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Why Problems With Estrogen Might Be Keeping You Up at Night and How to Fix It

Estrogen written on blackboard

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Estrogen (sometimes spelled oestrogen) is an important reproductive hormone which effects the sleep – both in men and women. Women produce more estrogen than men, which is natural because estrogen plays major roles in the menstrual cycle and pregnancy, as well as in the later stages of a woman’s life. Adult men have about 1-4 ng/dL, whereas this level greatly varies with women, depending on the part of the cycle they are in. The variation falls between the minimum of 2.7 ng/dL in the mid-follicular phase and the maximum of 43.6 ng/dL in the mid-luteal phase. After the menopause, this value remains below 1 ng/dL.

In medical terminology, it is usually talked about estrogens. The reason is that there are about 20 identified types of estrogens. All estrogens have a name and a purpose, but there are three most commonly mentioned. They are estradiol (prevalent in women’s reproductive years and present in men), estriol (the estrogen produced during pregnancy), and estrone (the estrogen produced after menopause).

Just like testosterone is important for reproductive health and sound sleep in both men and women, estrogen also has its role in the reproductive health and sleep for both genders.

What are hormones?

Hormones are chemicals produced by endocrine glands (glands which let their product out into the blood). Their role is to carry a certain message. Hormones can instruct a cell to grow, get activated, or stop growing; they can inform our body that we are sleepy, hungry, or that we are full.

Some hormones are produced in the brain – for example, hypothalamus excretes melatonin, the hormone which makes us sleepy, and cortisol, the hormone whose levels rise when we are in a stressful situation. They can also be excreted by the gonads (reproductive glands) – ovaries in women and testes in men, and other glands of our endocrine system.

Estrogen and sleep

Estrogen is more important for our sleep than we might think. Here is how healthy estrogen levels allow us to have a good night’s sleep:

  • It increases REM sleep cycles and deep sleep (slow-wave sleep)
  • It decreases sleep latency and reduces awakenings
  • It increases the length of uninterrupted sleep
  • It regulates the body temperature (especially core body temperature). We can sleep when our body temperature lowers down, and it increases when we’re supposed to wake up.
  • Estrogen affects cortisol (stress hormone) and that way indirectly affects sleep.

Estrogen levels naturally decrease with age in both men and women. This may lead to sleep problems in the older population.

Low estrogen and sleep problems

Various mood, sleep, and sexual dysfunction problems have been observed in individuals who suffer from a lack of estrogen. For men sleep-wise, it can disrupt the sleep-wake cycle, causing excessive daytime sleepiness, frequent sleeping and/or oversleeping.

In case you are wondering how a man can experience a lack of the main female reproductive hormone, you should know this – both testosterone and estrogen are important for men as well as women, but our bodies need them in different amounts. Testosterone produces estrogen and a low level of testosterone usually means a low level of estrogen. That is why symptoms of low estrogen are usually also symptoms of low testosterone for men.

When it comes to women, low estrogen is most frequently linked to menopause or post-menopause. However, various health problems and behavioral factors may lead to a low estrogen level. There are various treatments of low estrogen depending on the reason for a deficiency in this hormone.

Menopause and sleep

Menopause is a period during which hormones decline. It usually occurs when a woman is in her late 40s and 50s, but can be triggered if ovaries have been surgically removed, so estrogen can’t be produced in the body.

Women mostly complain about hot flashes, night sweats, and fatigue. These may be related to sleep problems like waking up early and having insomnia (difficulty falling asleep or staying asleep). Women are also likely to experience sleep-disordered breathing (for example, obstructive sleep apnea) and fibromyalgia (widespread muscle pain which is tied to sleep disturbances).

Such sleep disorders lead to non-restorative sleep, which results in cognitive decline. Some studies have shown that dementia in older women is likely developed due to sleep pattern changes or sleep deprivation.

Dealing with low-estrogen sleep problems

One way to fight sleep problems caused by estrogen deficiency is to try and increase the estrogen itself. However, some suggest melatonin therapy.

A Russian study has shown much improvement in sleep architecture (sleep structure consisting of four stages which repeat cyclically) of perimenopausal women. They were given 3 mg doses of melatonin over the course of three months, after which the researchers found an improvement in sleep latency, increased time women spent in REM sleep and overall more efficient and uninterrupted sleep.

Another study published in the Sleep journal was dedicated to perimenopausal and postmenopausal women suffering from severe hot flashes due to a lack of estrogen. They were treated with low doses of estradiol and low doses of an antidepressant called venlafaxine. The findings showed a small decrease in insomnia symptoms and improved sleep quality (subjectively assessed). However, antidepressants are known to decrease deep sleep and venlafaxine can cause REM sleep behavioral disorder (a disorder in which people are not ‘paralysed’ during REM, so they act out their dreams – which is dangerous for themselves and people around them).

However, there is plenty of research showing that estrogen replacement therapy (ERT) is an excellent way of clinically replenishing this hormone. Not only has sleep time and subjective sleep quality been improved after postmenopausal women used estrogen skin patches, but EEG (electroencephalogram) readings revealed deep sleep patterns similar to those of much younger, healthy women.

Boost your estrogen

Some women suffer from PCOS (polycystic ovary syndrome) and don’t ovulate for that reason. Treating PCOS could help the ovaries produce more of their hormone. Another reason why some young women might miss on ovulation is poor diet. If the body severely lacks nutrients, it will simply postpone or ‘skip’ ovulation – by restricting estrogen production. Having a healthy diet helps the body go through all the necessary processes.

Changing undesirable behavior, environment and/or diet can increase estrogen levels which are slightly low. Apart from not eating enough, things that can decrease estrogen are: consuming too much soy and soy products, having a vegan diet, and gluten sensitivity. Quitting smoking and relieving stress help with the estrogen increase.

For women after menopause, taking a hormone called DHEA might help because the body can convert it into estradiol, thus making up for the lack of ovary-produced estradiol. Another good solution are bioidentical estradiol patches applied on the skin.

A natural herbal remedy is black cohosh, because it contains certain chemichals which take the role of estrogen in the body.

High estrogen and estrogen dominance

Estrogen dominance can mean two things – either estrogen present in excessive amounts or that the amount of estrogen is disproportionate to hormone progesterone levels (there is more estrogen than progesterone, but it does not necessarily mean that estrogen is excessive).

Women who are likely to suffer from too much estrogen are either taking hormonal birth control, obese, in perimenopause (when estrogen can reach extremely high levels), histamine intolerant, or have hypersensitive estrogen receptors (where the problem is how the body reacts to estrogen, not the level itself).

Estrogen can cause sleeping problems – either an increased need for sleeping and fatigue or insomnia, because it stimulates the nervous system. A person with high estrogen experiences mood swings. Increased stress levels delay sleep onset.

How to lower your estrogen levels

There is a number of ways to directly or indirectly reduce excessive estrogen and avoid having high levels in the first place.

  • Don’t drink too much alcohol – it is known to increase estrogen in men and women
  • To prevent hypersensitivity in receptors, eat vegetables and nuts, and avoid dairy products (except those rich in friendly gut bacteria – probiotics).
  • Avoid antibiotics and eat probiotic foods like kefir and kimchi. They promote healthy gut bacteria, which indirectly keep healthy estrogen levels.
  • Reduce weight / keep healthy weight.
  • Eat organic and don’t use plastic-packed food – they contain xenoestrogens which imitate estrogen and bind to cell receptors.
  • Avoid hormonal birth control.

Can estrogen therapy be bad? Does estrogen cause breast cancer?

It depends on the type of estrogen prescribed. Bioidentical estrogen in combination with bioidentical progesterone produces the best results. In Europe, only bioidentical hormones are prescribed.

If either estrogen or other helping substances are synthetic (progestin), they can cause various problems in the body and even significantly increase the risk of breast cancer, according to some studies. However, FDA has stated there is not enough evidence to support that bioidentical hormones are safer, so in the US synthetic options are frequently prescribed.

Additional resources

  1. Sofronescu A. G. Estradiol. Medscape. March 18, 2015. https://emedicine.medscape.com/article/2089003-overview Accessed January 2, 2019.
  2. Eichling P. S, Sahni J. Menopause Related Sleep Disorders. Journal of Clinical Sleep Medicine. Vol. 1, No. 3, 2005. http://jcsm.aasm.org/articles/010312.pdf Accessed January 2, 2019.
  3. Gervais N. J, Mong J.A, Lacreuse A. Ovarian hormones, sleep and cognition across the adult female lifespan: An integrated perspective. Frontiers in neuroendocrinology. October 2017. https://www.ncbi.nlm.nih.gov/pubmed/28803147 Accessed January 2, 2019. doi: 10.1016/j.yfrne.2017.08.002
  4. Madaeva I. M, Danusevich I. N, et al. Melatonin in therapy of sleep disorders age-related estrogen deficiency. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. https://www.ncbi.nlm.nih.gov/pubmed/28638037 doi: 10.17116/jnevro20171175181-84
  5. Ensrud K.E, Guthrie K.A, et al. Effects of estradiol and venlafaxine on insomnia symptoms and sleep quality in women with hot flashes. Sleep. January 2015. https://www.ncbi.nlm.nih.gov/pubmed/25325454 doi: 10.5665/sleep.4332
  6. Williams R. R, Sandigo G. Venlafaxine-induced REM sleep behavioral disorder presenting as two fractures. Trauma Case Reports. https://www.sciencedirect.com/science/article/pii/S2352644017300547 Accessed January 2, 2019. doi:10.1016/j.tcr.2017.10.017
  7. Antonijevic I. A., Stalla G. K, Steiger A. Modulation of the sleep electroencephalogram by estrogen replacement in postmenopausal women. American Journal of Obstetrics and Gynaecology. February 2000. Volume 182, Issue 2, Pages 277–282. doi: 10.1016/S0002-9378(00)70211-0

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Read our full medical disclaimer.