Many women experience insomnia during perimenopause, which is the period when a woman transitions to menopause. While more extensive research is necessary, specialists have identified a number of factors that may cause difficulty sleeping during this phase of a woman's life.
Changes in Hormone Levels
Menopause is the time in a woman's life when her reproductive years have ended. Ovaries stop producing estrogen and progesterone and her menstrual cycle ends. These changes in hormone levels can be problematic, causing various issues, including difficulty sleeping. Progesterone promotes sleep and its declining levels are believed to be one of the reasons for menopausal insomnia. The decline in estrogen can also make you more susceptible to sleep issues caused by other factors, including environmental ones.
Some women have trouble sleeping because they are woken at night by hot flashes. These are surges of adrenaline that automatically wake the brain and activate your body's fight-or-flight response. They can lead to sweating and the body's temperature changing, which can be uncomfortable and make it even more difficult to fall back to sleep.
Depression and Mood Swings
A number of women find that they become depressed and experience mood swings, which can also make sleeping more problematic. Difficulty sleeping is one of the signs of depression. What's worse is that lack of sleep aggravates the depression, creating a vicious cycle.
For many women, besides the changes in their bodies, this is a time in their lives when they often experience changes in their lifestyle as well. For example, their children have come to the age when it's time to move out of their parents' home or they are undergoing career transitions. Combined with the stress of entering this new phase in their life, sleep hard to come by.
The Importance of Treating Perimenopausal Insomnia
Perimenopause can last between three and ten years and if you don't treat your sleep issues, you could find your body becoming used to the new normal. This can have far-reaching effects on your overall well-being. Instead of adjusting to a lifestyle of insomnia, you need to take steps to remedy the problem. The first step is to seek advice from your OB/GYN, who likely has extensive experience with similar issues with other patients. If not, then find an OB/GYN specialized in treating women in perimenopause and menopause.
Perimenopausal and Menopausal Insomnia Treatments
Traditionally, sleep issues related to perimenopause and menopause have been treated with hormone replacement therapy (HRT), where you supplement the estrogen level in your body through a tablet, vaginal cream, or a patch. You might also take progesterone. However, some studies have shown a connection between estrogen-progesterone therapy and an increased risk of heart disease, breast cancer, stroke, and blood clots so proper consideration needs to be done to ensure this therapy is worth the potential risk involved.
If you do choose to undergo this treatment, it is recommended to use HRT with the lowest dose possible and for the shortest timeframe feasible to minimize the associated risks. And, of course, you have regularly visit your OB/GYN while being treated.
Your OB/GYN may decide to take a less drastic approach, especially if your symptoms are not severe. Anti-depressants, for example, have been used to relieve hot flashes, while certain anti-seizure and blood pressure medications have also shown to be effective in treating the symptoms of menopause.
Your OB/GYN will also likely recommend a series of lifestyle changes, such as going to sleep at the same time every night, exercising regularly during the day, avoiding naps, and emptying your bladder before bed, all in an effort to create the best possible environment for a good night's sleep.
If you are entering menopause and are having trouble sleeping, schedule an appointment with your primary care physician or OB/GYN. If you need a doctor, try searching our provider directory. The symptoms you are experiencing are natural but you don't have to go through your journey alone.