How to Cope With Hormones and Sleep Problems During Perimenopause

According to CDC research, 25% of perimenopausal women have trouble falling asleep more than four nights per week. Even more have trouble staying asleep, and over 50% of surveyed women don’t wake up feeling rested during most of the week. These numbers are powerful confirmation that sleep duration and sleep quality are often serious concerns during the transition to menopause, and they’re affecting huge numbers of women across the globe.

If you are approaching menopause and struggling with hot flashes, night sweats, insomnia, or any other nighttime discomforts, your hormones could be to blame. In fact, sleep problems are often the first noticeable signs that a woman is entering perimenopause—the years leading up to the complete cessation of your menstrual cycle.

These sleep problems can be frustrating, disruptive, and unhealthy for your mind and body. But by understanding the cause of your perimenopause symptoms, practicing at-home strategies to lessen their severity, and seeking treatment as needed, you can go through the menopause transition with less exhaustion and more restful nights.

How Hormones Cause Sleep Problems During Perimenopause

Sleep involves a number of complex hormonal interactions in the body. While we’re asleep, our bodies produce higher levels of growth hormone, ADH, melatonin, oxytocin, aldosterone, and prolactin—chemicals that control everything from urine production to tissue repair to the content of our dreams. Additionally, sleep helps our bodies regulate levels of leptin, ghrelin, and insulin in order to signal and manage hunger. And we produce cortisol, a powerful stress hormone, shortly before we wake up to help our minds feel alert.

Female sex hormones like estrogen and progesterone are also crucial to the body’s sleep cycle. When these hormones gradually decrease during perimenopause, women may experience sleep problems due to the way these powerful hormones interact with other chemicals in the brain and body. Significantly, sex hormones seem to have a significant impact on temperature regulation, for example, which could explain why hot flashes occur during the night for women in perimenopause. Disrupted temperature regulation would also result in shorter REM cycles and less restful sleep overall.

Of course, not all sleep disturbances are directly caused by sex hormones. For example, sleep apnea and restless leg syndrome tend to be more common in women of menopausal age, but this is believed to be a coincidence rather than the result of changing estrogen and progesterone levels. If you’re dealing with sleep issues that go beyond insomnia and night sweats, you might want to consider seeking help from a qualified sleep specialist who can diagnose your symptoms appropriately.

Home Remedies For Hormone Changes and Sleep Problems

Many women try to address their perimenopause-related sleep problems on their own through home remedies and over-the-counter drugs. The problem is that natural remedies for hormone-related sleep problems are a bit of a mixed bag.

You’ll find hundreds of sleep-related products at your local drugstore or supplement shop—from lavender extracts to melatonin pills to natural progesterone cream. But there’s no guarantee any of these products will work for your symptoms, and they may come with unwanted side effects depending on how often you use them. Meanwhile, over-the-counter sleep medications can come with their own set of uncomfortable side effects and potential health risks and may not provide the relief you need.

If you’re interested in trying over-the-counter products, be sure to do your research and, ideally, consult a qualified hormone health practitioner before incorporating them into your daily routine. Even though these items are sold without a prescription, they could have significant effects on your hormones and end up doing more harm than good.

The only “home remedy” that’s guaranteed to help improve your sleep is practicing good sleep hygiene. We recommend including the following tips into your daily routine:

• Sleep and wake at the same time every day to help regulate your body’s natural circadian rhythms. Also plan on getting plenty of sunshine in the morning and midday.
• Don’t eat, exercise, or use electronics in the two hours before your bedtime.
• Avoid caffeine, alcohol, and nicotine as much as possible—but certainly after 4 pm.
• Wind down with calming relaxation techniques before bed. Try an herbal bath, journaling, breathing exercises, or meditation.
• Keep your bedroom cool, dark, and quiet (using white noise if it’s helpful for you).
• Sleep with a cold compress beside your bed in case you need to cool down quickly after a hot flash.

Treating Hormone-Related Sleep Problems With BHRT

If home remedies aren’t doing enough to address your sleep problems, the next step may be to seek help from a certified hormone health expert who can measure your hormones and prescribe medications that produce real results. Significantly, this typically doesn’t mean prescription sleep aids. In many cases, low doses of bioidentical hormone replacement therapy (usually a combination of estrogens and progestins) can provide all the help your body needs.

The practitioners in the BodyLogicMD network have seen firsthand that hormone replacement therapy has helped countless perimenopausal women who struggle with sleep. But this claim is also backed by a significant amount of clinical research. For example, a recent meta-analysis on menopausal sleep quality confirmed that hormone replacement therapy improved sleep quality in women who experienced hot flashes and night sweats, according to self-reported sleep questionnaires.

Sleep problems can be exhausting. But you don’t have to deal with them alone. By seeking help from a hormone health expert, you can alleviate the discomfort of changing hormone levels and sleep problems—and could minimize the risks of cognitive decline, diabetes and obesity, and cardiovascular disease that come along with them. You can get back to living your life and managing your health for now and for many years to come.

BodyLogicMD is a nationwide network of board-certified hormone health practitioners. These practitioners specialize in helping women address the symptoms of perimenopause—including hormonal changes and sleep problems. BodyLogicMD-affiliated practitioners take an integrative approach to health care and will create a fully customized treatment plan that fits your needs based on a combination of bioidentical hormone medications, nutrition counseling, and lifestyle advice. To take the first step toward a full, restful night’s sleep, contact a local practitioner near you. Or, take the BodyLogicMD Hormone Balance Quiz to learn more about hormones and how they impact your daily life. 

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended diagnose, treat, cure or prevent diseases.

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