Sleep Issues in Menopause
I don't know about you, but I started to notice a difference in my sleep in my mid 30's. I didn't contribute it perimenopause at the time, but looking back, I'm sure that's what it was.
My mother had always complained about not being able to sleep and so I assumed my issue was more heredity than related to my age and what was happening with my hormones.
Why am I not sleeping?
Sleep is impacted by melatonin, growth hormone, cortisol, thyroid hormones and sex hormones.
This type of interruption in sleep is called hormonal insomnia. It can be caused and is common during pregnancy and menopause.
Hormonal Insomnia Symptoms
If you are losing sleep due to imbalance of any of the sleep hormones, you may experience:
difficulty falling asleep after going to bed
waking up in the middle of the night and being unable to fall back asleep
waking up earlier in the morning than planned
difficulty maintaining a regular sleep schedule
fatigue, irritability, or difficulty concentrating due to lack of sleep
Sleep Hormone Melatonin
Melatonin, often called the sleep hormone, signals your brain that it’s time to sleep. It’s released in your blood in response to darkness. It gets reset each morning when sunlight hits your eyes which is why sleep experts tell you to put your "face in the sun" each morning. Once sunlight hits your eyes, your body knows that about 10-12 hours later it's time to release melatonin so you can fall asleep.
Melatonin production goes down as we age, which is one of the reasons why older people often experience insomnia.
Sleep Hormone Cortisol
On the other hand, cortisol, known as the "stress hormone," tends to peak in the early morning and gradually decrease throughout the day. Elevated levels of cortisol, especially during nighttime, can disrupt the natural sleep pattern and lead to insomnia.
Sleep and Estrogen
According to Dr. Michael Green, MD OB/GYN Chief Medical Officer at WINONA, "There is a direct correlation between estrogen and sleep disturbances. The relationship between estrogen and sleep are well researched, and we know that for many women if they replace the low progesterone and low estrogen, insomnia may finally end. By taking Hormone Replacement Therapy (HRT), you increase your estrogen and progesterone levels and can relieve menopausal symptoms."
Winona Progesterone
Research suggests that progesterone has a beneficial effect on sleep in certain populations, such as post-menopausal individuals and people with sleep apnea. Experts have offered several explanations for what this might be the case.
How progesterone may help:
Progesterone decreases menopausal symptoms
Progesterone may promote sleepiness and reduce anxiety
Progesterone appears to increase your respiratory drive, which may help reduce sleep apnea symptoms.
My initial dose of Progesterone tablets was 100 mg. I was sleeping better, but not as good as I wanted, so I researched and found that some of us need a higher dose, so I shared that with my HRT doc and we decided together to increase my dosage to 200 mg and BINGO that was the perfect for me.
Sleep Disorders and Menopause
What's a post-menopause woman to do? If you have already established a bed-time routine with all the noted recommendations, then it may be time to get your progesterone and estrogen levels checked by an HRT doctor or specialist.
Hormone Replacement Therapy, specifically estrogen and progesterone may help by helping to regulate neurotransmitters that affect our sleep-wake cycle. At the right levels, estrogen will help keep your body temperate low at night, which can help reduce hot flashes and lead to more restful sleep. Research also suggests that progesterone and estrogen may protect women against sleep apnea. However, menopause cancels out that benefit, and older women are just as likely to develop sleep apnea as are men.
Which HRT is best for sleep?
Hormones aren’t the only things disrupting your ability to get a good night’s sleep. “It’s not as black and white as hormones decrease so sleep decreases,” says Lubna Pal, MD, an endocrinologist at Yale Medicine. The symptoms of menopause, including hot flashes and night sweats, may underlie many of the sleep problems that peri- and early menopausal women commonly encounter, she explains. For women facing these challenges, estrogen replacement therapy may help them to sleep more soundly.
Bioidentical hormones are plant derived, FDA approved and are available by prescription from an HRT doctor or specialist.
If your sleep isn't the quality you would like, it might be time to find an HRT specialist or medical professional who can review your medical history, discuss your menopause symptoms and your poor quality of sleep. There is no reason to give up good sleep when there are natural HRT products out there that may help.
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