Cisgender women typically experience perimenopause four to eight years before entering menopause, with past studies showing that around 47% of perimenopausal women experience sleep disorders. New research suggests that there may be a link between estrogen levels and sleep in perimenopausal women. Perimenopause generally starts in a woman’s early 40s, although it can begin as early as the mid-30s and can last between four to eight years. During this time, the ovaries produce less estrogen, leading to irregular menstrual cycles and the onset of symptoms like hot flashes, night sweats, fatigue, mood swings, low sex drive, and sleep disturbances.
Difficulty sleeping is one of the most common symptoms experienced by women during perimenopause. Understanding the underlying physiology and treatment options for sleep disturbances during perimenopause is limited. Amy Divaraniya, PhD, founder and CEO of Oova, a women’s health company, conducted a study presented at the 2024 annual meeting of the North American Menopause Society (NAMS) which suggests that there may be a correlation between estrogen levels and sleep issues in perimenopausal women. The study recruited 503 perimenopausal women who used Oova’s at-home hormone monitoring kit to track their sleep patterns, with results showing that higher levels of estrogen (E3G) were associated with better sleep quality in the participants.
Researchers found that perimenopausal women who reported sleeping between six to nine hours per night had significantly higher levels of E3G compared to those who slept between three to six hours. While no notable differences were observed in levels of other hormones like LH and PdG, the correlation between estrogen and sleep quality was unexpected. Lower estrogen levels can lead to higher cortisol levels, known as the stress hormone, which can contribute to sleep difficulties and increased anxiety. This potential pathway requires further investigation, but if validated, it could lead to interventions aimed at improving sleep for women experiencing perimenopausal hormone changes.
The findings of this study may pave the way for interventions targeted at improving sleep and managing the impact of hormonal changes during perimenopause. By understanding the physiological pathways associated with sleep disturbances, effective solutions could be developed to support women experiencing perimenopausal symptoms. Further research is planned to identify hormonal relationships with other symptoms tracked on Oova’s platform, potentially opening the door for better support for perimenopausal women. Women who suspect they are in perimenopause and are experiencing sleep difficulties are advised to track their sleep hours and hormone patterns to potentially identify the role of reduced estrogen in their sleep disruptions.
Sherry Ross, MD, a board certified OB/GYN and Women’s Health Expert, commended the study for addressing sleep disruption during perimenopause and emphasizing the importance of understanding the connection to estrogen fluctuations. She emphasized the need for further research with larger patient populations to investigate all perimenopausal symptoms and consider variables such as diet, exercise, stress, and medications in addition to exploring more treatment options. Recognizing perimenopause as a significant stage in women’s lives, Ross stressed the importance of taking sleep issues seriously and prioritizing research efforts to better support women through this hormonal transition.
