Fluctuating Hormones – Fluctuating Sleep

Hormones. Can’t live with them. Can’t live without them.

For 27 years of my life, I experienced heavy, painful menstruation – on a more than monthly basis. At age 38, I had a hysterectomy and a brief reprieve from intense hormonal fluctuations before going into menopause at age 45. I suspect my story is familiar to a lot of women.

Hormones and sleep

The endocrine system which controls the production and release of hormones is a complex beast. It is in charge of over 200 hormones – little chemical messengers that convey important messages about all sorts of bodily functions, including blood pressure and blood sugar, appetite, aging, reproduction, metabolism, energy, mood, and sleep.

Women are 41 percent more likely to experience sleep disturbances than men, and while the causes for this statistic are many and varied, changes in hormonal levels can impact sleep.1

In my case, a lot.

Strong hormonal surges

For most of my adult life, I went through strong hormonal surges that brought about not just physical discomfort but emotional distress. All of which led to many a sleepless night.

I remember being about 14 and experiencing menstrual pain so intense that I was worried I would pass out in my flute lesson. Add to that the irritability so common with the vagaries of the menstrual cycle, and even the most intrepid of teenagers can be excused for becoming distressed with the physical and emotional onslaught of fluctuating hormones.

How hormones can affect sleep cycles

Estrogen

Estrogen hormones (oestradiol, estriol, and estrone) are more prevalent in women than in men as they are major players in menstruation, pregnancy, childbirth, and lactation. During menopause, women experience a reduction in estrogen and these lower levels can contribute to a range of issues, including sleep disruption.2

Estrogen is an important hormone in the sleep cycle. It increases REM sleep, reduces night-time waking, increases periods of uninterrupted sleep, regulates body temperature, and can impact the release of cortisol which can have an indirect effect on sleep.2

Cortisol

Cortisol is the hormone pivotal in the fight-flight response we all experience during periods of intense stress, fear, or worry. When cortisol levels remain elevated, sleep can be very problematic. I have experienced issues with hyperarousal for most of my adult life and the constant sense of being on high alert reduces the ability to both get to sleep and stay asleep.

Fluctuating estrogen levels can cause cortisol levels to vary. And vice versa. It’s a tightly tuned system.

Hormonal changes during pregnancy

Hormonal changes during pregnancy left me wide-eyed but exhausted, while the oxytocin that coursed through my veins during my breastfeeding years helped me to sleep.

Although newborn babies offset some of that relaxation. I also had a rapid progression of my restless legs syndrome during pregnancy, and the change never lessened.

Estrogen-based therapy

When my estrogen levels permanently dropped and I went into menopause, my sleep issues – always problematic – seemed to increase exponentially. In addition to low estrogen levels impacting the sleep-wake cycle, hot flushes, migraines, night sweats, and mood swings all contributed to a worsening sleep situation.

I went on to an estrogen-based hormone therapy, and a lot of my symptoms eased and I was able to catch a little shut-eye here and there. That was 10 years ago. I have experimented with going off estrogen tablets, but after about 3 months, the intense sleep deprivation gets me down, and I go back on. For now, I have accepted I may be on an estrogen supplement for life.

Accepting the nature of my hormones

As I age, I have become more accepting of the contrary nature of my hormones. They are what they are, and all I can do is manage symptoms as best I can. Sometimes knowledge is power. Sometimes sleep is a fickle foe, and I have to tackle it with all the tools I can find.

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