Excerpted from the Hopkins Health Watch Q & A
Q: I know you must have seen the word “insomnia” a thousand times used by women who are pre or post menopausal. I know from myself and my friends that this is a huge problem and since it seems to slowly come on around one's late 40s it probably has something to do with hormones. Millions of women are steadily taking sleeping pills which were never designed to be taken week after week, month after month. I fall into that category. I have read everything under the sun about menopause, insomnia, and hormones including all of Dr. Lee and your books. Everyone talks around the subject and offers simple cures, but nothing seems to help. What is the connection between waning estrogen and melatonin? Or is it the lack of progesterone?
A: Yes, I probably have seen and heard the word insomnia a thousand times from women at one end or the other of the menopausal transition. First I’d like to point out that once you get hooked into almost any of the prescription sleeping pills it can be very difficult to unhook yourself. And did you know that one of the side effects of sleeping pills can be insomnia? I kid you not. Some people even have to go into rehab to kick the sleeping pill habit, others have a few bad nights and are over it, and others have minor issues.
I’d also like to add a plug for “simple cures” for insomnia that falls into the “Be Aware” category. Here’s a familiar conversation:
“I’ve tried everything to get a good night’s sleep and nothing works!
How many cups of coffee are you drinking a day?
Just one cup in the morning—I have to because I’m so sleepy!
How many sodas are you drinking a day?
I’ve been keeping it down to a Diet Coke in the late morning and one in the late afternoon.”
Substitute your soda of choice for Diet Coke—the result is about the same. Diet Coke has 45 mg of caffeine in it. Two Diet Cokes contain the caffeine equivalent of a strong cup of coffee, more than enough to keep you awake most of the night if you’re sensitive to caffeine. Add to that the presence of the artificial sweetener aspartame, an excitotoxin (a substance that excites the brain). If your liver function is compromised, which it’s almost certain to be if you’re routinely taking sleeping pills or almost any type of drug, it can take very little caffeine and/or aspartame to keep you awake at night because they aren’t being efficiently excreted from the body.
On my website you’ll find an article by Dr. John Lee, Getting a Good Night’s Sleep, which yes, gives the simple cures for insomnia.
Now let’s get to the hormones. Estrogen could also be called an excitotoxin—in fact it’s so stimulating to the brain that women who take too much can go through terrible withdrawal and depression if they go off it suddenly. Here’s an example of how estrogen excites the brain: We’ve all been around women who, once they start talking, seem unable to stop—that’s a hallmark of excess estrogen. Add a caffeine habit to that and you have a woman who never stops talking a hundred miles an hour. Forget about sleeping.
This doesn’t just happen to women who are taking estrogen. As Dr. Lee has explained in all of our books, if you don’t have enough progesterone to balance your estrogen, you will have estrogen dominance, and many estrogen dominant women can’t sleep. Even fairly mild estrogen dominance can cause trouble sleeping, especially if you’re ignoring the simple cures. And remember, you can be estrogen dominant even when your estrogen is waning. No or low progesterone = estrogen dominance. Estrogen dominance also interferes with melatonin production, which is the brain hormone that makes you sleepy when it’s dark.
Progesterone calms the brain, but not in a groggy, druggy kind of way. It’s more like going from hyper to normal. I’ve read 100's of e-mails from women saying that once they started using progesterone cream they started sleeping normally again. However, if you use too much progesterone day after day you’ll start shutting down your progesterone receptors and won’t be able to sleep again. You might want to consider getting a saliva hormone level test to find out if a hormone imbalance is indeed contributing to your insomnia.