Health Topics

Sleep and Menopause

Approximately 75 percent of menopausal women experience hot flashes, a condition that can make it difficult for women to sleep. According to the National Sleep Foundation, approximately 40 percent of menopausal women have sleep problems caused by hot flashes.

How Can I Treat Sleep Problems Related to Menopause?

The traditional treatment for the symptoms related to menopause has been hormone therapy (HT). HT consists of estrogen given as a pill, patch or vaginal cream, either alone or combined with progestin (a synthetic form of progesterone, or micronized progesterone). However, results from a large study, the Women’s Health Initiative, showed that estrogen-progestin caused an increased risk of breast cancer diagnosis. Estrogen alone did not increase breast cancer risk, but the study also found that therapy with estrogen alone brings an increase in the risk of stroke in older women.

The latest recommendation for HT for menopause symptoms such as hot flashes is to use HT in its lowest dosage, consistent with the indication for use, with periodic re-evaluation with your doctor.

If you decide not to use HT, other ways to deal with hot flashes to improve your sleep include:

  • Staying cool during hot flashes by wearing loose clothing to bed
  • Keeping your bedroom well-ventilated to prevent night sweats and disturbed sleep
  • Avoiding certain foods that might cause sweating (such as spicy foods), especially right before bedtime

Aside from learning how to cope with hot flash symptoms, there are other ways to get better sleep. Try these practices to improve your sleep:

  • Maintain a regular bedtime schedule, including going to bed at the same time every night.
  • Exercising regularly, but not right before sleep.
  • Avoiding excessive caffeine.
  • Avoiding naps during the day, which can prevent you from sleeping well at night.
  • Talking to your doctor about other prescription medicines that can help you sleep.

What Alternative Treatments Can Treat Hot Flashes?

Alternative treatments for treating hot flashes have included soy products such as tofu and soybeans. Soy products contain a plant hormone called phytoestrogen that acts as a weak estrogen. Studies in general do not show significant hot flash reduction with soy products. However, soy foods have other benefits such as lowering cholesterol. Soy in women over the age of 60 was not associated with benefits for the bones or significant cholesterol reduction and actually increased hot flashes. High doses of soy supplements have been reported to stimulate problems with uterine lining.

Black cohosh, a perennial plant that is a member of the buttercup family, has also been used to treat hot flashes. In several studies, menopausal women who took black cohosh experienced relief from hot flashes and sweating, although most of these studies have been short-term, and used varying amounts of black cohosh, from different sources.

Please note that alternative treatment products are not regulated or controlled by the Food and Drug Administration, and the long-term benefits and risks are unknown. Talk to your doctor before you take any of these products.