Sleep and Menopause

Medically Reviewed by Brunilda Nazario, MD on August 03, 2022
3 min read

Menopause is a stage in a woman's life when their ovaries stop producing the hormones estrogen and progesterone and they stop having their monthly menstrual cycle (their period). It is a normal part of aging and marks the end of a woman's reproductive years. Menopause typically occurs in a woman's late 40s to early 50s. It can also lead to sleep problems.

When the ovaries no longer produce adequate amounts of estrogen and progesterone (as in menopause), the loss of these hormones can bring about various symptoms, including hot flashes (a sudden feeling of warmth that spreads over the body) and sweating.

Hot flashes and sweating can make it difficult to sleep. According to the National Sleep Foundation, approximately 61% of menopausal women have sleep problems associated with hot flashes. Sleep problems can lead to other issues, such as daytime drowsiness.

There are treatments for sleep problems in women going through menopause. Some are:

Behavioral modifications

The following tips might keep you cooler at night and help you sleep better.

  • Wear loose clothing to bed, preferably breathable clothing made of natural fibers, like cotton.
  • Keep your bedroom cool and well-ventilated.
  • Avoid certain foods that may cause sweating (such as spicy foods), especially right before bed.

Other tips that may improve sleep during menopause include:

  • Maintain a regular bedtime schedule, including going to bed at the same time every night.
  • Exercise regularly but not right before sleep.
  • Avoid excessive caffeine.
  • Avoid alcohol close to bedtime.
  • Avoid naps during the day, which can prevent you from sleeping well at night.

Medications

The traditional treatment for menopause symptoms has been hormone replacement therapy (HRT). HRT is associated with a small increase in risks for developing breast cancer and blood clots. As a result, doctors currently recommend using the lowest dose possible of HRT and for the shortest amount of time for moderate to severe menopausal symptoms, with regular follow-up with your doctor.

For women who choose not to take HRT, medications originally used as antidepressants may help relieve hot flashes. These include low doses of fluoxetine (Prozac), paroxetine (Paxil), and venlafaxine (Effexor). And two other drugs -- the anti-seizure drug gabapentin and the blood pressure medication clonidine -- also may be effective. Also, the drugs paroxetine (Brisdelle​) and Duavee (estrogens/bazedoxifene) are specifically formulated for the treatment of hot flashes.

 

Alternative treatments that may help reduce menopausal hot flashes and improve sleep include:

  • Soy products, such as tofu and soybeans. Soy products contain a plant hormone called phytoestrogen that acts as a weak estrogen. However, studies, in general, have not shown significant hot flash reduction with soy products.
  • Black cohosh, a perennial plant that is a member of the buttercup family, has also been used to treat hot flashes. In several studies, menopausal women who took black cohosh experienced relief from hot flashes and sweating, although most of these studies have been short-term, and used varying amounts of black cohosh from different sources. 

Keep in mind that alternative treatment products are not regulated or controlled by the FDA, and the long-term benefits and risks of these therapies are unknown. Talk to your doctor before you take any alternative products.

Learn more about menopause.
Get tips on how to get a good night's sleep.