Sleep and Hormonal Health
Updated: Dec 15, 2021
You know how important sleep is when you don’t get enough of it. An occasional night of restlessness due to stress or other factors is normal and expected. But, when you don’t get consistent adequate sleep, it can wreak havoc on your life. Some circumstances are out of your control- stress, restless children, noise, and a snoring partner (although a separate bedroom works in those cases!).
Hormonal fluctuations are a common cause of sleep disturbance, and fortunately, there are solutions for that problem. Even the usual sleep disruptions may be more easily tolerated with individualized hormone regulation.
Symptoms of Poor Sleep
In extreme cases, sleep deprivation can lead to delusions, hallucinations, and delirium. Chances are you haven’t reached that level, but if you are having sleep problems, you are probably familiar with these symptoms.
Fatigue. It seems obvious that fatigue would be the result of not enough sleep, but it is amazing how often people neglect to see that poor sleep is cause of their fatigue. If you are tired during the day, there could be all kinds of causes, but if you haven’t slept well, sleep is the culprit.
Difficulty Concentrating. If you aren’t sleeping well, your mind will not be at its optimal level. And you might not even know it is happening. If you work or have children and need to multi-task, chances are you are not operating at your best. You may be more forgetful or have trouble focusing on tasks.
Mood Changes. Can you say, “irritability?” You know exactly what we are talking about here. Frustration tolerance is compromised, and you find yourself snapping at your partner or kids for no good reason.
Reduced Sex Drive. To add to all of your other problems with lack of sleep, you find yourself with reduced libido. Sex releases endorphins and oxytocin, which can help you relax and sleep better. If you aren’t having sex, you aren’t benefitting from the hormones associated with orgasm. If you don’t have a partner, masturbation will do nicely!
What do Hormones Have to do With Sleep?
The short answer, a lot. Hormones affect our ability to sleep and are released before and during sleep. This chart from Science Alert shows the hormones released in the brain during sleep. It isn’t just the subjective benefits of sleep. Hormones released during sleep boost your immune system and balance your appetite so that you aren’t craving carbohydrates and eating more than you should.
Perimenopause and Menopause
The hormonal changes that occur during perimenopause and menopause are the perfect recipe for a poor nights sleep. Hot flashes, depression, anxiety, and sleep apnea are common. According to John Hopkins, postmenopausal women are 2-3 times more likely to have sleep apnea. Let’s look at the hormones most likely to interfere with your sleep.
Progesterone is called the “calming or soothing” hormone because it eases anxiety and promotes relaxation. In our clinic we call it “nature's valium”. During menopause and even at times during perimenopause, progesterone levels drop, contributing to problems sleeping. Progesterone levels typically drops well before the loss of estrogen. Low levels of progesterone have also been associated with an increase in breathing problems contributing to sleep apnea. Progesterone replacement is generally taken before bed to take full advantage of its sleep properties.
Plummeting testosterone levels in postmenopausal women can cause all sorts of problems, including sleep disturbance. And as if poor sleep weren’t enough, add these symptoms: Muscle weakness, fatigue, loss of bone density, weight gain, reduced sex drive, and vaginal dryness. Testosterone levels can decrease starting in our 30’s!
A decline in estrogen during menopause contributes to sleep disturbance due to menopausal symptoms of hot flashes, mood problems, and fatigue. It has been suggested that sleep disturbance may be the cause of mood disorders. Estrogen also plays a role in the metabolism of serotonin and other neurotransmitters that affect your sleep-wake cycle. The other benefit of Estrogen is its antidepressant effect.
Testosterone and Men
As men age, they begin to experience a decrease in testosterone just like women do. A decrease in testosterone for men can cause sleep disturbances. And it goes both ways. Low testosterone can cause sleep disturbance, and sleep disturbance can cause low testosterone. It can become a vicious cycle. Sleep disturbance can also increase the stress hormone cortisone which can also cause low testosterone.
Sleep, Hormones, and Sleep Hygiene
Getting enough sleep takes a multi-pronged approach. Start with good sleep hygiene practices which will give you the optimal foundation to have a good night’s sleep. Next, consider bioidentical hormone replacement. By determining your hormone levels now, we can tailor replacement to meet your unique and individual needs. The advantages are better sleep, energy and sex drive, improved bone density, and enhanced concentration and memory.