When I was a little girl, I used to envy princesses like Snow White and Sleeping Beauty for their charm, their beautiful voices and their ability to communicate with animals. When I entered perimenopause, I started to envy them for a different reason -- those brats had no trouble sleeping! All Snow White had to do to sleep for hours was take a bite of an apple! How dare Sleeping Beauty complain about being "doomed" to slumber for 100 years! I would have taken my chances on a wicked witch if it meant I'd actually be able to get a good night's rest.
Insomnia is something that many women encounter when they enter perimenopause. I have always been a very busy, multitasking kind of person who worked hard in the daytime and slept hard at night. All of a sudden in my forties, not only was I having trouble sleeping, but multitasking became more difficult, too, because my focus and memory kept failing me. I felt like I was going crazy (my kids probably wouldn't have blinked if I had actually started talking to animals). My insomnia was getting the best of my mental clarity as well as my physical appearance.
If you're suffering through insomnia, you are not alone. Only 45% of perimenopausal women report getting a good night's sleep almost every night, says the National Sleep Foundation (More). Hormones connect your brain and body. When they change, the way your brain and body function does, too. Progesterone is a very important hormone for sleep (Medscape), but progesterone levels drop when you enter perimenopause, making your body chemically less capable of sleeping well.
Another result of hormone changes are hot flashes. According to the North American Menopause Society, 75% of women experience hot flashes, and they definitely contribute to insomnia. A decline in core temperature is essential for falling asleep, so anything that raises your temperature in the middle of the night will combat that, especially something as uncomfortable as hot flashes!
Stress is another big influence on disrupted sleep patterns. As we can all recall from puberty, hormone changes can take a substantial toll on the body, and estrogen affects the stress hormone, cortisol. When estrogen is low, cortisol levels rise, raising blood pressure and blood sugar (34 Menopause Symptoms). Relaxation is of utmost importance for sleep, but with higher blood pressure and the never-ending mind racing, relaxing seems impossible. (Where is that wicked witch?!)
The solution to insomnia as well as some other common menopause symptoms is unfortunately controversial. Hormone replacement therapy saved my life (I take bio-identical hormones), but many women were scared away from using any form of HRT in 2002 when the Women's Health Initiative (WHI) reported that it raised your risk of breast cancer and heart disease. However, ten years later we now have new studies resulting in new guidelines. HRT can enhance your life in many ways if you start taking it before you reach 60-- as well as help your perimenopause and menopause symptoms, including insomnia! (For more easy facts on HRT, read Menopause Mondays: Take the 'Bite' Out of HRT.)
There are many different types of HRT to choose from, and that is a conversation you need to have with your menopause specialist, with your Menopause Symptoms Chart in hand. I wish the remedy to all menopause symptoms was as easy as eating a spoiled apple, but once you find your path to hormone happiness, you can live happily ever after (and start dreaming again!).
Always remember: Reaching out is IN. Suffering in silence is OUT!
Ellen Dolgen is the author of Shmirshky: the pursuit of hormone happiness