Betty came to visit me last winter. She was a funny patient with a serious
"When I wake up at night with one of my 'power surges,' I feel like I
could heat a small country. And I am having a hard time sleeping because my
husband's teeth are chattering so loudly from my keeping the window open. Doc,
it's December, but my body thinks it's July."
1. When can I stop worrying about getting pregnant?
2. What kind of birth control is best for me during perimenopause (the time leading up to menopause)?
3. How might my sex drive change as I approach menopause?
4. I'm not in the mood for sex as much as I used to be. Is it because I’m going through menopause, or could it be something else?
5. What can I do to get my sex drive back?
6. What can hormone replacement therapy do for my sex life? What are the risks?
7. What do I do about dryness...
Welcome to the signs of approaching menopause. In addition to hot
flashesand mood swings, many of
my patients report difficulty sleeping. Although some 40% of premenopausal
women report sleep problems, this percentage can double from the onset of perimenopause (the transition into menopause,
beginning as early as the late 30s for some women) through postmenopause.
That's a lot of women missing out on a good night's sleep.
During this transitional time, the ovaries gradually decrease production of
estrogen and progesterone (a sleep-promoting hormone). Hot flashes, typically
accompanied by a surge of adrenaline, can result. And when they happen in the
middle of the night, a woman may find it very hard to settle back into
How can women like Betty improve the quality of their shut-eye? Consider
some of these simple solutions to minimize the impact of sleep-marauding
Stay cool. Keep a damp cloth or a bucket of water nearby to
cool yourself quickly if you wake up feeling hot and sweaty.
Consult your doctor. If you have difficulty sleeping after
age 35 because of hot flashes, night sweats, or other symptoms of
perimenopause, ask about the possibility of taking a low-dose birth
control pill to stabilize estrogen fluctuations. Your doctor may
also consider short-term use of hormone replacement therapy (HRT) to help
relieve menopause-related symptoms. Note that HRT is not for everyone; ask your
doctor if it's right for you. To see if your sleep improves, your doctor may
also suggest a prescription sleeping pill for a short period of time.
Prevent pain. If aches and pains prevent you from sleeping,
try taking a mild, over-the-counter pain reliever or analgesic before going to
bed. Just be sure it doesn't contain any stimulants.
Ban Fido and Kitty. Your pet's movements -- or your allergiesto
animals -- could be disturbing your sleep. Animals can also give off a
tremendous amount of heat.
If you have trouble sleeping for more than a few weeks, or if sleep problems
interfere with your daily life, speak with your doctor or contact a
board-certified sleep specialist.
SOURCES: Kryger, Meir et al, editors: Principles and
Practice of Sleep Medicine. Fourth Edition. Elsevier. 2005: pp 1287- 1296.
Kryger, Meir, et al, editors Sleep Medicine, Third Edition, Elsevier
2000. WebMD Medical News: "Plant Estrogen Pill Gets Menopause Test Results
Similar to Fake Pill"; Timing, Ingredients May Need More Study." Bonnet
MH, Arand DL. We are chronically sleep deprived. Sleep ,1995; vol 18:
pp 908-11. Jewett ME, Dijk DJ, Kronauer RE, Dinges DF. "Dose-response
relationship between sleep duration and human psychomotor vigilance and
subjective alertness," Sleep, 1999; vol 22: pp 171-9. LUNESTA,
"Perimenopause-Menopause Study Shows Improvement for Women Suffering from
Insomnia," Sepracor news release. July 18, 2005.