The Hormonal Sleep Disruptor

Medically reviewed by Dr. Maureen Whelihan FACOG, Gynecologist at the Center for Sexual Health and Education LLC

Here’s something that might surprise you: Women are much more likely than men to report sleeping problems, including insomnia and daytime fatigue. In fact, research shows that as many as 1 out of every 4 women have a hard time getting a good night’s rest. While there are multiple explanations for this, the clearest one is hormones. Hormones play an important role in regulating the sleep cycle, and women typically undergo a number of hormonal shifts during the course of their life, from puberty through menopause.

Hormones that Affect Women’s Sleep Over the Years

There are three hormones in particular that can have a significant impact on a woman’s sleep cycle: Estrogen, progesterone, and androgens.

Estrogen

Estrogen is one of two primary female sex hormones and is responsible for controlling monthly menstrual cycles. Estrogen also contributes to physical shifts women face when going through puberty.

The main source of estrogen is produced by eggs from women’s ovaries; however, it can also be sourced from your fat tissue and your adrenal glands located above your kidneys. Estrogen can move through the blood and impact other parts of the body. 

Progesterone

Progesterone is considered the counterpart to estrogen; it is a steroid hormone that’s produced during the latter half of ovulation in order to prep the endometrium for a potential pregnancy. For this reason, progesterone is a crucial aspect of maintaining healthy pregnancies. Progesterone is often called the “relaxing hormone,” and can have a slightly sedative effect.

Androgen

Androgens are considered male hormones and are often associated with testosterone, but they play an important role in women’s bodies and development as well. Androgens are responsible for jumpstarting puberty in women and also play a role in regulating various organ functions. They are produced in the females’ ovaries, adrenal glands, and skin cells. 

Disruptions or imbalances with any of these hormones can have significant effects on overall health and wellness, including regular sleep patterns.

For women, there are several ways hormonal imbalances can occur. We’ll go through them one at a time, starting with puberty so that you can make an informed decision on treatment plans going forward. 

Puberty Related Sleep Problems

As the body hits a certain age, the brain releases what’s known as the gonadotropin-releasing hormone, or GnRH. This is the hormonal signal that puberty has begun. As the signal reaches the pituitary gland, it triggers the release of two additional hormones, luteinizing hormone (LH) and follicle-stimulating hormone (FSH). 

These hormones exist in boys as well as girls, but they impact the body in different ways. In girls, they affect the ovaries, causing the production of estrogen and preparing the body for a possible pregnancy.

So what does any of this have to do with sleep? 

As estrogen production begins, females start to experience their menstrual cycle, which leads to hormonal fluctuations that can alter sleep patterns. In fact, the discrepancy between male and female sleep problems typically begins at puberty. 

Sleep and Your Circadian Rhythm 

As puberty causes new hormonal patterns, it also changes the body’s circadian rhythm. The circadian rhythm is a natural, hormone-regulated cycle between sleepiness and wakefulness. 

As females become teenagers the body begins to prepare for sleep at a later hour. Consequently, once females hit puberty they may not feel tired at the same time they used to and commonly go to bed later. As a result of getting less sleep at night, pubescent females may begin to feel more tired later on in the afternoon as a result of hormonally triggered shifts in their circadian rhythm. 

Here are a few tips for girls struggling to sleep during puberty: 

Maintain a consistent sleep schedule

• Make sure you go to bed and get up at the same time each day. Consistency can be an important way to adapt to your new circadian rhythms.

Get plenty of exercise 

• This will help prepare your body for sleep. Studies confirm that aerobic exercise during the day is a key ingredient in sleep hygiene. 

Avoid caffeine and other stimulants

•  This is especially important in late afternoon and evening; keep in mind that stimulants can remain in the system for five hours or more, and make it harder for you to find rest.

PMS and Menstrual Cycle Sleep Problems  

Many women suffer from sleeping problems in the days leading up to their period; in fact, more than a third of women report this problem, with the primary cause being hormonal shifts. 

During ovulation estrogen production ramps up, sometimes making it harder for women to fall asleep at night; estrogen is essentially an energy supplement, stimulating the body and mind. Women also experience drop-offs in both estrogen and progesterone in the days leading up to their period which can further throw off their sleep cycle.

As for possible solutions, experts say that exercise during the day can help produce deep sleep cycles. Meanwhile, alcohol should be enjoyed in moderation. Progesterone can actually enhance the stimulating nature of alcohol, potentially causing sleep problems.

Pregnancy-Related Sleep Problems

Pregnancy can also lead to sleep problems. While most moms-to-be expect there to be some sleep deprivation once their little one arrives, it’s also important to prepare for possible bouts of insomnia during the pregnancy itself.

To be fair, pregnancy sleep disruptions aren’t always directly related to hormones; often, women are kept awake due to nausea/vomiting, back pains, or the need for frequent urination; however, it should be noted that women in their first trimester will have heightened progesterone production during the day, which can lead to drowsiness and an increased desire for napping. 

The result of this increase in progesterone can be daytime fatigue and difficulty sleeping at night.

Some ways to handle pregnancy-related sleep disruptions. Here are some adjustments you can make to help facilitate a healthy sleep schedule: 

Only Sleep When You Are In Bed 

If possible, try to only sleep in bed; make the bed your place for sleeping, and nowhere else. Train your mind to associate bed with sleep, and avoid any such associations with couches and chairs, which may cause you to become drowsy any time you sit down.

Keep Your Sleeping Patterns Consistent

Make sure you go to bed and get up at about the same time each day, even on weekends. This helps set your body’s internal clock, and experts say that it can ultimately help you fall asleep and wake up more easily.

Get Up if You Can’t Fall Asleep 

If you are lying in bed at night and all you can do is stare at the ceiling, try actually getting up from bed, and doing a restful activity such as reading or drawing. This will keep your mind off of the fact that you can’t fall asleep and give you the peace of mind for a good night’s rest. 

Address Your Stressors

Often pregnant women may experience anxiety and racing thoughts at night that can lead to trouble falling asleep. In fact, 1 in 5 women in a typical sample meets diagnostic criteria for at least one anxiety-related disorder. One way to prevent anxiety from keeping you up at night is to spend some time each day addressing the root causes of your anxiety whether it be by writing them down in a journal, talking them through with a loved one, or seeking help from a licensed counselor. Acknowledge and reflect on stressors can help free up your mind and body allowing for a more restful night’s sleep.

Postpartum-Related Sleep Problems

The season immediately after pregnancy can also lead to sleep problems.

During the Postpartum phase of a woman’s life, reproductive hormones drop off at a rapid rate, which can throw sleeping patterns completely askew. Additionally, hormones will impact brain chemistry, causing the new mom to be more alert to the sounds of her baby in the night. All of these factors can lead to sleeplessness.

This sleeplessness can actually be fairly dangerous; insomnia is one of the main contributors to postpartum depression, so it is important to address it. 

Here are some practical tips for new mothers dealing with sleep problems: 

• Don’t be afraid to accept help. As the old saying goes, it takes a village to raise a child. So, rely on your support system and let your loved ones take turns watching over your newborn during the day so you have time for some rest or even a quick nap. Even an hour can make a difference when it comes to sleep and your mental health. 
• If you’re a working mom, try to separate work from your life at home. Once you’re home, try to avoid stressful triggers such as work-related stress emails or text so that you can minimize stress and create a relaxing environment within your own home. When the boundaries between work and life at home are blurred so are the boundaries between your stress levels and the quality of your sleep. 
• When it comes to addressing sleep issues, try not to take short cuts. While it can be tempting to substitute caffeine for sleep, too much of a stimulant can cause an uptick in stress and anxiety and make it harder for you to eventually get the deep sleep that your body needs during a time of such large hormonal fluctuations. 

Perimenopause and Menopause Related Sleep Problems

Perimenopause and menopause are also a critical phase in a woman’s life marked by significant hormonal and physiological changes. During perimenopause, production of estrogen and progesterone decreases, usually over a period of several years.

It’s during the perimenopausal stage through the menopause phase, that women tend to report high rates of insomnia with the majority of post-menopausal women suffering from some sort of sleep problems. 

Some of the leading causes of insomnia during perimenopause and menopause include:

Shifts in Estrogen Levels 

Shifts in estrogen often lead to hot flashes and night sweats. In fact, more than 75% of women experience hot flashes during menopause. These sudden sensations of intense heat and redness are caused when blood vessels near the surface of the skin widen and cool off, releasing heat.

While there is no way to avoid hot flashes, there are some ways to prevent them from keeping you up at night. Investing in a cooling mattress is a good start. The right mattress material can help draw heat away from the body and promote healthy air circulation, while a bad mattress actually retains body heat. Also make sure to avoid tight clothing, alcohol, nicotine, and spicy foods, all of which can exacerbate hot flashes and night sweats.

Additional tips include getting exercise during the day and asking your doctor about plant estrogen supplements that may ease the symptoms of menopause.

Related: Best Mattresses for Menopause

The Takeaway 

Of course, it’s crucial to remember that all women are different, and not everyone will face exactly the same hormonal fluctuations or sleep disruptions. With that said, women face hormonal changes throughout their lives, from puberty through pregnancy, postpartum, and menopause. These changes can alter the body’s natural sleep cycles, and it’s common for them to result in sleep abnormalities.

If you’re experiencing difficulties sleeping, one of the best things you can do is visit your doctor and ask for some specific advice. They’ll be able to offer a more personalized assessment of sleep disruptions, hormonal, or otherwise.