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Hormonal Insomnia in Menopause

Sleep problems in Menopause - Eve Biology

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Have you started to find it difficult to fall asleep at night even though you’re feeling exhausted ? Do you fall asleep quickly but then can’t stay asleep? Do you get some weeks where your average sleep is well below the 7 hour benchmark and you have to drag yourself out of bed after a rubbish night?

Add a big dose of irritability with a chaser of anxiety into the mix, and you’ve got the perfect recipe for a bad day. Perimenopause sleep problems affect up to 57% of perimenopausal women and menopausal women. That's a lot of women missing their zzzz.Sleep is crucial for brain health and balancing the hormones which manage appetite. Sleep deprivation is associated with an elevated risk of obesity. Poor quality sleep can affect the hormones which control appetite, making you feel less satisfied and consume more calories.

In this article, we’ll look at what causes menopause sleep problems, and how you can get your sleeping pattern back on track to start feeling like yourself again and manage this health depleting symptom of menopause.

What is good quality sleep?

The recommended amount of sleep for a healthy adult is around seven hours a night. And that’s not all that defines good quality sleep. If you don’t fall asleep within 30 minutes of getting into bed, you often wake up more than once a night, or you feel tired during the day, your sleep quality may be poorer than you think.

What sleep issues are caused by menopause?

Sleep problems are complex because they can be triggered by a number of things. The transition into menopause brings with it a lot of physical and hormonal changes, which means it can kick off a few different sleep issues. As women, the more we know about these kinds of menopausal symptoms which can affect sleep, the better we can manage them. Here are the three most common ones.

Night Sweats

Because they often occur at night, night sweats are considered one of the main sleep problems faced by perimenopausal and menopausal women. A night sweat is a sudden, intense feeling of warmth in the upper body – usually accompanied by heavy sweating which can soak through bedding and night clothes. Even if you manage to get back to sleep quite quickly after changing your bed, your sleep quality suffers, resulting in that oh-so-familiar tiredness the next day.


Some women experience a need to get up more regularly during the night to empty their bladder which can disturb sleep every few hours.They may put it down to ageing but in fact it could be caused by hormones declining.

Hormonal Insomnia

Insomnia is a well-known chronic sleep problem that can affect anyone, at any age. It’s defined as having difficulty falling or staying asleep for more than three days a week on average, and it can leave you feeling massively fatigued during the day. Consistent poor-quality sleep can cause headaches, irritability, anxiety and trouble concentrating, too.

Restless Leg Syndrome

According to The Sleep Charity Restless leg syndrome is a condition that affects the nervous system and can affect 10% of people but women are twice as likely to experience it. The syndrome manifests as an overwhelming need to move the legs and symptoms can also include aching or pins and needles at night.

What causes menopause sleep problems?

Declining hormone levels and the symptoms this creates can cause poorer quality sleep nights in perimenopause and menopause, though midlife is, for a lot of women, one of the busiest times in their lives with significant stress and this can make counting sheep or writing lists in the small hours of the morning a familiar scenario.

Let’s take a look at some of the key culprits.

Falling hormone levels

Estrogen and progesterone hormone levels start to stutter in perimenopause and steadily decline during menopause, which leads to a growing range of potential symptoms. Hot flashes and night sweats can occur in either stage and can last for many years. These happen because the disruption of hormonal supply changes the way the brain works and how it manages temperature.

The hormone estrogen helps the brain to make melatonin which helps to regulate sleep. Progesterone supports sleep because it is connected to the production of GABBA ( gamma aminobutyric acid ) which has a relaxing effect on the body in preparation for sleep.


Estrogen supports serotonin production which helps to regulate anxiety and also plays a part in in endorphin production, the feel good chemicals, when hormones fall heightened anxiety can be a result, a feeling of irritability and worry, often with no logical cause. And for many of us, the feeling of constant worry can keep us from falling asleep. It’s a vicious cycle because sleep problems can make our anxiety worse.


Menopause aside, there are many frustrating factors that are just part and parcel of getting older. One of them is a change in our sleep-wake cycle, meaning we tend to feel tired earlier and wake up earlier, leading to less sleep overall.

Life stresses

As a woman in your or 50's or 60's, it’s likely that menopause isn’t the only stressful thing going on in your life at the moment. Maybe you have health concerns, you’re worried about losing older relatives, or you have children who are leaving home. All of these factors can contribute to sleep troubles.

How to get a good night’s sleep

You’ll be glad to hear that even during menopause, there are plenty of things you can do to get your sleeping pattern back on track. and Here are some of the most common treatments and a few of our top tips.

Hormone replacement therapy (HRT)

HRT replaces the hormones lost in menopause, which means it treats all the day-to-day symptoms, including the likes of hormonal insomnia. It’s not suitable for everyone, so we recommend speaking to your doctor to find out if it could be an option for you.


Melatonin is the body’s natural sleep hormone, and you can buy it in low doses over the counter. In postmenopausal women, it’s proven to improve mood and help you get to sleep.


Cited at Sleep Foundation, plant based adaptogen Ashwagandha KSM66 has five different research studies that show Ashwagandha supplements can assist adults both with and without insomnia sleep. More specifically, taking Ashwagandha meant people fell asleep faster and had better sleep quality. Eve Biology supplement for women in menopause uses the herb to target symptoms of sleep and anxiety.

Tips for better sleep

Cut down on nicotine, caffeine and alcohol

Caffeine, nicotine and alcohol can all wreak havoc on your sleeping pattern, especially when you consume them in the afternoon or evening. By cutting down on how much you smoke, drinking less coffee and skipping that pre-dinner glass of wine, you might get a better night’s sleep.

Keep cool

If you suffer from hot flashes or night sweats, keeping your bedroom nice and cool could stop them from interfering with your sleep. So, keep a window open, wear breathable nightwear, stick a fan on, or swap your thick sheets for thinner ones.

Stick to a routine

Getting into a proper routine can help kickstart your body clock and get you back into a healthy sleeping pattern. You can try adding a night-time bath, meditation, or reading into your routine, as well.

Breathing Exercises

The 4-7-8 technique is a breathing exercise that involves breathing in through the nose for four counts, holding that breath for seven counts and exhaling through the mouth for eight counts. Breathing techniques for better sleep

The bottom line

Thanks to plummeting hormone levels, life stresses and anxiety, menopause and sleeplessness go hand in hand. Thankfully, treatments like HRT and lifestyle changes like cutting back on caffeine can help get you dozing off again, so you won’t need to struggle through tiredness forever.


Does menopause insomnia go away?

Menopausal sleep issues are usually temporary but can last longer. There are treatments available to help improve your sleep and if you try to introduce some relaxation tactics you can help to improve your sleeplessness.

Does HRT help sleep problems?

HRT is an effective treatment for menopausal sleep problems because it replaces the estrogen that’s lost as you go through perimenopause.

What helps restless legs in menopause?

Restless legs might not be caused by menopause directly, but many women suffer from it, especially at night. Taking magnesium can help ease the symptoms, as it helps promote normal muscle function.

Read More

What are the symptoms of low oestrogen

How To Recognise and Manage Menopause Anxiety

Night Sweats and Hot Flashes