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Menopause and Insomnia

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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.

What is menopause?

By definition, menopause is the final menstrual period. Menopause marks the end of the reproductive period of a woman. Women can no longer bear children upon reaching menopause.  A woman can confirm that she has reached menopause if she missed her menstrual period for 12 consecutive months without other obvious reasons like pregnancy. Menopause is a normal condition that all women experience as they age.

Menopause is not something that happens overnight. It is a gradual process. The first stage of menopause is Perimenopause. This is a stage that typically begins several years prior to the actual menopause. The main characteristic of this stage is the gradual decrease in the amount of estrogen that the ovaries produce. Perimenopause is a stage that lasts until that point when the ovaries stop releasing eggs. During the last 1 or 2 years of perimenopause, the decrease in the production of estrogen accelerates. This is the stage when a woman starts experiencing menopause symptoms.

What are the symptoms of menopause?

As a woman approaches menopause she will experience one or more of the symptoms listed below:

Irregular or skipped periods

Irregular periods become frequent as one approaches menopause. This is due to the irregularity of ovulations brought on by menopause. As a result the length of time between periods can become longer or shorter. Menstrual flow can alternate between light or heavy. There is also a chance that a woman approaching menopause may skip some periods. A persistent change of seven days or more in the duration of the menstrual cycle marks early perimenopause. Late perimenopause on the other hand, usually results in a space of 60 days or more between menstrual periods.

Hot flashes

Hot flashes are often described as sudden sensations of heat in the chest, face, and head. What usually follows is flushing, perspiration, and chills. Hot flashes are also known as vasomotor symptoms. When someone experiences hot flashes during sleep the person usually ends up drenched in sweat.

Mood swings and depression

When a woman transitions to menopause the levels of the hormone estrogen in her body also drop. This drop results in a wide variety of changes in her body. Many of these changes can cause menopausal mood swings.

This drop in estrogen levels is thought to be connected to the way that the human body manages serotonin and norepinephrine. These two substances have a link to depression. There are also links between low levels of estrogen and irritability, stress, anxiety, forgetfulness, and lack of concentration. Women entering perimenopause also have higher levels of the brain protein known as monoamine oxidase A (MAO-A). This brain protein is linked to depression.


Estrogen withdrawal triggered by menopause can cause migraines. For women who already experience frequent migraines prior to menopause, these migraines can get worse upon entering perimenopause.

Changes in sex drive

Menopause causes a loss in estrogen and testosterone. This can lead to changes in a woman’s sexual drive or libido. Menopausal women often notice that they’re not as easily aroused. They are also less sensitive to touching and stroking. In addition, the vagina also has less lubrication during menopause. This can make the vagina too dry to make sex uncomfortable. These factors can lead to a decline in interest in sex.

Vaginal dryness

Although vaginal dryness is something that can affect any woman, it is quite common in menopausal women. It affects more than half of post-menopausal women between the ages of 51 and 60. One of the hallmarks of menopause is the decline in the levels of estrogen. This decline is often signaled by the reduction of lubrication during sexual activity. When estrogen production halts the skin and support tissues of the vulva and the vagina become thinner and less elastic. It also starts to become dry.

Bladder control problems

When a woman enters menopause she experiences changes in her urinary functions. The primary cause of these changes is urogenital atrophy. Urogenital atrophy is the deterioration of the urinary tract and the vagina.

The estrogen levels in a woman’s body drop during menopause. This reduces the urinary tracts’ ability to control urination. Menopause also coincides with advanced age. Aging also results in debilitating effects on the pelvic area organs and tissues.

What is the relation between menopause and insomnia?

The many changes that a woman’s body undergoes during menopause can impact a woman’s sleep. These include:

Hormonal changes. Progesterone is a sleep-promoting hormone. During menopause there is a gradual decrease in its production. This shift in the ratios of hormones is an unsettling process. It can also contribute to a person’s inability to sleep. The decline in the levels of estrogen can also make a person more sensitive to environmental factors or stressors that disrupt sleep.

Hot flashes. A hot flash is a surge of adrenaline. This surge awakens the brain from sleep. Hot flashes also produce sweat. This leads to a change in temperature. A change in temperature can disrupt sleep. It also makes falling asleep uncomfortable.

Depression. Around 20% of menopausal women experience depression. Some of these cases showed a link to the loss of estrogen.

What is the treatment for women who suffer from insomnia due to menopause?

The most common treatment for menopausal women suffering from insomnia is Hormone Replacement Therapy (HRT). Hormone Replacement Therapy supplements estrogen hormone that a woman’s body lacks when it enters perimenopause. The presence of estrogen can help reduce hot flashes, vaginal problems, and bladder issues. HRT is a treatment that is ideal for the shortest possible duration. The lowest possible dose is also recommended.

There are several types of HRT. Estrogen therapy is the first type. There are different ways of delivering estrogen to the body. Estrogen delivery is available through patches or pills. There is also topical estrogen that comes in creams, sprays, or gels. There is also vaginal estrogen that comes in creams, vaginal rings, or vaginal estrogen tablets.

There is also a combination therapy. It is a combination therapy because it combines doses of estrogen and progestin. Progestin is the synthetic form of progesterone.

Is Hormone Replacement Therapy safe for everyone?

No, some women have conditions that make them unfit for HRT. Women who have the following conditions should avoid HRT:

  • Blood clots
  • Cancer
  • Heart attack
  • Heart or liver disease
  • Stroke
  • Suspected pregnancy

Are there side effects of Hormone Replacement Therapy?

Just like any medication or treatment, HRT comes with some side effects. These are common side effects caused by HRT:

  • Swelling or tenderness of the breasts
  • Headaches
  • Bloating
  • Nausea
  • Vaginal bleeding
  • Mood changes

Are there alternatives to Hormone Replacement Therapy?

If HRT is not viable or if the symptoms caused by HRT are severe, there are alternatives that can help a patient with insomnia.

Melatonin is a hormone that is responsible for the regulation of the Circadian Rhythm or the Sleep-Wake Cycles.There is a link between low levels of melatonin and sleep troubles. Melatonin supplements can help a person suffering from insomnia. A doctor or a sleep specialist can recommend a safe dosage of melatonin that can help a patient get quality sleep.

Although melatonin supplements can help a person get better sleep, this should only be a short-time treatment. There are other non-pharmacological ways of dealing with insomnia. These natural and behavioral remedies can go a long way towards helping a person get better sleep.

Sleep Hygiene

Sleep hygiene refers to good sleeping habits. These are things that a person can do to make sleeping easier. One of these is establishing a regular sleep schedule. Sleeping and waking at the same time every single day can help a person sleep and wake easier. Following a sleep-wake schedule will train the body to feel sleepy or active during a particular time of the night or day. However, a patient should follow this sleep schedule religiously. An individual should follow the sleep and wake schedule even during weekends for it to be effective.

It is also important to ensure that an individual wears comfortable clothing before going to bed. Pajamas are ideal sleeping attire because they are comfortable. Most of the time they are also made of materials that allow air to circulate to help a person stay cool even during warm nights.

Relaxing routine

A relaxing bedtime routine can help the body get to sleep easier. Taking a warm bath prior to sleep can help soothe the body and make it feel more relaxed. After taking a warm bath, the hot water evaporates from the skin. As this hot water evaporates the body cools down and it will make the person feel relaxed and sleepy.

There are also breathing exercises that can help relax the body. Practicing these exercises can clear the mind and relieve them of stress. Taking a relaxing drink can also help a lot. A warm glass of milk is effective in relaxing the body. Valerian root tea is also effective in promoting sleep. According to a 2011 study Valerian root tea helped improve sleep quality for postmenopausal women.

Create a bedroom environment conducive to sleep

It is difficult to fall asleep if the body is not comfortable. There are many ways to make a bedroom comfortable for sleeping. Blackout curtains are effective in ensuring that the bedroom is free from outside lights that can interfere with sleep. These curtains not only keep a bedroom dark, but they are also great in keeping the bedroom temperature down. Blackout curtains can keep out heat from the sun. They are also great in reducing outside noises. Menopausal women are more sensitive to environmental stresses and keeping a bedroom free from disruptive noises can help promote sleep.

Use a comfortable bed

Beds play a vital role in making a person comfortable while sleeping. Aside from this there are also beds designed to help relieve back pains. There are also mattresses made of materials that promote proper air circulation. This will help keep the body cool while a person sleeps. This can relieve the uncomfortable effects of hot flashes.

Aside from mattresses, there are also pillows designed to help a person sleep better by relieving back pains. These pillows can help an individual maintain proper posture while sleeping. When a person sleeps with the spine properly aligned, it helps to relieve pressure from the lower back. In turn this can help ensure that a good night’s sleep won’t get interrupted by back pains.

Menopause is something that all women have to go through. Insomnia is a symptom of menopause that can greatly impact a person’s productivity whether at home or at work. Fortunately there are ways to minimize if not completely eliminate the symptoms of insomnia. There are treatments that a menopausal woman can benefit from. On top of these there are also non-medical ways of combating insomnia. These natural ways can help those who are unfit for medical treatments or those who experience severe side effects from medicinal treatments.

A sleep specialist can help a patient choose an appropriate treatment. Whatever treatment works best, the bottom line is that a menopausal woman doesn’t have to suffer through insomnia.

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.

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