The word menopause is often used to describe the entire menopausal transition, but it is only a small part of these changes.
Menopause starts 12 months after a woman has her last menstrual period. But the menopausal transition begins four to eight years before this moment and continues for five to seven years after.
The first phase of menopausal transition is perimenopause, and the final phase is post-menopause. Most women start perimenopause in their 40s.
The levels of two hormones made in the ovaries—estrogen and progesterone—begin changing as ovaries prepare to stop releasing eggs. These hormonal changes represent the start of perimenopause, and perimenopause shares many symptoms typically associated with menopause.
Menopause Symptoms
The severity of menopause symptoms can vary. Some women experience mild symptoms, while others have severe symptoms that make routine daily tasks difficult.
The symptoms of menopause often subside later in the menopausal transition. But full relief may take years.
Menopause symptoms include:
- Anxiety or depression
- Bladder leakage
- Brain fog and difficulty concentrating
- Heavier than usual menstrual flow
- Irregular menstrual cycles
The most common menopausal symptoms are hot flashes and night sweats, which are hot flashes that occur at night. Both include a sudden uncomfortable feeling of warmth, a racing heartbeat and sweating. They may also cause redness of the skin and can be followed by a chill or shiver.
Night sweats may also happen alongside insomnia, another common side effect of menopause.
Lack of sleep for any reason, including menopausal insomnia and night sweats, can take a significant toll on general health and functioning.
Managing these sleep problems can help you maintain your quality of life while you are experiencing the other changes that come with menopause.
Hormone Replacement Therapy
Hormone replacement therapy, or HRT, helps many women treat menopause symptoms, and is available in multiple forms including creams, patches, pills, and pellets implanted under the skin. HRT reduces menopause symptoms by increasing levels of estrogen, progesterone or both.
However, HRT can also raise your risk of blood clots, breast cancer, heart attacks and strokes. If you decide to try HRT, your provider will help you choose the right type based on your menopause symptoms, medical history and lifestyle.
Other Medications for Menopause Symptoms
Some women take non-hormonal medication such as clonidine, gabapentin or selective serotonin reuptake inhibitors, also known as SSRIs, to decrease menopausal symptoms.
Do not take non-FDA-approved herbal supplements, dietary supplements or hormones without your provider’s approval. Many non-FDA-approved drugs and supplements have not been tested for effectiveness or safety and may cause unwanted side effects.
Lifestyle Changes to Manage Menopause Sleep Problems
In addition to HRT, lifestyle changes can be useful in managing insomnia, hot flashes, night sweats and other menopausal symptoms.
Try these lifestyle changes to help you sleep better during menopause:
- Avoid caffeine and spicy foods.
- Develop a regular bedtime routine that includes a calming activity before getting into bed.
- Don’t eat large meals just before bed.
- Exercise daily, but avoid exercising close to bedtime.
- Go to bed and get up at the same time every day, even on weekends.
- If you smoke, try to quit.
- Limit alcohol—just one drink may make it more difficult for you to stay asleep.
- Keep your home cool and quiet at night.
- Practice meditation, deep breathing, or other mindfulness techniques regularly.
- Turn off your TV, tablet, phone and other screens before you go to bed. Keeping them out of your bedroom altogether is best.
It can take a few weeks or months to see the full benefit of lifestyle changes. But once they are a part of your regular routine, you may experience other health benefits too, like decreased stress or a healthier heart. These changes may also help you stay healthy as you move into and out of post-menopause.
Techniques to Try When You Can’t Sleep
There will likely be sleepless nights during the menopausal transition, even with lifestyle changes and HRT or other medication to manage the symptoms.
If night sweats keep you up:
- Aim fans at your bed.
- Keep an insulated cup with ice water on your nightstand.
- Place an ice pack under your pillow.
- Put a cool, damp washcloth on your neck or face.
- Use multiple layers of light bedding and remove layers one at a time as needed.
If your body is comfortable, but you can’t fall asleep:
- Get out of bed and do a calming activity in another room until you feel sleepy.
- Meditate or take slow, deep breaths.
Some women find it helpful to track their menopause symptoms to identify possible triggers. A symptom log can also be an invaluable tool to share with your provider to determine which treatments are working well for you.
More to Read
- 4 Post-Menopausal Conditions You Should Know About
- Everything You Need to Know About Urinary Incontinence
- 5 Easy Ways to Get a Better Night’s Sleep
Listen to a Podcast about Sleep
Do you have trouble falling asleep or wake up feeling just as tired as when you went to bed? You are not alone! But don’t fear, Dr. Emerson Wickwire, a sleep specialist at UMMC Midtown Campus, is here with tips on how to get better sleep and when to know if you should see a specialist to get some rest. Listen to the podcast below or look for “Live Greater Podcasts” on your favorite streaming network.
Listen to a Podcast about Menopause and Sleep
Unravel the mysteries of sleep disruptions during menopause. In this podcast, Dr. Mokerrum Malik, an OB/GYN at University of Maryland Women’s Health, offers valuable insights and practical tips so you can reclaim restful nights.
