Get refreshing sleep in perimenopause
From the mid-40s onwards a woman’s reproductive system starts to get ready for retirement. This 5-10 year period before your period leaves town for good is peri-menopause. Along with hot flushes and mood swings, one of the most distressing symptoms women experience is the inability to get a decent night’s sleep.
You may find it:
1. Difficult to go to sleep
2. Wake up frequently, or
3. Wake up in the earning morning hours feeling alert and not being able to get back to sleep.
Sometimes it’s a combination of all three. You’re exhausted, irritable and unmotivated to do healthy things that would help the problem.
What’s with insomnia in menopause?
Rather than declining gradually and gracefully estrogen and progesterone often fluctuate wildly – like a rollercoaster. Estrogen has a role in controlling your internal thermostat. Hot flushes and night sweats occur as a results of these dips.
In order to sleep your body temperature needs to be slightly lower at night. Estrogen’s dance partner is the neurotransmitter serotonin, which has a role in helping you go to sleep. When estrogen plummets, it brings serotonin along for the ride.
The other main reproductive hormone progesterone calms the brain and helps you cope with stress. As you progress through perimenopause, you don’t ovulate every month, and ovulation is the primary way you get progesterone. Your brain reacts more strongly to stress.
Melatonin secretion can also change during this time. Melatonin is a hormone that has a role in your sleep/wake cycle. During perimenopause, some women suffer from “phase-delayed melatonin release”. Melatonin, which usually starts ramping up around 9 pm is delayed by an hours or so making it difficult to go to sleep at your regular bedtime.
With all this hormonal/neurotransmitter shifting and shuffling going on it’s no wonder you get tired and wired. Refreshing sleep can seem as elusive as your children when the dishwasher needs to be emptied.
What’s the natural solution?
Some of the medical options (such as HRT, antidepressants and sleeping pills) aren’t attractive to many women. What natural things can help?
Let’s face it – excessive stress is not helpful for most things, but it has a significant impact on both hormones and sleep. Perimenopause already makes you more sensitive to stress, but if you add additional emotional, physical (too much intense exercise is a big one), dietary (either nutrient-poor diets or calorie restricted), then things are going to be a lot worse. Why?
Even though your ovaries are getting ready for retirement, your adrenals still produce smaller amounts of estrogen and progesterone. These more modest amounts can help smooth out the bumps in the perimenopausal road. If your adrenals are busy making excessive ‘stress” hormones such as cortisol, adrenaline and noradrenaline you’ll get less of the estrogen and progesterone which can help calm things down. Eliminating or managing chronic stress in your life is one of the biggest things to can do to improve sleep.
A healthy diet with plenty of vegetables, some fruit, moderate amounts of protein and good fats are essential. Reduce refined sugar and processed foods. If you’re drinking more than one standard alcoholic drink per day now is the time to cut back.
Phytoestrogen foods can also be a helpful inclusion in your diet. These include tofu, tempeh, linseeds, alfalfa sprouts.
Regularly breaking a sweat is healthy; however, too much intense training can create a stress response and unbalance hormones. Every woman will respond a little differently here. My advice is to limit intense exercise to around two sessions per week. Make the remainder of your activities low impact (yoga, swimming or gentle walking).
Magnesium is THE mineral for sleep. It relaxes muscles, supports melatonin and GABA and reduces the impact of cortisol.
Calcium is magnesium’s dance partner and also has a role in muscle relaxation. Calcium also supports the neurotransmitter serotonin.
Did you know leafy, green vegetables are packed with both calcium and magnesium in the perfect ratio for your body? Get your 2 serves a day in!
I love herbs to smooth out the rough edges of perimenopause and promote restful sleep. There are many options but here are some of my favourites.
Calms and relaxes the brain and helps your stress coping mechanism. It also supports thyroid function.
Often described as an oestrogen tonic black cohosh doesn’t contain any hormones. However, it is thought to act as a selective estrogen receptor modifier (SERM), weakly stimulating the receptors. Black cohosh also supports serotonin and could be the herb if you have low mood and back pain associated with peri-menopause. (Only use under professional supervision if you have issues with your liver or estrogen-sensitive cancer).
St John’s wort
Most known for the effects on mood, St John’s wort is not the herbal equivalent of an anti-depressant. It acts more broadly in the nervous system to promote relaxation. St John’s wort combines well with Black Cohosh. Avoid if you are on antidepressant medications (risk for serotonin syndrome) or are using the oral contraceptive pill.
This herb is effective for dealing with the circular thinking stopping your brain from relaxing. Passionflower helps reduce cortisol, increases GABA and supports melatonin.
If anxiety, exhaustion and night sweats are in your symptom picture, then Zizyphus is the herb for you. It may reduce the time to get to sleep, and like many of the other herbs works on both serotonin and GABA.
As menopause approaches the hormonal fluctuations become less erratic, your body gets a chance to adapt to the new hormonal status quo your sleep should return to its premenopausal state.
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Norelle Hentschel is an experienced naturopath with a clinic in Crows Nest, Sydney who enjoys supporting her clients to reach their health goals.
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