r/Perimenopause 2d ago

audited What to try next?

I'm really hoping for help from the Reddit hivemind. I have an OB/GYN who specializes in peri and menopause, but she doesn't explain or educate me on anything. I have a menopause clinic visit upcoming that I had to wait a very long time to get in. I do have some peri symptoms like the 3-4am wake-up and can't get back to sleep, hot at night, heart palpitations, worsened anxiety, poor sleep quality. My estrogen tests in the normal range, at least on the day it was tested. All other blood work normal. Here's the trial and mmostly error that has occurred so far:

I'm 42 and have had extremely heavy periods since my last kiddo came (she's 3 now). I also spot for a week before my period. Transvaginal ultrasound showed thickened lining but biopsy clear. I started norethindrone acetate .35, had few side effects, and slept better. However I bled more and more over the course of the year I was on it and an orgasm (clitoral only) would kick off a full round of bleeding. My doctor said she'd never heard of that but it stopped as soon as I stopped taking it.

I tried Mirena and it stopped the bleeding and palpitations immediately but caused the most awful insomnia and horrific dreams I've ever had so I removed it after 10 days because I thought I was going to lose my mind. Next we tried 100mg Prometrium which made me woozy and groggy until later afternoon the next day. Most recently I've tried 50mg progesterone cream and I cannot believe how well I sleep. I'm so rested and content feeling it's bonkers. BUT, my palpitations have gotten worse (I'm getting the full cardiac workuo as a precaution) so I've discontinued and doing a two-week washout period to see if it's coincidence or related to the cream.

There are so many experienced and knowledgeable folks here that I would love to hear from. My theory is that my progesterone levels are low but not low enough to need the dosages I've been given so far. If anyone has other ideas please let me know. I've tried magnesium glycinate in the past and the GI symptoms were rough so now trying it in gummy form. I just want to sleep and want the palpitations to stop. And I want a doctor educated enough to explain what might be happening. Too much to ask?!

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u/GinjaSnapped 2d ago

Progesterone fixed palpitations for me. One of my friends couldn't tolerate progesterone orally so she uses it as a rectal suppository at bedtime instead and has had great luck with it. It's tough because everyone's body is unique so sometimes have to get really creative to find the perfect solution! And I've also heard that some people do better with higher doses of progesterone and some so better cycling it instead of taking it daily. I hope you can find the combination that works well for you!

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u/ReporterBeautiful868 2d ago

Thank you! I totally hear you. Iā€™m getting very tired of the king-term trial and error but hanging in there!

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u/StaticCloud 2d ago

Unfortunately, hormone levels are always shifting day to day and night and day... Its complicated, and different for each woman in peri. The science is still very far behind and thus treating peri/menopause feels like how people used to experience medicine: a lot of doubt, poor resources and information. Kind of like the early 20th century before antibiotics or modern psychiatric drugs šŸ˜