Hormone replacement therapy (HRT) Systemic HRT can improve sleep quality, making it easier to get off to sleep, with less night-time waking; it has also been shown to improve chronic pain, mood and genitourinary symptoms.
Yes. HRT is known to improve sleep, mood and hot flushes, all of which may disrupt your sleep and lead to tiredness. However, HRT comes with risks and is not suitable for everyone.
1) You are tired ALL the time.
This is often because the oestrogen used in HRT is the most active form of oestrogen and it's also a pretty big dose of it. This oestrogen is very stimulating. If we have already been dealing with quite a lot of stress, our nervous system can struggle to deal with this much stimulation.
During the follicular phase of a woman's cycle as she approaches ovulation, estrogen and progesterone levels rise, preparing the body to release an egg. Women may report feeling drowsier during this phase. After ovulation, estrogen and progesterone levels peak, and sleep may come more easily.
Tiredness. You may feel more tired when you are taking hormone therapy.
Many women take micronised progesterone (Utrogestan) as the progestogen part of their HRT. Utrogestan is a natural sedative and is usually taken at night time, so can cause drowsiness for some women – an added bonus if you're struggling to sleep.
Although rare, swings in estrogen levels can disrupt sleep for some women with premenstrual syndrome (PMS). High levels of estrogen prior to menstruation can cause anxiety, mood swings, and insomnia.
Melatonin plays an important role in regulating human sleep. Administration of sustained-release or transdermal formulation melatonin reduces sleep latency, increases total sleep time, and improves sleep maintenance [12, 13].
For example, estrogen helps control cortisol, the stress hormone. When that regulation is weakened, the increased stress response can result in crushing fatigue. And feeling tired goes hand-in-hand with another common perimenopausal symptom—trouble sleeping.
It can give you more energy, elevate mood, and increase sex drive. It can make sex more comfortable and improve sleep in both men and women. All of these things may help you not only feel better and more confident, they can also spur you to stay active and take better care of yourself.
Symptoms of a high HRT dose: Nausea and vomiting. Breast tenderness and enlargement. Spotting or heavy bleeding.
HRT does come with certain side effects, which tend to be most pronounced in the first few weeks and months of use. If you are unlucky, you may even find that HRT can make you feel worse before you feel better.
Many women actually find that they lose weight by using HRT as it shifts the metabolism back into a pre-menopausal metabolic state. Progesterone can sometimes cause fluid retention which can mimic weight gain, but there are alterations that can be made to the regime to minimise this impact.
The first changes you will probably notice are that your skin will become a bit drier and thinner. Your pores will become smaller and there will be less oil production. You may become more prone to bruising or cuts and in the first few weeks you'll notice that the odors of your sweat and urine will change.
It usually takes a few weeks before you feel the benefits of HRT. It can take up to 3 months to feel the full effects. If you have not felt the benefit of HRT after 4 to 6 months, it may help to try a different type. It can take your body time to get used to HRT.
The sex hormone progesterone not only triggers ovulation but also promotes sleep. It does this by stimulating your brain to produce a neurotransmitter (a chemical that has an effect on your brain) called gamma-aminobutyric acid (GABA). The more progesterone you have, the more GABA you'll produce.
You might feel sick when having HRT. Taking the HRT tablet at night with food instead of in the morning can help with this. Changing from tablets to another preparation of HRT (such as a gel or patch) might also help.
This medicine may cause some people to become dizzy or drowsy. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert. Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine.
Your body needs estrogen for your reproductive, cardiovascular and bone health. Too much estrogen, though, can cause irregular periods and may worsen conditions that affect your reproductive health. Your provider can help diagnose what's causing your high estrogen levels and recommend treatments that can help.
Estrogen helps protect the heart from disease, potentially by maintaining higher levels of good cholesterol, called high-density lipoprotein (HDL), in your blood. Lower estrogen levels, especially during menopause, can increase your risk of developing heart disease.
"A return of night sweats, flushes, not sleeping and so on is very indicative that your hormones are not quite in balance. I recommend all my patients have a blood test once a year as part of an annual review to see where their oestrogen is at and whether an HRT adjustment is required."
A review approximately 3-4 months after starting or changing HRT is a good time to assess both satisfaction with the HRT prescription and its effectiveness in treating menopause symptoms. By this time most start-up symptoms (if any occurred) should be settling.
As estrogen levels drastically change in perimenopause, high levels can cause bloating, breast tenderness, and heavy bleeding. Once these levels become more consistently low, that can cause hot flashes, night sweats, mood changes, changes in fat distribution (new or growing “spare tire”), insomnia, and fatigue.