Melatonin, your body's natural sleep hormone, can also be taken as an over-the-counter medication. Low doses of melatonin improved mood and sleep onset in postmenopausal women.
In addition, bazedoxifene (Duavee) has been shown to increase sleep quality. And two other drugs -- the anti-seizure drug gabapentin and the blood pressure medication clonidine -- also may be effective for menopausal symptoms.
Some women who have trouble sleeping may use over-the-counter sleep aids such as melatonin. Others use prescription medications to help them sleep, which may help when used for a short time. But these are not a cure for sleep disturbances, such as insomnia, and should not be used long term.
Sleeplessness due to menopause is often associated with hot flashes. These unpleasant sensations of extreme heat can come on during the day or at night. Nighttime hot flashes are often paired with unexpected awakenings.
Having said all that, international studies suggest that melatonin in low doses can be helpful for midlife women struggling to get to sleep.
Melatonin at dosages up to 5 mg may be helpful for perimenopausal and postmenopausal women with sleep disorders, although more research is necessary to delineate the indications, length of treatment, and dosage.
The good news is that sleep issues during menopause are usually temporary and there are treatments available to help you get to sleep more quickly and stay asleep – yes, there is hope!
Normally, at night time, melatonin levels will naturally increase, and cortisol (our stress hormone), will naturally be lower (than in the mornings). If you are under acute stress, or you have been under chronic stress, you may notice that you tend to wake up between 2-4 am and have difficulty falling back asleep.
One study of older adults with insomnia found that magnesium supplementation at a dose of 500 milligrams daily for eight weeks helped them fall asleep faster, stay asleep longer, reduced nighttime awakenings, and increased their levels of naturally circulating melatonin.
Estrogen therapy is the most effective treatment option for relieving menopausal hot flashes. Depending on your personal and family medical history, your doctor may recommend estrogen in the lowest dose and the shortest time frame needed to provide symptom relief for you.
Reasons this might happen include drinking caffeine or alcohol late in the day, a poor sleep environment, a sleep disorder, or another health condition. When you can't get back to sleep quickly, you won't get enough quality sleep to keep you refreshed and healthy.
The best way to put an end to late-night awakenings is to keep a consistent sleep-wake schedule. That means getting up at the same time each day (yes, even on weekends). Committing yourself to a proper bedtime is only half the battle to improve your sleep hygiene. Having other good sleep habits is just as important.
You can sleep better with menopause by improving your sleep hygiene, including getting light first thing and avoiding light, caffeine, and alcohol too late in the day. Hormone replacement therapy may also help you fall asleep faster and wake up less often during the night.
During the night, hormone levels can swing even more drastically, which sometimes results in much more severe hot flashes that can leave clothes and bedding soaked. Diet – caffeine, spicy foods, and alcohol are just a few of the dietary contributing factors that can create more severe hot flashes at night.
The menopausal decline of estrogen contributes to disrupted sleep by causing menopausal symptoms from hot flushes and sweats (vasomotor symptoms) to anxiety and depressed mood; anxiety leading to difficulty getting to sleep, and depression leading to non-restorative sleep and early morning wakening.
"By adding extra melatonin every night, you might throw off that delicate balance in the long run, and might experience the side effects of the body needing to re-balance, whenever you decide to stop using melatonin," says Dr. Raymann.
Do not use melatonin if you are pregnant or breastfeeding or have an autoimmune disorder, a seizure disorder or depression. Talk to your health care provider if you have diabetes or high blood pressure.
Most people overdo it with melatonin by taking upward of 10 milligrams or more prior to bed and then claim it doesn't work. Taking too much melatonin can actually cause rebound insomnia —either rendering the supplement ineffective or worse, exacerbating your already sleepless nights further.
The usual dose is one 2mg slow release tablet taken 1 to 2 hours before bedtime. Sometimes your doctor will recommend that you only take melatonin 2 or 3 times a week to see if that improves your sleep first.
A single case study in 2008 suggested that one woman had higher levels of estradiol (a form of estrogen) while taking melatonin therapy. Still, there is no clear evidence that melatonin causes higher estrogen levels and no other studies on this topic have been published.