HRT and insomnia?

TLDR: has anyone experienced worse luteal phase insomnia after starting HRT? How long after stopping do hormones level back out?

Sleep has always been a challenge for me. Lately it’s really bad, even worse than when my son was a newborn.

For reference: I’ve been on Olanzapine since Dec ‘23ish. It helped with sleep while I was on Prozac, and I stayed on it after stopping Prozac because it helped so much with sleep. I was also on Yaz and it seemed like a good combo, I didn’t have anymore pre-period insomnia for several months.

Then it started creeping back in. I discontinued the Yaz at the end of last year. It wasn’t helping and I didn’t want to deal with the other side effects anymore.

I started HRT in late February of this year. I started with 100 mg progesterone and .025 mg estradiol patch. At some point we increased it to .0375.

Things went well until June of this year when I had the first of one of these terrible insomnia cases. Before this I was sleeping so great, even needing to force myself to get up most mornings which hadn’t been the case in years! But it started with waking up at 2, then midnight, then 11, then not being able to sleep at all until after 2 AM and not past 5:30 AM.

I was advised by a psych nurse to discontinue the estradiol. After my period started in July I was on just the progesterone and olanzapine. I slept GREAT for four weeks and then boom, the insomnia came back. That cycle ended up being over 50 days but again, it was two weeks before my period that it started.

I was advised by an OBGYN to “taper” off the progesterone since it wasn’t helping with sleep by taking it every other night. I took the last one on 7/31.

My sleep this last follicular phase was better than during the previous luteal, but back to still being less than great (5-6 hours a night). I’m silk in the process of tapering off Olanzapine and I’m back on my original dose before we do a more gradual step down.

But I’m in luteal phase insomnia hell.

I’m so tired of people telling me to try melatonin or magnesium. I do everything you’re supposed to do for sleep hygiene.

I’m seeing an endocrinologist and had lab work done this morning to check thyroid/DHEA/cortisol. I’m just so scared it will all come back normal.

And I think that’s really the heart of why I’m posting - I’m just scared and I don’t know what to do. Sleep doctor says it’s an OBGYN thing since it’s cycle related, OBGYN says it’s a sleep doctor thing. And the Midi clinician’s only idea was to increase the estradiol.