Wake-up call
Menopause-related insomnia’s a part of life, but can be treated
WHEN Lori Ann King had a total hysterectomy in 2015, she was surprised to find that the surgery triggered menopause, which in turn brought insomnia.
“It would take me an hour to get to sleep and then I’d be waking up at 1 a.m., 2 a.m. and so on,” the 46-year-old, who suffered from ovarian fibroids and endometriosis, tells The Post. “The fatigue was overwhelming.”
Sleep expert Dr. Mayank Shukla, head of the Asthma, Allergy and Sleep Center of New York, says insomnia is a common consequence of this change in life.
“Women’s bodies undergo many changes before, during and after menopause,” Shukla says. “There’s a dramatic shift of hormonal balance, which often causes cycles of insomnia because of the depletion in estrogen and progesterone.”
In 2011, the Study of Women’s Health Across the Nation (SWAN) found that sleep disturbances increase with age. The prevalence of insomnia in the premenopausal age group ranged from 16 to 42 percent, rising to 39 to 47 percent in perimenopausal women. For postmeno- pausal women, the range was anywhere from 35 to 60 percent.
King, a writer and wellness coach, says her inability to sleep soundly left her feeling exhausted.
“When I don’t sleep, I’m a mess,” she writes in her recent book, “Come Back Strong: Balanced Wellness After Surgical Menopause.”
“I became cranky, irritable and susceptible to tears, outbursts and illness [such as headaches].”
She says she often couldn’t get through the working day without frequent naps. The anguish also put a strain on her marriage.
Things got so bad that she was prescribed the sleeping pill Ambien. She also tried bioidentical hormone replacement therapy (BHRT), a natural hormone therapy recommended by her gynecologist. Its medication comes in the form of a combination of progesterone and estrogen cream applied to the skin of her wrists.
“I like to be as natural as possible and the treatment works for me,” says King, who, under her doctor’s guidance, has the medication compounded by a pharmacist near her home in Kingston, NY.
“Now, I am sleeping a lot better and things are pretty good.”
Dr. Michelle Warren, founder of New York’s Center for Menopause, Hormonal Disorders and Women’s Health, explains that the mix of hormonal imbalance, anxiety and thyroid issues common among mature women makes “a perfect storm for a disaster” when it comes to sleep.
To combat it, she recommends conventional hormone replacement therapy (HRT), such as systemic estrogen, which comes in the form of pills, skin patches, gels, creams or sprays.
Regular exercise, as well as cutting down on alcohol and stimulants — such as caffeine — and screen time before bed, can also reduce insomnia.
Some women have benefited from using breathable bamboo bedsheets (to help ease the symptoms of hot flashes) as well as psychological counseling, antidepressants and melatonin supplements.
“The good thing about menopause and sleep issues is that it’s treatable,” says Warren.