How Can Menstruation and Menopause Affect My Sleep
Many factors can affect how well you sleep at night, such as your diet, how you exercise or even certain lifestyle choices. But, if you’re a woman, you also have to consider the implications of the hormonal fluctuations during menstruation and the menopause.
Sleep patterns are governed by the intricate relationships between neurotransmitters (chemical messengers) and hormones in the brain. Notably, some of the most important biological processes involve female hormones, like oestrogen and progesterone. It should come as no surprise, then, that hormonal changes and sleep issues are often inextricably linked.
These hormonal fluctuations can affect women in varying degrees; not everyone will experience the same sleep disturbances. Here, we outline how menstruation and the menopause may disrupt your rest.
What happens to sleep during the menstrual cycle?
Rising and falling levels of the sex hormones oestrogen and progesterone — which oversee the menstrual cycle — can significantly impact the quality and quantity of your sleep.
Just before you menstruate (the point at which you often experience premenstrual syndrome (PMS)), there’s a sudden drop in oestrogen and progesterone, resulting in the release of an egg. PMS can affect your physical and emotional health, and, in turn, have implications on your sleep hygiene.
How does PMS affect my quality of sleep?
Research suggests PMS can negatively affect the quality of rapid eye movement (REM) sleep. REM sleep is the deeply restorative phase of the sleep cycle; it’s where dreaming happens, learning is consolidated, and memories are entrenched. It’s also essential for restoring emotional health.
Some studies suggest women who experience serious PMS symptoms attain less quality REM sleep, resulting in restless, fragmented sleeping patterns and compromised cognitive and emotional wellbeing.i
Why can’t I fall asleep?
PMS can also make it harder to fall asleep. Evidence suggests that PMS decreases levels of melatonin secreted in the brain, lessening the body’s ability to prepare for rest.ii Often, falling asleep can be made even harder by menstrual migraines, which can occur due to the drop in oestrogen just before your period.iii
Can my mood impact my sleep?
Changes in your mood can also accompany fluctuations in your hormones. Increased feelings of sadness or anxiety are common during PMS and can affect sleep.
Low mood or anxiousness can counteract the sleep-promotion process. Mood disturbances can impact the ability to initiate sleep, the duration of sleep, and the quality of sleep.iv Sleeplessness can also increase feelings of anxiety and low mood, and thereby perpetuate a vicious cycle.
How does the menopause affect sleep?
As you enter the menopause, levels of oestrogen and progesterone gradually decline. The shifting hormonal ratios can be a disrupting experience and often contribute to sleeplessness.
A hot flush is a huge rush of adrenaline, which can awake your brain from sleep.v It often leads to sweat production and a change in body temperature — both of which can disturb the comfort needed to sleep. Typically, it can take some time for your adrenaline levels to realign.
As aforementioned, your oestrogen and progesterone levels drop during the menopause. This can trigger changes in your lifestyle, especially sleeping habits.vi One explanation for this is because progesterone is a sleep-inducing hormone. As your body tries to compensate for the diminishing hormone levels, it’s possible you’ll find it harder to fall asleep or stay asleep.
The drop in oestrogen can lead to mood changes, too. As with menstruation, anxiety and low mood can prevent you from falling into a restful, restorative sleep.
How can I sleep better during menopause or menstruation?
Regulate your sleeping environment
Keep your bedroom temperate; 15 – 19 degrees is the optimal temperature for sleeping. To trick your body into feeling drowsy, take a hot shower or bath before bed. The contrast between your cooler bedroom environment and the hot shower will encourage your body temperature to drop and speed up the onset of sleep.
If you have hot flushes regularly, try sleeping with a fan or air conditioning.
Stick to a bedtime routine
Like any other period of sleeplessness, try to maintain a healthy bedtime routine. Go to bed at the same time every night, disconnect from your digital devices 90-minutes before bed, and ensure your bedroom is a place of quiet and darkness. Try to practice the same rituals every night to help you wind down and prepare your body for rest.
Try relaxation techniques
Relaxation techniques, such as yoga, deep breathing, journaling, and visualisation, can help tackle feelings of anxiety and get you in the right mindset to fall asleep. Try using any combination of these strategies before bed. Lavender essential oils can also promote relaxation. Sprinkle it on your pillow or into a warm bath to encourage rest.
Support your nutrition
To support your body’s progesterone production before your period, make a conscious effort to add more foods rich in magnesium, zinc, and vitamin B6 to your diet.vii Increasing your fibre consumption will remove excess oestrogen, too, which can help to readjust your hormones. Try to resist the urge to eat junk food, sugar, or anything refined as this will only exacerbate your PMS symptoms and worsen sleeplessness.
Adding phytoestrogens (soya products, seeds, and legumes) can aid with the production of oestrogen during the menopause. Besides this, eat plenty of healthy fats (oily fish, flax seeds, and hemp seeds), since they’re thought to support the reduction of hot flashesviii. Avoid drinking alcohol or caffeine, too, as they can aggravate your menopausal symptoms.
Try to be active for around 30 minutes most days of the week. Not only will this physically prepare the body for rest, but it will also help to combat feelings of irritability, sadness, and anxiety – often associated with both the menopause and PMS. Notably, sweating in a gym class can be a helpful way to excrete excess oestrogen just before your period, too.
It’s not uncommon for hormonal changes to affect your sleep. Hopefully, the above suggestions can help you manage some of the implications that often contribute to poor sleep quality. If you have any further concerns about your hormonal health and sleep, it’s always worth speaking to your doctor.
If you found this article helpful, feel free to browse the rest of our sleep health hub and learn more about how to get a restful night’s sleep.
Jehan. S., Auguste. E., Hussain. M., Pandi-Perumal. S.R., Brzezinski. A., Gupta. T., McFarlane. S.I. (2016). Sleep and Premenstrual Syndrome. Journal of sleep medicine and disorders. 3(5), 1061.
Jehan. S., et al. (2016). Sleep and Premenstrual Syndrome. Journal of sleep medicine and disorders. 1061.
Mayo Clinic. (2019). Headaches and hormones: What's the connection? Available online: https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/in-depth/headaches/art-20046729
Khazaie. H., Ghadami. M.R., Khaledi-Paveh. B., Chehri. A., Nasouri. M. (2016). Sleep Quality in University Students with Premenstrual Dysphoric Disorder. Shanghai archives of psychiatry. 28(3), 131–138.
Sleepfoundation.org. (2019). Menopause & Sleep - National Sleep Foundation Available online: https://www.sleepfoundation.org/articles/menopause-and-sleep
Baker. F.C., de Zambotti. M., Colrain. I.M. & Bei. B. (2018). Sleep problems during the menopausal transition: prevalence, impact, and management challenges. Nature and science of sleep. 10, 73–95.
Fathizadeh. N., Ebrahimi. E., Valiani. M., Tavakoli. N. & Yar. M.H. (2010). Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iranian journal of nursing and midwifery research. 15(Suppl 1), 401–405
Patade. A., Devareddy. L., Lucas. E., Korlagunta. K., Daggy. B. & Arjmandi. B.(2008. Flaxseed Reduces Total and LDL Cholesterol Concentrations in Native American Postmenopausal Women. Journal of Women's Health. 17(3), 355-366
Olivia Salter has always been an avid health nut. After graduating from the University of Bristol, she began working for a nutritional consultancy where she discovered her passion for all things wellness-related. There, she executed much of the company’s content marketing strategy and found her niche in health writing, publishing articles in Women’s Health, Mind Body Green, Thrive and Psychologies.