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Why Am I Not Sleeping Now That I Am in Perimenopause?

by Debra J. McGinley

I don’t know about you, but I appreciate my sleep. And I mean, 8 hours of uninterrupted quality sleep. Today, sleep can be elusive right before my period and I am up until 5am before my body crashes. I get about 4 or 5 hours of sleep before I have to get up and get going with my day. Why am I not sleeping now that I am in perimenopause?

A 28-day Cycle

To answer this question, let’s go back to understanding the 28-day cycle. There are two phases: the follicular phase (days 1-14) and the luteal phase (days 15-28). Technically, day 14 is considered ovulation but it falls under the follicular phase. And, for every woman, the duration of each phase can be longer or shorter.

During the follicular phase, an egg in the follicle matures within the ovaries in preparation for release during ovulation. At this time, the uterus lining thickens in preparation for pregnancy. Estrogen levels are dominant during this phase, supporting tissue proliferation in the uterine lining, along with elevated levels of follicle stimulating hormone (FSH), which stimulates egg production. On the other hand, progesterone and luteinizing hormone (LH) levels are low.

As you transition from ovulation into the luteal phase, estrogen, FSH, and LH levels drop at the same time progesterone levels rise. Elevated levels of progesterone serve to protect a fertilized egg. If, however, an egg is not fertilized, during the last week of the luteal phase progesterone levels drop. The lining of the uterus is shed, we menstruate and begin the cycle all over again.

So, why am I not sleeping during perimenopause?

Let’s connect some dots here. Estrogen’s role is to stimulate the growth of the egg follicles in the ovaries, maintain the thickness of the vaginal wall, stimulate lubrication of the vagina, and maintain the mucous membrane that lines that uterus.

Low levels of estrogen are associated with breast tenderness, dry skin, weak/brittle bones, trouble focusing, moodiness, tiredness, vaginal dryness, hot flashes and night sweats, irregular or no periods, and elevated cholesterol levels. I like to look at estrogen as being responsible for my energy; “e” estrogen: “e” energy.

In contrast, progesterone’s primary role is to create a stabilized uterine lining for embryo implantation. Progesterone also plays a role in mood regulation as it attaches to receptors in the brain where GABA is found. GABA is a neurotransmitter responsible for producing a calming effect and plays a role in controlling nerve cell hyperactivity associated with stress, anxiety and fear.

Low levels of progesterone are associated with mood swings, anxiety, and depression, in addition to irregular periods, difficulties in conceiving, bloating and weight gain, hot flashes, and…

Here’s the connection

…trouble sleeping. My inability to obtain a good night’s sleep is because of declining progesterone levels. This decline is more drastic for some than it is for others, causing insomnia. For me, the decline is too substantial.

Despite my best efforts, such as night time tea rituals, baths in Epsom salts and lavender essential oils, and listening to calming music, I couldn’t sleep. My focus on exercising, eating for my cycle, and ensuring cool temperatures at bedtime didn’t matter. Nothing helped me to fall asleep. I would go to bed at 10pm only to lay there until midnight as I listened to my husband and dog sleep. When I realized sleep was evasive, I would make my way down to the living room in the pitch dark just to sit there and stare at the dark walls. I would try breathing techniques from yoga, but I knew nothing would help. It was just a matter of time until my body shut down, which was often at 5am.

How I finally achieved a good night’s sleep

After having checked off everything I could have done to support sleep, and I cannot stress the importance of these interventions, I saw my integrative practitioner about other options. For me, the right answer was going on compounded bioidentical hormone replacement therapy (BHRT) while continuing with my nutritional, lifestyle, and supplemental interventions.

I know the rumors and misinformation pertaining to BHRT, and I promise a new blog is forthcoming to address this. The truth is, BHRT has allowed me to sleep at night — especially right before my period when my progesterone levels drop drastically. It has also improved my mood, energy, and PMS symptoms.

How to improve your sleep

There are nutritional, lifestyle, and supplemental interventions that I can help you utilize to support a restful night’s sleep while also minimizing symptoms associated with perimenopause. All of these factors play a major role in balancing hormones while you are going through these changes.

Need to learn more about the basics of perimenopause, click here.

Get on my calendar by clicking the button below. Let’s get you sleeping better and improve your wellness as you take this new journey through perimenopause.