I had my hormone levels tested by blood and they came back normal, not menopausal. I asked for a copy and hopefully will have soon. I am age 40, and for the last 18 months I cannot get a good nights sleep. I start waking up about 2 hours after I go to sleep, I always go right back to sleep, and will continue to do this until the morning. A good night is two awakenings, a bad night is 6-7 awakenings. The good nights are usually a result of having a sleep aid. This is a every night occurance. I have been to a sleep doctor and had a sleep study which shows I have very mild apnea and shouldn't cause me to be this tired, plus I only have them on my back which I hardly ever sleep on, mostly stomach. I was given a CPAP and have used it faithfully and it has helped me feel about 10% better, but I am still very tired and fatigued. I have been to 5 different type of doctors and none can find anything, thyroid is fine, iron levels are good, blood count is good. I really had to push to get my hormones checked and then they only tested for FSH, LH, Testerone, Progesterone, Estrogene.

I have consulted several doctors in the past year and am very frustrated that I cannot seem to find relief on this issue. I had hoped my hormone levels were out of wack and maybe that would explain the fragmented sleep issue. I have seen insomnia on the boards but not this type of sleep problem. I have noticed other things on the list but not any major ones and some seem like they are more from lack of good sleep.

I will note the sleep study was inconclusive, I did not sleep well with all the wires and on my second study the tech woke me to turn to my back and was not able to get back to sleep even though I had taken a sleeping pill, so the CPAP was given as a experiement and then I had APAP to see if I had a correct pressure and it showed pressure is fine and apneas are minimal and shouldn't cause me any problems.

Any feedback is much appreciated since this has been on going and am desperate for a good nights sleep. I dread the thought of having to take a sleeping pill everynight to get a good nights sleep and even then its not great. For now I only take one about every 6-7 days when I need some decent sleep.

Karebear - this reminds me of when my kids were babies. They would wake at regular intervals (multiples of exactly an hour), grumble a bit & then settle themselves off to sleep. I think a lot of it is about getting into a bad routine. Your subconscious carries an amazing clock and is probably expecting you to wake. Maybe you could try a mild sedative for a couple of weeks to break the habit & get into a better sleeping pattern. Or try going to bed really late one night so that you might sleep through the first waking time. I know with my kids they gradually dropped these waking "appointments" one by one by us trying things like that. Maybe it might help adults too?

KareBare-I feel for you-a bad nights sleep is a recipe for a bad day to follow-I'm 54 and have had sleep issues for the last few years-mine seem to be from night sweats and creepy dreams-I usually wake around 2:00 and it's pot luck if I get back to sleep-I can lay there for hours waiting for morning and it's awful and the next day I feel wiped out and I over react to every little thing and make myself and everyone else miserable-sleep is serious stuff-it sounds like you have really covered your bases for a medical reason-squiggles idea makes sense-try to reset the system-it's worth a try-I hope you find an answer-hang in there

My hormone levels also came back as normal,but my dr admitted she believes I am in peri.I too did the every two hrs wake up thing-I thought I was going to lose my mind.When my bcp finally kicked in(yasmin)it started going away,But I truly believe GOD gave me my sleep back.I have an off night now and again,but I am better.The problem you are talking about is very debilitating,and it made me very weepy,anxious and TIRED!!I truly hope you find relief soon.GOD bless.

Have you tried any natural/over the counter products to help you sleep? I am 45 and several years ago I started having a horrible time sleeping. I started taking 5-HTP and it helped a huge amount. In the past few months I added the amino acid GABA and it helps as well.

As we get older our production of the hormone melatonin decreases. Without enough melatonin we do not sleep well. You can take melatonin or it’s precursors. Melatonin makes me sleepy the next day so I do not like it. Precursors to melatonin are tryptophan and 5-HTP (take one or the other, not both). I have read that tryptophan has less possible side effects than 5-HTP so it is probably better to try it first. Tryptophan used to be hard to get (back when my sleep problems started) but it is much easier to find now. GABA is an amino acid that makes you sleepy. If you decide to try these, start with a low dose and go up. If I take too much GABA I get a headache and if I take too much 5-HTP I feel like I overdosed on Sudafed and cannot sleep. When I started with 5-HTP I had to cut my 50 mg tablet; my dose was 1/4-1/5 of a 50 mg tablet. My dose of GABA is about 250-500 mg. When you take amino acids you need to make sure you are taking them on an empty stomach close to bedtime so that other proteins do not compete with them.

Kathy

I have tried Melatonin, makes me sleepy but stay in light sleep on it, very strange and wake more than normal for first hour. I have also tried Valerian without much luck.

I have not tried the 5-htp, or GABA. I recall reading something about 5-htp and there was something that was a warning not to take it if you were taking something or had a tendency toward something. Will have to recheck it and see if I can figure out what it was and if I still need to be cautious with it.

I was really hoping it was my hormones off balance but since the test results were normal, I guess not. I had read that if you are declining in Estradiol it can affect your sleep.

Karen

Karen,
I had the same problem in y early 40s: fall aleep, then wake up, and then go back to sleep, etc. I used to wake up at 2 am and toss and turn until 4-5 am, and then I was a mess all day. it is a sing of swinging hormones and dropping estradiol, I knwo it now. I am 50 and still not menopausal according to my blood test and regular periods, but frequent awakening at night is worst. I take xanax before bed, otherwise, i would wake up with pounding heart either from panic or bad dreams, so xanax helps to sleep through the night. Good sleep quality is crucial for one's health, so try to find either natural herbal remedy (valerian helps too), or some Rx medications just so you can get uninterrupted 7-8 hours of sleep.
I believe isnomnia is 100% hormonal and awakening at night is due to overworked and overstressed autonomic system, which is typical during perimenopause, and poor quality of sleep makes it all worse. Kinda vicious cycle, so try to sleep through the night, at any cost, and you will feel the difference. I was zombi-like at one point: fatigues, bags under eyes, brain fog. Once I started to sleep thorugh the night, I feel much better. Oh, alcohol and caffeing close to bed is bad idea too, as well as late dinner.
HTH,
I.

Karen,

Just because your hormone levels came out “normal” does not mean that they are not declining or “normal” for you. Do you have any other low hormone symptoms other than sleep problems? You could ask your doctor for a trial of topical estradiol to use before bedtime to see if it helps you. You could also just buy some on the internet and try it for a few nights. If it works you could go back to your doctor and ask for a RX. If you decide to try it, start with a really low dose and work up if necessary. When I first started triest my dose was 1/32 teaspoon and it helped me feel so much better. If you take too much estradiol you will know it because your breasts will become sore and swollen and you will retain water—just cut back. If you make a habit out of estradiol you will also need to add progesterone to protect your uterus (if you have not had a hysterectomy).

Do you have any of the women’s hormone books yet? Natural Hormone Balance for Women, by Uzzi Reiss is helpful in figuring out signs and symptoms of low/high hormone levels.

I think there may be some warnings about 5-HTP just because doctors do not know much about it. If I were starting over I would use tryptophan instead because both 5-HTP and tryptophan convert to melatonin in the presence of darkness. I would first try about 250-500 mg and go up as needed. Some of the women here use Valerian Root and I think it may help them. I never tried Valerian Root because it is supposed to increase your GABA levels; I take GABA instead.

Kathy

I also have fairly bad sleep problems going on several years now. I have all kinds symptoms of delclining estradiol and my blood tests always come back low but because of my age, no doctor I've seen wants to give me hormones. I'm 32 and menstruating regularly. If I use a little estradiol topically or in a patch, will this screw up my monthly cycle? I always thought it would...but I really need to do something because I'm too young for some of these changes, especially this sleep thing. If only I knew I wouldn't mess me up worse.

You could also just buy some on the internet and try it for a few nights.

Where would I be able to get Estradiol without a rx? I thought you needed a rx tp get estrogen hormones. I think I am going to have to find a new doctor because the one I'm seeing does not seem to interested in bios.

In the past two years I have developed GERD, nausea, low libido, generally haven't felt well, irritable (up til now I have assumed the irritable, fatigue, and mild depression have been sleep deprivation). Don't know if they are peri-menopause are not. One thing I noticed and cannot figure out is one minute I'm fine and then five minutes later I have to go to the bathroom now. Is that a sign or something else. This started about 9 months ago, it reminds me of when I was pregnant only then it was my bladder being pressed on.

Karen

Sleep? What's that? I fall asleep ok around 10:00 after reading for awhile, but then I have seen 12:00, 2:00, and 4:00 and hope to fall back to sleep before morning. And I get to watch hubby snooze away all night. My wake ups are usually from being too hot. Falling to sleep is hastened by too many thoughts about what I have to do the next day, week, year etc. So many problems escalate in the middle of the night. I've tried books, crossword puzzles, (never tv) and eventually I'll fall back to sleep. This is a common occurance and I feel like the days of having a newborn around. Only now, I'm the one waking every 2 hours!
Mary

Teal,

Dr. Vliet in Screaming to Be Heard talks about using extra estrogen as necessary. Dr. Reiss in Natural Hormone Balance for Women does as well and has a segment in his book about estrogen for younger women. Dr. Reiss will say that you need to take extra progesterone along with your estrogen though but Dr. Vliet has a different opinion (you only need it if your progesterone levels show that you need it. You have to be careful though because one month you may make enough progesterone and the next month you may not. Personally, I am afraid of endometrial buildup so I would probably want the extra progesterone. The book by Dr. Reiss is easier to read than Vliet’s book but I would recommend that you read both of them. Just be aware that Dr. Reiss LOVES progesterone and some of his dosing may be off. Vliet is more reasonable about progesterone. Reiss likes triest, Vliet likes estradiol in patch form.

What you may want to think about and research is that if you are not producing enough estrogen you may not be producing enough progesterone either. Without enough progesterone you may get endometrial buildup which can cause heavy bleeding and other problems which include endometrial cancer at the far extreme. If you read through the forum you may notice women having heavy bleeding all of a sudden—This may occur because they have some of their own estrogen but they are no longer producing progesterone. Without progesterone the endometrium builds up creating lots of problems including heavy bleeding when the buildup finally decides to slough off.

A small amount of extra estradiol should not mess up your cycles. If you get patches you may wind up having to cut them though. Adding estradiol does not diminish your own estradiol production.

Have you tried getting a referral from your local compounding pharmacy? Talk to the pharmacist who deals with women’s hormones and tell him/her your story and ask for the name of a doctor that will give you what you need. Pete on PowerSurge (Bellview Pharmacy I think) may be able to help you as well.

Kathy

KareBare,

Have you had your thyroid levels chacked? Prior to being diagnosed with hypothyroidism I was having the same sleep issues. (I am having them again now but this time it is perimenopause). The symptoms of hypothyroid are very similar to perimenopausal symptoms and the thyroid interacts with all of the other hormones. Also, thyroid problems usually begin to show up in women in their 40's. I would suggest having that checked. I would have sworn I was in perimenopause based on all of my symptoms. I was totally foored when the doctor said it was my thyroid.

Good luck.

My thyroid has been checked twice in the past year and both times it was fine, same with iron levels. I am at my wits end on this and can't imagine sleeping like this for the rest of my life.

Karen

Okay, I got my test results in the mail and am having trouble interperting them. They are:

LH 6.9 MIU/ML
Estradiol 22 PG/ML
FSH 15.8 MIU/ML
Progesterone .4 NG/ML
Testerone 25 NG/DL

Any ideas or opinions as to whether these could cause the sleep problems.

Thanks,


Karen

I recommend ear plugs !! My sleep is drastically improved when I sleep with them, leading me to believe that many of my mid-night wakeups are due to me hearing noises.

I have high quality foam earplugs, Deci 4200. They are very soft and very comfortable. It does take some getting used to, the stuffy feeling and hearing your own heartbeat. :-) But it's a very cheap and easy and presumably 100% safe and side effect-free sleep aid. Might as well give it a try before you attempt any more elaborate solution.

Karen,

Will you post the ranges (normal values) that came with the results?

Kathy

Sandra,

That is a really good idea. I use ear plugs, a loud fan right next to my head, and a pillow over my ear. That sounds like too much but with the snoring from my husband it is impossible to sleep without this extra help even with my 5-HTP and GABA.

Kathy

My only problem with ear plugs is that I need a much louder alarm clock. :-) Sometimes I sleep right through the alarm from my current clock.

Sorry bout that

LH 6.9 normally menstruating follicular 1.9-12.5
Estradiol 22 pg/ml follicular phase (-12) 19-83
(-4) 64-183
FSH 15.8 MIU/ML Normally menstuarting Follicular 2.5-10.2
Progesterone .4 ng/ml Norm. Menst. follicular 0.2-1.4
Testerone 25 NG/DL 14-76

The estradiol is the one I am most confused about. I don't understand the # in parathesis.

My blood was drawn two days after I started my monthly cycle.

Thanks for any feedback

Karen

Karen,

I do not know what the -12 means either.

It looks like your estrogen is on the low side of “normal”. Low “normal” for me means that I feel terrible. I think that if I were you I would ask for a trial of estradiol to see if it would help. Your doctor may not want to give it to you though because he thinks you are “normal” but you could think about the internet option that we discussed earlier for your testing. You could try a small dose an hour or so before bedtime and see if it helps you. I think a small dose would be about 1/32 of a teaspoon and go up very slightly each night if necessary; if you get excess estrogen symptoms (sore breasts/water retention, cut back). I think that the only way to know for sure is just to try it. Do you have your sleep problems all month or are they worse around your period when your estrogen is lower?

I cannot remember if I recommended any books to you. Natural Hormone Balance for Women by Uzzi Reiss has good information about estrogen and dosing. He likes triest though, substitute estradiol gel for triest when you read the book. Dr. Reiss thinks low estrogen can cause sleep problems. He wants women to try estrogen for a couple of weeks to get dosing correct and then add in other hormones as necessary.

Kathy

Thank you so much for your replies. I think I will try a estrogen product. I went to a compounding pharmacy and did a consult and they want to do the estradiol with progesterone. I have a question in to them about the progesterone. I thought the amounts they wanted to do were a bit high. I have read that Progesterone can cause dizziness and since I have a medical condition that can bring on vertigo attacks I am a little scared about that. If I get my questions answered and my doctor approves the rx hopefully I will be all set to go this week.

Hope this helps with my sleep issues, even a little will be an improvement.

Karen

Karen,

Do they want to mix the progesterone with the estrogen? Don’t let them do that because then you will not be able to tweak your dosages. Be really careful with progesterone especially if you think the dose is high. Doctors do not agree on progesterone doses and some of us have found that the high doses recommended by some doctors and pharmacies are way too high. For example my compounding pharmacy told me I could use several hundred milligrams of topical progesterone/day—that is way way too high (see dose below).

If they want you to take progesterone every day it may make you feel bad. I try to take it for only 10-12 days/month because I do not feel as well when I take progesterone. You can take oral, vaginal, topical, and sublingual progesterone. Each route has its plusses and minuses and the dose for each route are different. For example if you take oral progesterone you should take 200 mg for 10-12 days/month (cycled) or 100 mg every day (continuous). Vaginal progesterone is probably 50 mg for 10-12 days/month. I am not sure about topical but I think the dose is low (10-20 mg—Sandra Smith here knows about topical progesterone). If she does not respond you could PM her for advice or look at her posts.

Do you have the names/amounts/routes of the estrogen/progesterone handy so you can post it?

Kathy

Karen,

I am with Kathy; do take the estrogen and progesterone pills separately. I take .5 mg estradiol/day continuously and 100mg progesterone (10-25 days of my cycle). My doctor wants me to try adding more progesterone in cream form this month (15- 25 day)to see if it improves my sleep... will see what happens.

Let us know how you do.

Plumeria

Thank you for that advice. I just called my pharmacy and asked to them to do them seperate at least for my first month to see how it goes. I do not have the amounts, but they agreed to half the original amount we discussed on the progesterone because of my concern with dizziness. Saind I would have to pay two copays, but would rather be cautious for now.

I am going to get Reiss' book from our library today and see what it says. I am still waiting for the doctor to approve the rx, she was in a different office yesterday and hopefully today the pharmacy will receive it.

Feel like I am coming down with my daughters cold, was hoping to try the hormones this week but may wait til over cold. Don't want to many things going on at once.

You all have such good thoughts and advice, I thank you for helping me get started.

Karen

Karen,

I really like the book by Dr. Reiss. However, he LOVES progesterone. I think he thinks we all need to be pregnant all the time! Anyway, just be aware that if you follow the progesterone advice in that book you may have difficulty. I tried to “maximize” my progesterone as he suggests and I have a pregnancy line below my umbilicus. It is fading but reminds me every day to take the minimum rather than the maximum. Dr. Vliet is much more reasonable about progesterone. If you follow her advice you will probably feel better. Dr. Vliet likes patches and Dr. Reiss likes triest. I have not tried patches but I like topical estradiol better than triest.

I would start my estrogen sooner than later; it may help you feel better with your cold if you can take the right amount. When we are sick we can use up more of our hormones so we probably need them then more.

Kathy

Good point on the using more hormones when we are ill. I am still waiting to hear from the pharmacy so it might be out of my hands anyway. I have Vliet's book It's My Ovaries Stupid, but haven't seen dosage amounts in it. I will pick up her other one and see what she says as well.

I am approaching mid cycle so should I hold off on the progesterone and try the estrogen alone or try both since I will be in mid cycle in 3 more days?

Karen

Karen,

At one time, my doctor took me off completely from progesterone because she thought that the tinnitus (ringing in the ear) may be cause by it, so I was only on estrogen alone for one month. I asked my doctor of the danger of doing this and she said, it will not hurt if we do it for a month... it is the prolong use of estrogen without progesterone that may cause problems.

So anyway, I think it would be okay to do the estrogen only for this month and see how you feel, then next month, introduce the progesterone.

Plumeria

Karen,

I forgot to add that I don't think you should increase your estrogen when you are sick, just my opinion.

Plumeria

I'm not going to add extra estrogen, only start my rx when it has been approved by my doctor. That is good to know that using estrogen for a short period of time for a trial will not cause long term health issues. My plan is when I pick up my rx to review the dosage amounts and then determine if I should start with just the estrogen or both. I asked that they be dispensed seperately so I have some versatility at first and can tweak the amounts if I need.

I will post amounts when I get the rx to see what you think. You have been very helpful and informative, thank you so much. Well need to get some rest, I think I have my daughters cold, hooray.

Karen