Women, Hormones, and Sleep Problems

From the WebMD Archives

Women are much more likely to report sleep problems like not getting enough sleep or being sleepy during the day, according to the National Sleep Foundation.

One possible culprit? Our hormones. Hormonal changes can wreak havoc on sleep. In turn, sleep deprivation can affect hormone levels in a sleepless vicious cycle. So when hormone levels spike or drop -- such as during the menstrual cycle, during and after pregnancy, and especially around menopause -- women may be more vulnerable to sleep problems.

How Menopause Messes With Sleep

As menopause approaches, hormonal changes can affect sleep more than during any other period in a woman’s life.

“There is a big impact from the loss of hormones, particularly estrogen, and our sleep quality is affected,” says Tristi Muir, MD, director of the Pelvic Health and Continence Center and an associate professor of obstetrics and gynecology at the University of Texas Medical Branch at Galveston. “There are declining levels of estrogen long before you are in actual menopause." Hot flashes and irritability can happen off and on throughout the decade before menopause hits, she adds.

Researchers have found that women who have hot flashes during perimenopause (the years preceding menopause, when hormone levels are declining) are also more likely to have sleep disturbances. About 2/3 of perimenopausal women have hot flashes, according to Muir, and many of these women will also have associated sleep problems.

Sleep studies have shown that women are more prone to having their sleep disturbed in the first half of the night by having a hot flash,” says Sharon Wong, MD, FACOG, chairman of the perinatal department at Adventist Medical Center in Portland. “During REM sleep, in the latter half of the night, women seemed to be more able to suppress their sleep disturbances.”

Once you’ve actually made it into menopause, which doctors usually define as at least a year without a menstrual cycle, your sleep will probably settle down, along with your hot flashes. But perimenopausal women may struggle with sleep disturbances for years.

How to Deal With Sleep Problems During Menopause

What can you do? First, talk to your doctor to try to pinpoint the source of your sleep problems. Lack of sleep and night wakings can be caused by many factors, and hormones are only one of them. If you can’t get to sleep at all, says Ricki Pollycove, MD, FACOG, former chief of the Division of Gynecology at the California Pacific Medical Center and the author of The Complete Idiot’s Guide to Bioidentical Hormones, your sleep problem may not be due to menopause.