Letter: Treatment can help menopausal sleep disruptions

Graphic by Lori Deaton

Thank you for your recent piece on how to reduce insomnia [ “Sleepless in Asheville: Insomniacs Share Strategies for Finding Rest,” Nov. 22, Xpress], because this is such a huge problem, particularly among midlife women. I was especially glad that the article specifically highlighted menopause as a major driver of sleeping problems in women. As a menopause specialist working in health care, I spend a lot of time educating women and providers alike about perimenopausal changes and how hormone changes impact well-being in midlife. There is a lot of misinformation around menopause in health care, and as a result, many women’s health providers remain uneducated about the benefits of hormone replacement therapy.

Many people don’t realize the cost of women not treating these temporary but often debilitating symptoms. The perimenopause transition begins on average seven-10 years before a woman reaches full menopause. The average age that women reach menopause in the U.S. is 51, which means that hormonal shifts begin on average around ages 41-45, and sometimes even earlier. The most common hormonal problems that contribute to disrupted sleep and altered circadian rhythms in midlife women are waning progesterone levels, erratic estrogen levels and sometimes depleted levels of testosterone.

In addition to causing multiple nighttime wake-ups and sometimes increased difficulty falling asleep, early menopause symptoms like anxiety, fatigue and decreased resilience can start years earlier than hot flashes for some women. In addition, as a woman gets closer to her menopause transition, hot flashes and feeling increasingly uncomfortable and wakeful when hot at night (“night sweats”) are the most common driver of sleep disruption. Together with hormonal weight gain and increased risk of sleep apnea (as the article also mentions), midlife women really suffer as a result of not sleeping well. Sometimes several nights per week of sleep are affected, over a period of nearly a decade.

Over 80% of women report sleep difficulties during their menopause transition, but only 12% or less are offered hormone replacement therapy, or HRT. Despite what many people have been misled to believe, modern body-identical HRT is safe and affordable, and offers highly effective treatment for hot flashes and sleep disruption with the most long-term benefits (namely, reducing osteoporosis, diabetes and heart disease). Women and providers can get more education about ways to treat menopause symptoms safely and effectively by reading the Menopause Society guidelines at [avl.mx/d7w].

— Jill Gustafson
Certified menopause specialist and nurse-midwife


Thanks for reading through to the end…

We share your inclination to get the whole story. For the past 25 years, Xpress has been committed to in-depth, balanced reporting about the greater Asheville area. We want everyone to have access to our stories. That’s a big part of why we've never charged for the paper or put up a paywall.

We’re pretty sure that you know journalism faces big challenges these days. Advertising no longer pays the whole cost. Media outlets around the country are asking their readers to chip in. Xpress needs help, too. We hope you’ll consider signing up to be a member of Xpress. For as little as $5 a month — the cost of a craft beer or kombucha — you can help keep local journalism strong. It only takes a moment.

About Letters
We want to hear from you! Send your letters and commentary to letters@mountainx.com

Before you comment

The comments section is here to provide a platform for civil dialogue on the issues we face together as a local community. Xpress is committed to offering this platform for all voices, but when the tone of the discussion gets nasty or strays off topic, we believe many people choose not to participate. Xpress editors are determined to moderate comments to ensure a constructive interchange is maintained. All comments judged not to be in keeping with the spirit of civil discourse will be removed and repeat violators will be banned. See here for our terms of service. Thank you for being part of this effort to promote respectful discussion.

Leave a Reply

To leave a reply you may Login with your Mountain Xpress account, connect socially or enter your name and e-mail. Your e-mail address will not be published. All fields are required.