Perimenopause and Sleep: The Latest from the Endocrine Society

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This post, sent to me by the Endocrine Society, focuses on sleep. The images are from their Menopause Map. Check out the map after your read the article! Click here to access their excellent guide to menopause.


Hormone Fluctuations Disrupt Sleep of Perimenopausal Women

Study finds sleep interruptions worsen during certain phases of menstrual cycle

Women in the early phases of menopause are more likely to have trouble sleeping during certain points in the menstrual cycle, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

During perimenopause – the earliest stage of the menopausal transition – women may have irregular menstrual cycles due to the body’s fluctuating hormone levels. Symptoms such as sleep disturbances and hot flashes typically begin three to five years prior to the onset of menopause, when a woman is in her 40s, according to the Hormone Health Network.

The study examined how hormone fluctuations affected sleep during the luteal and follicular phases of the menstrual cycle. The luteal phase occurs prior to menstruation. The follicular phase refers to the two weeks after menstruation.

“We found that perimenopausal women experience more sleep disturbances prior to menstruation during the luteal phase than they did during the phase after menstruation,” said one of the study’s authors, Fiona C. Baker, PhD, of the Center for Health Sciences at SRI International in Menlo Park, CA, and the University of the Witwatersrand in Johannesburg, South Africa. “Measures of electrical brain activity found that the hormone progesterone influences sleep, even at this late reproductive stage in perimenopausal women.”

The laboratory study examined sleep patterns in 20 perimenopausal women. Eleven of the participants experienced difficulty sleeping at least three times a week for at least a month, beginning with the onset of the menopausal transition.

The women each slept in a sleep laboratory twice – once in the days leading up to the start of the menstrual period and the other time several days after the menstrual period. Researchers used an electroencephalogram (EEG) to assess the women’s sleep and brain activity. Each participant also completed a survey regarding their sleep quality in the month prior to the laboratory testing and underwent a blood test to measure changes in hormone levels.

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Researchers found women had a lower percentage of deep, or slow-wave, sleep in the days before the onset of their menstrual periods, when their progesterone levels were higher. The women also woke up more often and had more arousals – brief interruptions in sleep lasting 3 to 15 seconds – than they did in the days after their menstrual periods. In contrast, sleep tends to be stable throughout the menstrual cycle in younger women.

“Menstrual cycle variation in hormones is one piece in the overall picture of sleep quality in midlife women,” Baker said. “This research can lead to a better understanding of the mechanisms behind sleep disturbances during the approach to menopause and can inform the development of better symptom management strategies.”

Other authors of the study include: Massimiliano de Zambotti, Adrian R. Willoughby, Stephanie A. Sassoon and Ian M. Colrain of the Center for Health Sciences at SRI International.

The study, “Menstrual-cycle Related Variation in Physiological Sleep in Women in the Early Menopause Transition,” was published online at http://press.endocrine.org/doi/10.1210/jc.2015-1844,

About the Endocrine Society: Founded in 1916, the Endocrine Society is the world’s oldest, largest and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, the Endocrine Society’s membership consists of over 18,000 scientists, physicians, educators, nurses and students in 122 countries. Society members represent all basic, applied and clinical interests in endocrinology. The Endocrine Society is based in Washington, DC. To learn more about the Society and the field of endocrinology, visit their site at www.endocrine.org. Follow them on Twitter at https://twitter.com/HormoneHealthN

9 responses »

  1. Boy, I sure wish they’d get on the stick on that “development of better symptom management strategies.” I’m technically menopausal, but those few years before things got official were almost hell regarding sleep. I still have some problems, but not like then. Blech. Thanks for the info!

  2. Sleep for me, was, and continues to be, a major problem compared to my earlier days prior to perimenopause.

    IIn the early stages of menopause, I found that my natural estrogen supplement (which was prescribed by a compounding pharmacy for the estrogen “estriol”) was perhaps the best in this regard – It seemed to be especially helpful in assisting my natural patterns in falling asleep. It really did help to use this estrogen cream. I would fall asleep quite readily after applying it.

    As I got older, things changed. First of all I stopped using estrogen as an aide. So, now I find that if I personally am deficient in a natural form of dopamine “mucuna pruriens” that I really have a hard time sleeping. This supplement seems to restore my natural ability to have a good night’s sleep – It is derived from Velvet Bean Extract and you can buy it from the company “NOW Foods.”

    Obviously, every person’s metabolism and profile is different, so one should consult their trusted health care advisor/physician.

  3. Just thought I might add that I believe I am somewhat deficient in dopamine. For someone who isn’t, then dopamine might affect their sleep in a completely different way (or possibly even opposite way). Scientists apparently know that dopamine does affect the sleep cycle, but don’t know exactly how or in what way at this point.

    • It’s all so confusing. This sleep stuff is major. I am up in the middle of the night as I type this. Ugh and sigh. It doesn’t help that I woke up because a giant June bug was buzzing over my bed. Cliff kindly rescued the bug and put it out the window. I bet the bug is now sleeping better than I am.

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