More Sleep May Ease Perimenopause Symptoms Linked to Low Estrogen

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Perimenopause is the time when a woman’s body begins transitioning toward menopause. For most, it starts in their early 40s, although it can sometimes begin in the mid-30s and can last from four to eight years. During this phase, the ovaries slow down estrogen production, which may lead to irregular periods or even a complete stop.

Due to these hormonal changes, many women experience symptoms like hot flashes, night sweats, fatigue, low sex drive, mood swings, and trouble sleeping. Studies have shown that around 47% of perimenopausal women experience sleep issues.

“Difficulty sleeping is one of the most common symptoms women experience during the perimenopausal transition; however, understanding of the underlying physiology and, more importantly, treatment options, remains limited,” said Amy Divaraniya, PhD, founder and CEO of Oova, a health-tech company that uses biomarkers for women’s health.

Dr. Divaraniya is the lead author of a study recently presented at the 2024 Annual Meeting of the North American Menopause Society (NAMS), suggesting that there may be a link between estrogen levels and sleep issues in perimenopausal women.

Tracking Hormone Patterns

In this study, 503 women who identified as perimenopausal, with an average age of 44, tracked their hormone levels and sleep patterns using Oova’s at-home hormone monitoring kit. “Each kit includes urine-based, multi-hormone tests that measure key biomarkers such as luteinizing hormone (LH), progesterone (PdG), and estrogen (E3G), along with a platform for real-time data tracking,” Dr. Divaraniya explained.

By using this kit, women could monitor their hormone levels throughout the month, identify hormonal patterns, and track symptoms. Many participants also logged their sleep hours on the Oova platform, which led researchers to investigate any potential link between hormones and sleep.

More Estrogen May Mean Better Sleep

The study found that women who slept between six to nine hours a night had higher levels of estrogen (E3G) compared to those who slept only three to six hours. Interestingly, the levels of LH and PdG didn’t seem to change based on sleep duration.

“We were surprised to see such a significant correlation between E3G levels and the hours of sleep women were getting each night. Once we examined the results, it made a lot of sense. When estrogen levels are low, cortisol levels are typically higher. Cortisol, often referred to as the stress hormone, is released in response to stress. Elevated cortisol levels can lead to difficulty sleeping and increased anxiety.” – Dr. Divaraniya

These findings suggest a potential connection between sleep disturbances in perimenopause and lower estrogen levels, although further research is needed to understand this fully. “The results from this analysis suggest a potential pathway, but it requires further investigation,” said Dr. Divaraniya.

Possible Steps for Managing Perimenopausal Symptoms

These findings may help guide future interventions focused on sleep improvement for managing perimenopausal symptoms. “The first step in developing an intervention is to fully understand the physiological pathway associated with sleep disturbances,” Dr. Divaraniya explained. “Once this pathway is identified, interventions can be developed to address specific points within it to support women.”

For now, if you suspect perimenopause and struggle with sleep, try tracking your hormone levels and sleep patterns. “Noticing a reduction in estrogen during restless nights could help explain sleep difficulties,” added Dr. Divaraniya.

It has a huge impact on my days, I am constantly tired. I’ve tried napping during the day, but it doesn’t really make up for unbroken sleep at night. MG, Ireland

Taking Perimenopause Seriously

Dr. Sherry Ross, OB/GYN, and Women’s Health Expert, emphasized that the medical community should take sleep disruptions during perimenopause seriously. “It’s been said, ‘a night without sleep is a day without perspective,’ so understanding why sleep problems occur in perimenopause and how they can be avoided or treated should be a priority,” she said.

Dr. Ross also highlighted the need for more research on perimenopausal symptoms, considering factors like diet, exercise, stress, and medication. “The time is now to take perimenopause seriously!” she said.

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