Started these about 18 years ago and thought it was the menopause (about 40 at the time). Been on and off HRT since then - told I have to keep off it by GP but they are back with a vengeance. Wondered if the PBC is a contributory factor - liver affects hormones so would this have an effect. With the tiredness of the PBC and waking up throughout the night with hot flushes - thankfully do not suffer too bad with the itching - have trouble staying awake during the day! Anyone else in a similar situation? Saw consultant today he doesn't seem to think there is a connection but as we all know - they do not know everything!!