HRT And Sleep: Does it Help?

HRT and sleep
Hit by insomnia and exhaustion in the menopause years? Us too. The good news is that HRT can help sleep. Here’s what you and your hormones need to know.

You don’t need us to tell you that the years surrounding menopause bring about lots of changes. You also don’t need reminding that the list of symptoms can seem never ending. At Hylda, one of the top symptoms women mention is lack of sleep. Getting to sleep or sleeping through the night is a bigger challenge at menopause. For those of us (and there are many) who can’t afford a sleep coach (yes, there are such specialists out there, it just proves how big the issue is) long nights often feel endless. The good news? there are solutions and easy tips… some that focus on the body, some on the emotions, and we are here to help.

This article answers these frequently asked questions about HRT and sleep, and menopause and sleep:

  • Can HRT cause sleep problems?
  • Does HRT make you need more sleep?
  • Can estrogen keep you awake at night?
  • Why do I wake up at 3am?
  • Can HRT cause insomnia?

It’s important to remember that every woman’s menopause will be different but one thing that seems to affect many of us is insomnia. Data from energy and sleep tracker RISE shows that women have more sleep debt (accumulated lack of sleep) than men between the ages of 50-59. It’s why our medical advisor Dr Stephanie Goodwin is often asked about HRT and sleep, and if it can help.

What causes sleep problems in menopause?

Poor quality sleep can cause chronic exhaustion. It can also make symptoms of menopause worse. At the same time, it’s the hormonal shifts that occur during these years that may be contributing to your sleep disturbances. Finding the right routine is critical. Caught in a catch 22? It can certainly feel like it.

READ MORE Menopause and sleep, how to make it better.

Some of the reasons that menopause causes sleep problems include:

• Hot flashes – You might wake up drenched in sweat and unable to cool off.

• Neural changes – The brain changes that trigger hot flashes may also cause abrupt awakenings at night.

• Sleep apnea – This sleep disorder is more common among postmenopausal women than premenopausal ones. Lower levels of reproductive hormones are associated with an increased risk of sleep apnea.

• Mental health issues – The depression and anxiety that may crop up due to menopause symptoms and life changes at this stage could interfere with healthy sleep.

• Joint pain – Aches and pains that accompany menopause can make it hard for you to sleep (as anyone who’s been woken up by a frozen shoulder knows only too well).

READ MORE What are the 34 symptoms of menopause?

Does estrogen help you sleep better?

Estrogen affects the body chemicals that regulate your sleep-wake cycle. Estrogen has been found to help menopausal women sleep better for a number of reasons, including:

• Improving quality of sleep

• Reducing the amount of time necessary to fall asleep

• Boosting the amount of time spent in REM sleep

• Reducing the number of times you wake up during the night

Can low estrogen cause insomnia?

As your body prepares for menopause, your estrogen levels drop. Your circadian rhythm is disrupted, and you may develop other symptoms, like hot flashes, that keep you awake. Plus, reproductive hormones are closely linked to melatonin, a chemical that regulates your circadian rhythm and sleep. It makes sense that when your estrogen levels diminish, you have more trouble sleeping.

Does HRT help with sleep problems?

Are you curious about HRT and sleep? Hormone replacement therapy, or HRT, addresses just about every cause of sleep disturbances during menopause. It diminishes other distressing menopause symptoms, helping to alleviate the night sweats, joint pain and mental health issues that crop up during this time.

One review found that women who had night sweats and took HRT, experienced better sleep patterns. However, HRT was not as effective for improving slumber in women who didn’t have hot flashes.

READ MORE HRT, is it safe? Everything you need to know.

Can HRT make you sleepy?

One of the longest trials of HRT found that the treatment improves sleep and other quality of life measures. However, taking too much estrogen can make you feel tired. Therefore, it’s important to adjust your levels carefully and under the supervision of a medical professional.

How can I get a better night’s sleep during menopause?

As you age, your circadian rhythm shifts. Most postmenopausal women experience changes in their internal body clock that make them sleepier earlier in the evenings. In fact, it seems that the ideal time for older adults to sleep may be between 7pm and 3am. Not very practical for modern life.

A 3am start may not be feasible (although a 7pm early night with a good book is sometimes very tempting), you should try to follow your body’s sleep cues. Don’t push yourself to stay up late. You might even want to head to bed a bit earlier every night to gradually transition your sleep schedule to match your body clock. If, like many menopausal women, you wake up early and can’t go back to sleep, don’t fight it. Instead, adjust your bedtime so that you get enough hours of high-quality rest.

If you feel tired during the day, do your best to avoid napping. Instead, get plenty of fresh air and sunlight. Wind down early with a relaxing bedtime routine that encourages you to close your eyes and rest.

READ MORE Menopause and anxiety, the lowdown.

Lifestyle changes to help with sleep

The question of menopause insomnia comes up a lot in our monthly IG Live menopause and midlife health clinics with Dr Stephanie Goodwin. She always stresses the importance of sleep hygiene. That means a regular bed time, no staring at screens before bed – and definitely no checking your emails (or Tik Tok) once you’re in bed. Cutting back on alcohol and sticking to a regular exercise routine will also help.

Dr Steph often recommends taking a magnesium supplement to help with sleep. Many women also find that CBD supplements are hugely helpful – they have certainly made a difference to several members of the Hylda team. One thing to remember when buying CBD – you need to ensure you’re buying a quality brand.

Evidence shows that good products with a high amount of cannabidiol (CBD), can help reduce menopause symptoms like insomnia and anxiety. We love these Sleep Drops from CBD brand OTO, which contain 10% CBD and do seem to have had a real impact on our sleep and rest. We’re impressed.

READ MORE What is The Difference Between Perimenopause And Menopause?

You should also ensure that you don’t have an underlying medical condition that impairs your sleep. Some medications can interfere with the quality of your slumber as well. Talk to your medical professional if you think that your medications are keeping you awake.

Menopause side effects are harder to deal with when you’re already exhausted. But as you age, it can become harder to get the level of rest that you need. It’s all about balance which is why, for many women, HRT and sleep go hand in hand. Levelling out your hormones while creating a routine that supports high-quality sleep can ease the frustration and make bedtime peaceful again.


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