Has anyone else experienced this during (peri)menopause?

Since September, I have been experiencing hot flushes during the day and terrible night sweats (the latter being much worse than the former), despite being on Estrogel and Utrogestan prescribed by Hertoghe doctor. I have been using Estrogel from day 5-25 of cycle and Utrogestan from day 15-25 for the past six years, so since I was 42. All of a sudden, they did not seem to help at all.

I raised this with my OB/GYN who ordered tests (estradiol and testosterone). I went to the lab on day 23 of cycle (so luteal phase). My estradiol levels came back slightly elevated (565 pg/mL; ref luteal phase 21-312). FSH 2.7 UI/L (ref 1.4-5.5), LH 2.7 UI/L (0.6-14). Testosterone 0.38 ng/mL (ref 0.10-70.0).

My estradiol levels were what you'd expect to see during the ovulatory phase.

My OB/GYN said she thinks my body produces too much estrogen on its own, so I went off the Estrogel immediately. She also prescribed an OTC product (Abufene) to help with the hot flushes.

However, the hot flushes and night sweats have continued, keeping me awake at night. On a typical night nowadays, I go to bed around 9 pm, read for a while, fall asleep around 10, then wake up some time between 1 and 2 am and either cannot go back to sleep at all, or lie awake until 4 or 5 until finally going back to sleep...only to wake up exhausted. I rarely sleep through the night nowadays...and I have never had any problems falling or staying asleep, and I used to look forward to going to bed at night. Now, I dread it.

Last night, I decided I could not stand another night like that, so I applied the usual dose of Estrogel before going to bed. What happened was that I fell asleep around 10 pm as usual, woke up around 2 am, decided to get up at 5 am but then must have fallen asleep as all of a sudden the alarm went off. The only difference compared to previous nights is that, last night, I did not sweat at all.

Has anyone experienced anything like this during (peri)menopause? I was given a clean bill of health this summer. That was about a month before the problems started. My OB/GYN has not found anything abnormal either (apart from my slightly elevated estradiol levels).

I would be interested in finding out about other people's experiences, as I read that hot flushes and night sweats typically last 4-5 years, although I am not sure if this applies to women who use HRT. So I am trying to find out as much as possible about this condition, so as to be able to live with those symptoms as comfortably as possible.

To sum up: I started having symptoms (hot flushes and night sweats) of low estrogen while on HRT (bio-identical E and P), went off it after labs showed elevated estradiol levels, after which the problems continued and even got worse.

My OB/GYN thinks I'm hyperthyroid because my TSH is suppressed on NDT, although my FTs are in range. But my hot flushes start in the chest and then rise to my neck, face and scalp, sometimes making me feel like I've washed my hair...so I'd say a typical hot flush, as it does not affect my whole body, only my upper body...

It would help to know if others have experienced the same thing or something similar, and if you found something that helped.

[Naomi8]

I am now 67.When I was perimenopausal I could not take HRT in any form when the hot flushes & night sweats started,as I had fibroids-which run in my family & are deemed symptomatic of oestrogoen dominance.

You could be low in progesterone,leading to oestrogen dominance now you are entering perimenopause.It could be worth testing for this.

I used transdermal natural progesterone cream & also agnus castus in capsule form & they definitely helped.I avoided anything that may mimic oestrogen in the body eg phyto-estrogens like wild yam,soy etc.

I have since done a genetic test(23&me) that confirms I have predisposition to oestrogen dominance through a genetic inability to process it.

Since my perimenopause MACA has become very popular for balancing hormones.I do not know if this "adaptogen"could help.

Your symptoms sound like classic menopause symptoms.Not everyone finds HRT resolves these,even bio-identical HRT.This could be due to a drop in progesterone as menopause approaches or other reasons for oestrogen-dominance.

[Hidden in reply to Naomi8]

Thanks for your input and suggestions!

As far as I know, progesterone is only supposed to be taken for the second half of cycle before menopause, and then it's possible to take it from day 1-25, but it should never be taken continuously?

Anyway, I was recently put on Duphaston (dydrogesterone) by OB/GYN to treat an ovarian cyst, and dydrogesterone is apparently made from wild yams...it seems my problems have got worse in the past couple of weeks, but maybe that's just a coincidence...?

My hormone doctor whom I've contacted says hot flushes and night sweats are indicative of low, not excessive, estrogen. However, my most recent labs show out of range estradiol levels, there is no way denying that. Which has made me wonder if I should simply go off estrogen for a while, take Duphaston for the prescribed three months, and then go back to Utrogestan for ten days a month...?

At least my most recent labs show I don't risk dying from a lack of estrogen...!

[Hidden in reply to Hidden]

PS. One things strikes me as odd: my hormone doctor told me to continue to use Estrogel, but apply it at night instead of in the morning to see if that improves my sleep...which seems odd since my most recent labs showed excess estrogen. My OB/GYN, on the other hand, told me to go off estrogen altogether which makes more sense to me...after all, why take more of something you already have in abundance...?

In this context, the theories of Dr. Christiane Northrup makes a lot of sense to me (that is, that many peri-menopausal women are estrogen dominant rather than deficient). I think I will stay away from estrogen for a while and use progesterone only. After all, it cannot hurt, and might even prove helpful...

[Naomi8 in reply to Hidden]

Google natural progesterone cream information.Most Doctors dismiss the importance of falling progesterone levels at perimenopause.They only see oestrogen as an issue at menopause,not hormone balance.From what I have read,having thyroid issues increases the relevance of balancing the sex hormones.

Also,some doctors use only artificial progesterone,which has different effects.

The fact that your two health practitioners are contradicting each other with regard to oestrogen use says much!

[Hidden in reply to Naomi8]

True! My OB/GYN has never even mentioned progesterone, much less had it tested...the more I read about this, the more I feel that there needs to be a proper balance between the two main female sex hormones (E and P), and that more is not always better...

[lily82]

Just a tip for night sweats- get a climate control duvet.

[Hidden]

Thanks to all of you for your help and advice!

From what I've read, if your symptoms are caused by fluctuating hormone levels rather than hormone deficiencies, there really isn't much to do, as adding hormones at that stage tends to make things worse...it makes sense to me not to take a hormone you have too much of, so I will stay away from estrogen for a while, continue to take Utrogestan for 10 days during the second half of cycle, and see if there is any improvement.

I also read that, about a year after symptoms such as mine appear, a woman will get her last period. At some point, hormone levels must stabilize. However, I wonder when that will (hopefully) happen; as soon as I've had my last period? Or after twelve months without a period, at which point I can assume I am fully post-menopausal? Or even longer...?