Are your hormones balanced for sleep or are they keeping you awake?

There are over 50 hormones in your body, each having a particular role in either starting or stopping various biological functions we rely on, they are our bodies chemical messengers. hormones are produced by the endocrine system and travel throughout the body to tissues and organs in the bloodstream. They can affect a range of body functions, including growth, sexual function, mood, metabolism, and reproduction.  

Approaching the menopause, known as perimenopause, the three main hormones of oestrogen, progesterone and testosterone fluctuate and decline leading to various physical, emotional and cognitive changes.

Oestrogen the primary sex hormone, regulating the menstrual cycle and reproductive health. Progesterone prepares the uterus for pregnancy and maintaining pregnancy. And testosterone (present in smaller amounts then in men), maintains muscle mass, bone health and sexual function.

The decline in these hormones during menopause can lead to a plethora of symptoms, including hot flashes, night sweats, mood swings, cognitive changes, and vaginal dryness. Furthermore, the reduced levels of these hormones can increase the risk of certain health conditions, such as osteoporosis and heart disease.

During the menopause the ovaries no longer respond to these hormonal messages, sent from the pituitary gland in the brain, which eventually leads to the end of ovulation and the menstrual cycle.

Hormones and Sleep Difficulties during Perimenopause and Menopause

One in seven adults experience chronic insomnia with this number nearly doubling for women during the menopause phases with over 60% of perimenopausal women experiencing insomnia symptoms (difficulty falling asleep, frequent nighttime awakenings, waking up too early and being unable to go back to sleep, feeling tired and irritable during the day, and experiencing difficulty concentrating).

The reducing level of the three primary hormones can adversely affect the quality of sleep as the brain may produce less melatonin (the hormone integral for sleep). In particular, progesterone which increases the production of GABA (gamma aminobutyric acid) another key chemical the brain produces for sleep. Progestogen also helps with relaxation and mood thus falling levels have been shown to increase anxiety, restlessness in limbs and middle of the night awakenings too.

Add to this the lowering and fluctuation of oestrogen causing hot flashes, we can understand how sleep during the menopause phases can bring on insomnia symptoms and even keep these anchored post menopause.

HRT (hormone replacement therapy) is shown to be effective in treating vasomotor symptoms, improving sleep quality and is one of the main therapies for Osteoporosis. If you are already taking HRT and feel your sleep is progressively getting worse, it is advisable to discuss this with your GP. Changing the level of progesterone may help with better quality sleep.

Tip, Try incorporating soy-rich foods, which are high in phytoestrogen (a chemical that mimics the effect of oestrogen in your body), into your diet. Avoid eating spicy food and other potential triggers for hot flashes.

There is evidence that shows how the lowering of progesterone and oestrogen, which protect women from sleep apnea, during the menopause cancels out this protection as older women are just as likely to develop sleep apnea as are men.

Other sleep disorders like Sleep-disordered breathing (SDB) encompasses a range of conditions characterized by abnormal breathing patterns during sleep. The most common type is obstructive sleep apnea (OSA), where airflow is blocked, causing pauses in breathing. Other forms include central sleep apnea and upper airway resistance syndrome. SDB can lead to serious health problems if left untreated. Also, studies have shown menopause reduces the amount of rapid eye movement sleep (REM) which is our cognitive restorative sleep, so when waking up lacking full Rem sleep cycles, the cognitive function is impaired.

At Sleep-focus.com, we screen you for SDB by asking you to complete a questionnaire and also, if you have a bed partner, for them too. If there is a clear indication that SDB may be present, we can arrange for a private home sleep study to confirm the type and extent and if necessary give advice on pathways for treatment.

For more information on SDB please visit the Sleep Better Clinic where Dr Ingleby explains more on this condition and treatment.

References

Yale Medicine. 2017. Women, Are Your Hormones Keeping You Up at Night?. https://www.yalemedicine.org/news/women-are-your-hormones-keeping-you-up-at-night

Forth. 2020. Menopause Hormones – What Are They And How Do They Change?. https://www.forthwithlife.co.uk/blog/menopause-hormones/

Cleopatra. 2023. A Closer Look at the 3 Hormones Affected During Menopause. https://cleopatrarx.com/a-closer-look-at-the-3-hormones-affected-during-menopause/

Dr Louise Newson. 2025. Sleep and hormones. https://www.drlouisenewson.co.uk/knowledge/sleep-and-hormones#:~:text=The%20hormones%20oestradiol%20(oestrogen)%2C,fluctuating%20oestrogen%20levels%20%5B2%5D.

Woolcock. 2023. Untangling the mysteries of sleep in menopause. https://www.woolcock.org.au/news/untangling-the-mysteries-of-sleep-in-menopause