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Perimenopause and Insomnia

by Vera
(British Columbia)

Hello, I'm 51 and have had very irregular cycles for last 2 years and during this time some very heavy/long bleeds. Also many cycles way too short. Started to have insomnia issues end Nov/early December 2024. Blood work showed very normal/slightly high levels estrogen. Took 100mg Prometrium orally starting Dec 7 every evening almost daily since. In February added progesterone cream twice daily, every morning and night, totally about 50mg. My insomnia has only gotten worse. December was still tolerable, with many nights sleeping 2 to 4 hours several times. This last month and half its horrible! I either don't fall asleep for hours and get in a few short "naps" before morning, or lately, have been falling asleep ok, but always wake up between 1 and 3, and rarely can i get back to sleep easily. Usually i toss for hours and might doze off one more time. I never have sleep issues, the only other time was in 2nd trimester in my last pregnancy 15 years ago for 3-4 months and again briefly after that birth. Both times i'm very convinced linked to low progesterone. Now i'm back to the same insomnia i had then. Over the last week I've started to take more oral prometrium, upping my amounts to between 300-400mg per night. Still having just as bad of sleep. Fall asleep ok, then awake most of night. Am also noticing I am getting flushed in the face and feel warm during the day and when i wake up at night and that didn't happen before at all. I take B vitamins, my Vitamin D was actually high when tested, my iron is low (ferritin storage at 10), am on iron supplements, take 300 mg magnesium daily, etc. I eat almost all organic and am slim. Getting naturopathic help here is so slow (not enough NDs)as is getting test results. I know blood tests aren't accurate but had it done a few weeks ago on day 21 of cycle. Estradiol was at 2328 pmol/L and Progesterone at 23.5 nmol/L. I am wondering if this estrogen dominance can continue for 3 months of taking Progesterone daily? Is my dose of progesterone just too low? Taking the 100 mg oral and 2 times cream daily probably gave me at most 50-70mg per day. Since last week, I'm taking 300mg orally every night plus the 2 times cream so that would give me a bit more. Not sure if i should go off of progesterone and start again or just adjust dose of cream higher. Thoughts on this would be appreciated!
thank you!

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Feb 28, 2025
 Perimenopause and Insomnia
by: Joy

Hi Vera

Peri-Menopause can be a terrible thing for most women. Irregular cycles and heavy/continual bleeding are common symptoms, unfortunately. While we can't change the natural process of the body, the correct use of progesterone can certainly make things bearable.

This heavy bleeding protocol has helped many, perhaps it will help you:

400-500mg Natpro Progesterone Cream per day
2000mg N-Acetyl-Cysteine (NAC) per day
2000mg Taurine per day
5000iu's Vitamin D3 per day
1000mg Bioflavanoids or Vitamin C per day

Insomnia is also common and usually means that your adrenals are taking strain, which will affect cortisol levels. Progesterone helps with this, but this Adrenal Fatigue Cocktail has helped many.

125ml Orange Juice or Grapefruit Juice, you are looking for vitamin C
1/4 teaspoon Celtic Sea Salt or pink Himalayan
1/4 teaspoon Cream of Tartar

Mix the above at the start of the day with enough liquid for two (2) applications i.e. 8oz/125ml of orange juice. Drink it mid-morning, as well as mid-afternoon. In addition, any time that you are feeling particularly anxious it would be advisable to prepare another mixture and take it.

Also look at your thyroid. Did you have this tested and are you taking iodine? Please view this video by Dr David Brownstein. We should all be taking iodine whether we have a thyroid issue or not.

Normal or slightly high/low test levels mean nothing. What is your Vitamin D3 test result? I am pleased that you are taking magnesium, but what about vitamin K2 and zinc? These are most important. A Vitamin D3 deficiency will reduce the benefits of progesterone.

Your progesterone:estrogen ratio is 10:1, it should be around 600:1 before one benefits from progesterone therapy. See Hormone Testing.

No wonder you are feeling horrible. All oral progesterone is not the best Delivery Method as around 96% gets destroyed by the gut and liver. This now aggravates estrogen receptors. Not what any woman wants. Unfortunately, you haven't been advised to use progesterone correctly. The 50mg that you used would also aggravate estrogen receptors making Estrogen Dominance symptoms worse. This will also affect your sleep. If you want to continue with oral progesterone, then please use enough progesterone cream so that it equates to no less than 100mg per day. Use a good quality organic cream such as Natpro, which is a 3% cream. You can also insert the prometrim in your vagina. See if that helps. Switching from 300-400mg is not a good idea, this causes another imbalance. If you use 300mg then stick with that for a week or so, if that doesn't help, then up to 400mg. Also using progesterone now and again is not the correct way to use it. This will cause progesterone levels to spike. See How to use Progesterone Cream.

Pregnancy and or breastfeeding put hormones in a tizz. The body needs to adjust. Who advised that blood and saliva tests aren't good enough? They are more than good enough. It's the only way I test my levels and many other women with no problems at all. Other tests are so expensive. Of course this is up to the individual.

Take care.

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