Mood changes, memory difficulties, and body aches can all be factors affected by menopause. But sleep issues are another huge factor that many experience but did not anticipate. And it’s no surprise, as according to a survey conducted by Ipsos MORI, 79% of women surveyed experienced hot flushes and 70% experienced night sweats, one of the leading causes of poor sleep during the menopause. However, this doesn’t mean that a restful night is out of reach. Don’t worry, we’ll consult with experts on how to manage this.
What is menopause?
So, what is menopause? If you’re reading this, you may be currently experiencing menopause, about to go through it or be out the other side. Or maybe you’re a friend or family member interested in learning more. Either way, here is a brief overview of menopause. The menopause marks the end of your menstrual cycle. Still, before this stage, for many years, you can be in the perimenopausal stage, having more irregular periods while your estrogen levels are dropping and your levels of the hormones that tell your ovaries to work are starting to rise.
How does menopause affect sleep?
During this “change of life” many expect mood changes, brain fog and a loss of libido, but according to a survey completed by Ipsos MORI 22% experienced unexpected sleep issues.
Menopause doesn’t always affect sleep, and even if it does, not all women will be affected in the same way. For some, it is difficult to fall asleep; the head hits the pillow, and nothing happens, resulting in hours of ruminating and tossing and turning. For others, it is constantly waking in the night and continually experiencing disturbances. On the other hand, sleeping for too long and still waking up feeling exhausted can be another confusing issue.
Anything can disrupt your sleep during the menopausal transition, but there are a few primary factors. In response to follicle-stimulating hormone (FSH), a hormone essential for reproduction, regulating menstrual cycles, and stimulating egg growth, some women experience an increase in vasomotor symptoms. These include hot flashes, night sweats, and heart palpitations, which can all contribute to poor sleep. Dr Alison Maclean, an expert in women’s health and gynaecology and a member of Between2ovaries, says, “Women can wake up completely drenched, really uncomfortable, either hot or cold, depending on what point they’ve woken up.
“It’s quite often the night sweats that cause the sleep disturbance.”
Fluctuating hormone levels can contribute to mood changes during menopause and perimenopause. A study by UCL found that women are 40% more likely to experience depression in the perimenopause than those who aren’t experiencing any menopausal symptoms. Additionally, feelings of anxiety can also be a factor impacting women’s sleep. Dr Nicola Tempest, consultant gynaecologist, expert in women’s health and another member of Between2ovaries, says, “Anxiety and depression lead to sleep issues.
“A lot of the time, it may be waking up and then not being able to get back to sleep because you’re anxious about various things. Anxiety and depression go up through the perimenopause.”
Will menopause affect your sleep?
Menopause doesn’t always affect sleep; just because you are going through menopause doesn’t mean you will experience sleep issues. If you have previously had sleep issues, then you’re more likely to experience them through the menopause. Similarly, if you’re somebody who’s already got anxiety and depression, it may get worse. Even if you are experiencing sleep issues these generally don’t last forever, symptoms are more prevalent during the perimenopause transition.
The knock-on effect
A bad night’s sleep is frustrating, but what’s even worse is the knock-on effects the next day. Sleep is a vital part of restoring balance in the body, and when it’s disrupted, it can intensify other menopausal symptoms. Lack of rest can amplify mood swings, make hot flushes worse and lower your ability to cope, making previously minor issues feel overwhelming. Meaning poor sleep isn’t just a result of menopause, but can become a key factor in making menopause more difficult. Dr Maclean says, “Everything is made better with sleep. It’s like with anything, if you’re not sleeping well, it’s going to affect every aspect of your life.
“You could be underperforming at work because you’re sleepy and not able to concentrate. You’re likely to have a negative impact on your relationships because you’re grouchy and irritable.
“And if this goes on for a while, then it can have a massive impact on your quality of life.
How to fix it
Like anything, there’s not a quick fix, one-size-fits-all solution to improve your sleep. And although sometimes this phase may pass for many, it doesn’t, and they need to seek help. The first thing to consider is sleep hygiene and ensuring that you create the right environment for sleep. Make sure your room is dark, no screens or caffeine before bed, keep your bed for sex and sleep only. All of these are things you can try before heading for professional advice.
If you’re looking to seek professional help for sleepless nights, try to figure out what is keeping you awake. Is it anxiety, hot flushes, night sweats, vaginal dryness or another symptom? This makes it easier for a doctor to direct the treatment. Dr Maclean says, “If something’s affecting your life negatively, talk to your GP.
“For hot flushes, there are lots of treatments, but also for depression, anxiety or low mood, there are different treatments you can try for that.
“Don’t suffer in silence, definitely speak to your GP.
Once you’ve identified the problem, you’re a step closer to finding a solution. And the solutions for symptoms vary, so just because one person is on HRT doesn’t mean that you need to be. There are many hormonal and non-hormonal treatments to improve your symptoms, it’s about treating the symptoms, not menopause itself.
Cognitive behavioural therapy (CBT) has been recommended by The National Institute for Health and Care Excellence (NICE) for anxiety and depression experienced by women during menopause and post menopause transition. However, for CBT to be effective, you must be genuinely invested in it and not merely go through the motions. However, CBT has been proven to be effective, providing reassurance and motivation to engage in the therapy and reap its rewards.
In the media, there’s lots of talk about how hormone replacement therapy (HRT) can ‘revolutionise your life’ with a few celebrities, including Davina McCall, pushing for it. Doctors have seen an increase in people requesting to go on HRT when they wouldn’t benefit from it. Dr Tempest says, “It’s not a one-size-fits-all pill that will make everything better. A few celebrities are pushing for it.
“People are going on it for brain fog, vaginal dryness, hair loss and lots of different things.
“However, the NICE guidance is specific about what HRT is beneficial for, and it’s not beneficial for anything but vasomotor symptoms such as night sweats and hot flushes.”
So not everybody needs HRT. If you’ve got one of the vasomotor symptoms, then speak to your doctor about it, but it is not the answer for everything. Although it can be beneficial for some women and is safer than previously thought, certain risks remain.
While HRT’s benefit is mainly for hot flushes and night sweats, if vaginal dryness is keeping you up topical estrogen cream can be good for treating it.
Partners and family support
Partners, family members, and friends also play an important role during this time. Simply being understanding and patient can make a huge difference. Offering emotional support, helping to create a calm sleeping environment, or simply learning more about what menopause entails can help someone feel less alone in their experience. Dr Maclean says, “You need to be like a sidekick, support them through whatever they’re going through, if she’s hot, open the window and grab an extra blanket, help her with her struggles.”
Whether it’s improving sleep hygiene, trying CBT, exploring hormonal or non-hormonal treatments, or simply consulting your GP, support is available. Sleep might feel out of reach right now, but with the right guidance and care, restful nights and better days are possible. You don’t have to suffer in silence.
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