Studies show us that women have many more issues with sleep than men. While there are multiple reasons for this, the sporadic changes in hormones common to women are a major cause of sleep problems. These fluctuations in hormone levels such as in the menstrual cycle, during pregnancy, and around menopause frequently impact sleep habits by multiple means. 

Some women have problems with sleep during their normal menstrual cycle but it is more common in the perimenopause time of life. Perimenopause is the time immediately before the full menopause and can last a few years for some women.   This sleep problem occurs less often than in menopause or pregnancy, but often enough if it happens to you.  

During pregnancy, many changes are occurring simultaneously and some of these are at least indirectly hormone related.  A growing baby and belly, extra urination, and tender breasts are some of these factors. It is known that women who experience sleep disturbances during pregnancy are more likely to suffer postpartum depression. Additionally, any sleep deprivation during pregnancy could leave the mother and/or baby more susceptible to illnesses. Immediately after birth, there is another huge shift in hormones, so this is another possible time for sleep problems and since it occurs at the same time as the new responsibilities of caring for the newborn and beginning to breastfeed the sleep issues are magnified.  

Most of the problems associated with hormones causing sleep issues occur during menopause or peri-menopause. In the peri-menopause time, hormones frequently fluctuate wildly and this interferes with sleep. Women can start having hot flashes and night sweats which will obviously interfere with normal sleep.   These occur in approximately two thirds of women at some point in the process.  Hot flashes/night sweats occurring in the first half of the night will cause more sleep problems than in the latter half of the night since during REM sleep women are more able to suppress these disturbances.

One of the most effective ways to reduce sleep disturbances is to balance the hormones. Sometimes in peri-menopause, a woman has close to normal levels of estrogen and low levels of progesterone, which is a “relaxing” hormone especially if given orally. In fact, many women consider progesterone at an oral dosage of around 200mg to be a good “sleeping pill”. Later in the process, since there is a continual decline of hormones, estrogen would need to be added to maintain a good balance of hormones and keep hot flashes/night sweats under control.  

In addition to hormone replacement, women can get some relief of sleep issues by lowering the room temperature, and by wearing layers of clothing to bed which can be removed or put back on as needed. Other things like guided imagery, yoga, and breathing control are sometimes effective also.