Women, Hormones, And Sleep Problems

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.

A possible cause? Our hormones. Hormonal changes can wreak havoc on sleep. Hormone levels can be affected by sleep deprivation, resulting in an uncontrollable vicious circle. 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.

What Menopause Does

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." She adds that hot flashes or irritability may occur at any time during the decade prior to menopause.

Research has shown that hot flashes in women during their perimenopause (the period before menopause when estrogen levels decline) can also increase the likelihood of sleep problems. Muir estimates that hot flashes affect about 1/3 of all perimenopausal females. Some of them will have sleep issues.

Sleep studies show that hot flashes are more common in women than in men. Sharon Wong MD FACOG is the chair of Adventist Medical Center's Perinatal Department. Women seemed more able in the late hours of REM sleep to control their sleep disturbances.

Your hot flashes and sleep disturbances will stop once you are in menopause. However, perimenopausal woman may experience sleep disorders for several years.

The Menopause Sleep Problems: How do you deal?

What are your options? Talk to your doctor first to determine the cause of your sleeping problems. Hormones may not be the only factor that causes night awakenings and sleep problems. Ricki Pollycove MD FACOG, ex-chief of the Division of Gynecology of California Pacific Medical Center and author of The Complete Idiot’s Guide To Bioidentical Hormones may be the reason for your insomnia.

One option is to try hormonal support. "This type of sleep disorder is often very well treated with a low dose of estrogen," says Pollycove. In fact, a large study, presented at the annual meeting of the American College of Obstetricians and Gynecologists in May 2010, found that menopausal women with sleep problems due to hot flashes got significant relief from estrogen therapy.

Pollycove recommends mind-body methods such as guided imagery and breathing control. These are highly effective with no side effects and good for your brain," Pollycove says.

You can also take steps to lessen the effects of hot flashes. Wong states that hot flashes are reduced in women who sleep with lower temperatures, have layers on their beds that they can put on or take off, and that this results in more peaceful sleeping patterns.

Retired Pregnant Woman Needs to Sleep

Women often joke that the sleep problems they have during pregnancy are just preparing them for motherhood, when they'll be waking up countless times in the night. But sleepless nights during pregnancy, and in the postpartum period, can be very serious. Too little sleep can make you and your baby more irritable, and leave them vulnerable to sickness.

It's hard to tease out exactly how much of pregnancy-related sleep problems are directly due to hormonal changes. Many other things can keep you from a good night's rest: the constant need to urinate, tender breasts, and a growing belly.

Pollycove says that one thing is certain: women who have a lot of sleeping problems during pregnancy are more susceptible to depression after birth."

Here are some tips for a good night's sleep during pregnancy:

• Avoid exercising within an hour to two hours before bed.
• Take a warm cup of milk or calm tea to soothe your soul in the evening.
• Maintain a comfortable bedroom temperature, perhaps slightly lower than normal (pregnant women and menopausal ladies often feel too hot).
• If you're congested, which often happens in pregnancy because women produce more mucus, try clearing your nose with a neti pot or nasal rinse to make yourself more comfortable.

Postpartum Sleep and Mental Well-being

After the birth of your baby, another major shift occurs in hormones. This is why you might have trouble sleeping.

Postpartum sleep disorders, combined with caring for a newborn and learning new things like breastfeeding , can be a killer," says Pollycove. "It's the most demanding job a woman has ever done."

Antidepressant medication may be helpful, as a lack of sleep can increase your risk for depression after birth. Low-dose estrogen may also help, and the hormone doesn't interfere with lactation and breastfeeding, Pollycove says.

"The low estrogen levels that create sleep disorders in postpartum women are also very much associated with depression. You may need to take a tiny amount of estrogen in order to get the desired effect. This is a very rare issue, however it is one that Pollycove has mastered.

What is the difference between menstrual cycles and sleep?

But what about the menstrual cycle itself. Can you have trouble sleeping at "that time of the month?" It's much less common than in menopause and pregnancy, but it does happen.

"Menstrual cycles for the vast majority of us are regular, in terms of a predictable hormonal sequence of events," says Pollycove. "In young women, it's pretty rare that the regular rise and fall of estrogen and progesterone disrupts sleep. Premenstrual syndrome can cause sleep disturbances in women who have it.

If you're one of them, and if sleep issues are really wreaking havoc in your life every 28 days or so, then one possible solution is hormonal birth control.

"If you're not trying to conceive a baby, birth control pills can put your hormones in more of a steady state," says Wong. While most people won't feel the need to use birth control pills after a few sleepless nights, that is only one reason why they might.

The mind-body therapies, such as guided imagery, yoga and breathing techniques can be used.

You can combine a pain relief medication with a sleeping aid if your menstrual discomfort is bothering you.