@angierivas1 It’s good that your appointment in GYN is coming up so soon. The symptoms that you describe are what I had when I was peri-menopausal (I’m 71 years old). When I entered the post-menopause phase the night sweats and hot flashes went away. But the vaginal burning during and after intimacy remained. I had very little help from the providers I consulted with at home. In retrospect I’ve realized that they just did not know what to advise.When I was referred to the Women’s Menopause and Sexual Health Clinic at Mayo Clinic in Rochester, MN I met with providers who were experts with this. It was such a relief to be helped by providers who know that sexual intimacy is an important aspect of our well-being and they even met with me and my partner together.

If you cannot take HRT, can you ask the gynecologist if you are a candidate for vaginal estradiol? This is an estrogen product and I learned (at Mayo Clinic) not to insert into the vagina as the package instructions directed. Instead I put just a little on my finger and gently massaged it into the lower inner lips of the vulva and lower vagina. This is apparently where it does the most good. I’ve been advised that I can no longer use the estradiol because I had a recurrence of ER+ endometrial cancer so the oncologist advised against it. Still - and this is important - vaginal estradiol is applied topically. Very, very little is absorbed into the bloodstream. If your gynecologist thinks this might be a possibility maybe you can ask about taking progesterone - even as a transdermal cream. It’s just an idea I’ve had but I would not do that without the OK of my doctor.

I have other moisturizers I use that do not have any estrogen on the advice of my doctor. These do work well and are an option.

As for sleep? Yes, restful sleep was and is an issue for me peri- and post-menopause. Maybe your doctor will have some ideas of what you could do if you cannot take HRT. There are cognitive-behavioral approaches to sleep hygiene that are helpful too.

I hope all of this rambling is helpful to you. Will you let me know if you have other questions or other ways I might be supportive to you?