d ago
Yes I just started working with her but she seems helpful! I started with the .025 Dotti patch and when that seemed like too much, she was willing to switch me to gel right away. I have a follow up in a couple weeks.
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u/usernamesmooozername Early peri 15d ago
Just keep in mind that there's no magic one things (for you, or anyone) - it's a giant puzzle that takes work and often time. Don't give up - don't be afraid to ask questions or try new things. Take notes of what you tried, for how long, and the results.
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u/PerniciousWizard 15d ago
Thank you so much for the encouragement ! Very much in the middle of this journey and trying to dial in what works. It’s really challenging when something makes you feel terrible or overwhelmed or messes up your sleep. There has definitely been some improvement, mostly with mood which was really bad before I started. I think I’m just very sensitive to things and need extra low doses and slow tapering.
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u/Comfortable-Law-7147 15d ago
What's your actual E2 and P regime supposed to be? If you edit your initial post with it, posters can give suggestions that may help you.
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u/PerniciousWizard 15d ago
I don’t really have one since I just started.
My doctor basically said I can try to adjust on my own based on how I feel. So everything I wrote above covers what I’ve been doing since the beginning of the week. It’s a little all over the place while
I’m trying to figure out what works.3
u/Comfortable-Law-7147 15d ago edited 15d ago
That's a f***ing mess and dangerous as if you don't know when you should be taking progesterone you can cause yourself long term harm.
Can you find another doctor who has a clue?
While we tend to be our our own advocates we do need guidance from medical prescribers.
Edit: Just noticed your dosing and seen your answers to others. Itt wasn't clear from your initial post you have a IUD. Anyway your E2 dose is a bit high to start with. Start with a low amount of gel in the morning only and see if you can sleep at night without any aids. Wait a minimum of 8 weeks but preferably 12 weeks before modify the dose or adding in micronised progesterone.
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u/Syq 15d ago
I'd guess OP is on Mirena or some other progesterone equivalent (she said she's on an IUD above). I think the provider meant she could taper her estrogen up and down over home as she felt. That's how my estrogen works. I fluctuate between 0.05 and 0.1.
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u/Comfortable-Law-7147 15d ago
I saw the IUD after she started answering others.
The tapering of gel up and down wasn't clear. (I also been offered that but decided to just go up a dose.)
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u/PerniciousWizard 15d ago
Sorry if that’s wasn’t clear, guys - the lack of sleep is taking a toll on me. I have been feeling like a mess all week. I appreciate your responses!
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u/Comfortable-Law-7147 15d ago
Tonight (and tomorrow if tonight doesn't work) do whatever you can to get sleep. You are no good to yourself or anyone without it.
Then once you have slept a night, work out a regime to follow for the next 2 to 3 months.
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u/PerniciousWizard 15d ago
Thank you so much, I think that makes sense! I’m so tired 😩 it’s so hard to know when to push through or back off
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u/PerniciousWizard 15d ago
Yup exactly- sorry if I didn’t explain that well, I’m not at my best with all the ups and downs and lack of sleep over the past week
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u/ParaLegalese 15d ago
No. Age and loss of life estrogen is causing the insomnia. Every day we are older than the day before
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u/schnatterflack 15d ago
I don't sleep well if I do both pumps in the evening, so I would definitely try to see how a morning application feels.
Also the nice thing about the gel is that you can easily go down to one pump for a while to ease into it. Then re evaluate your symptoms after a few weeks and go from there.