Written by Thy Thy TranHoang
How Hormone Replacement Therapy Affects Sleep
Sleep is important in our daily lives. Quality sleep can help our bodies and minds be healthy by promoting our immune system, managing our mood and energy, as well as help us carry out cognitive functions—such as concentration, memory and creativity. In this article we explore the effects of hormone replacement therapy on sleep.
Perimenopause and Sleep Disturbances
Experts recommend 7-9 hours of sleep every night. However, insomnia and sleep disturbances due to hormonal changes, night sweats, and other perimenopause symptoms can hinder women from reaching this recommendation. Along the way, women may choose to start hormone replacement therapy to help ease some perimenopause symptoms. The question is: does hormone replacement therapy affect sleep?—and if yes, in what way?
Overview of Hormone Replacement Therapy
According to The North American Menopause Society, hormone therapy is the most effective treatment for menopausal symptoms thus far. Hormone replacement therapy is the prescription of medication that contains female hormones. These hormones are meant to replace those that your body stopped producing during perimenopause.
Women who have not had their uterus removed will be prescribed estrogen along with progesterone or progestin. Women who have had their uterus removed may be prescribed estrogen only. This is because the use of estrogen alone can stimulate growth of the uterus lining, increasing the risk of endometrial cancer.
Hormone replacement therapy is recommended for women up to 59 years of age or within 10 years of menopause. The form of hormone replacement therapy is dependent on the individual, provider, symptoms that the hormone replacement therapy will address—and sometimes, the individual’s medical and family history.
How Hormone Replacement Therapy Affects Sleep
According to The Journal of The North American Menopause Society, a low dose hormone replacement therapy can be the solution to sleep difficulties for perimenopausal and early menopausal women. Specifically, women who were prescribed low dose hormone replacement therapy were twice as likely to achieve quality sleep compared to women who did not use any form of hormone replacement therapy.
Estrogen has a wide range of effects that can affect sleep. The hormone is associated with metabolism of norepinephrine, serotonin, and specific neurotransmitters that affect sleep patterns. This aids in the increase of deep sleep and total sleep time.
Professionals have used progesterone as a respiratory stimulant to treat mild obstructive sleep apnea on several occasions. This is because progesterone has sedative and anxiolytic features where it can stimulate the production of gamma aminobutyric acid receptors—which are the receptors that initiate sleep.
Due to the effect that estrogen and progesterone has on sleep, hormone replacement therapy is highly recommended for individuals who may be experiencing sleep difficulties. With that factor in consideration and the potential of alleviating perimenopause symptoms, hormone replacement therapy is a great option to consider during a woman’s perimenopausal and menopausal period.
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Lee, J., Han, Y., Cho, H. H., & Kim, M. R. (2019). Sleep Disorders and Menopause. Journal of menopausal medicine, 25(2), 83–87. https://doi.org/10.6118/jmm.19192
Mayo Clinic Staff (2022). Hormone therapy: Is it right for you? Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/menopause/in-depth/hormone-therapy/art-20046372
The North American Menopause Society (n.d.). The experts do agree about hormone therapy. https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/the-experts-do-agree-about-hormone-therapy
Pershad, A., Morris, J. M., Shearer, K., Pace, D., & Khanna, P. (2023). Influencing factors on women’s attitudes toward hormone therapy acceptance for menopause treatment: a systematic review. Menopause (New York, N.Y.), 30(10), 1061–1069. https://doi.org/10.1097/GME.0000000000002243
Reller, K. (2017). Study finds hormone therapy improves sleep quality for recently menopausal women. Mayo Clinic. https://newsnetwork.mayoclinic.org/discussion/study-finds-hormone-therapy-improves-sleep-quality-for-recently-menopausal-women/