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Of all the things in the body that hormones affect, sleep is one of the most important.
Without quality sleep, it is difficult to regulate appetite, to burn fat, to feel good, and to be happy and calm. Poor sleep can cause inflammation, poor blood sugar control, depression, anxiety, and a whole host of other issues.
Women suffer from insomnia at nearly twice the rate of men. This may in part be due to social and psychological factors, but it is also no doubt also due to the physiology of female hormones.
Fortunately, even though it’s nearly impossible to find great information about female hormones and insomnia on the web, the basics of are actually quite simple. Here is what you need to know about female hormones and insomnia.
Female hormones and insomnia: low estrogen levels cause insomnia
Low estrogen levels cause insomnia. Why? Because estrogen helps move magnesium into tissues. Magnesium is crucial for catalyzing more than 300 reactions in the body, the synthesis of important sleep neurotransmitters and the sleep hormone melatonin included.
When this happens, it is both harder to fall asleep as well as harder to stay asleep throughout the night.
Female hormones and insomnia: when estrogen levels get low
Estrogen levels can fall for a number of reasons. Here are the most common:
Female hormones and insomnia: psychological stress
High amounts of psychological stress can cause the female body to shut down reproductive function. This happens because the body would prefer to wait until less stressful time before becoming pregnant. It is much easier to become ill or die while pregnant if you are in a stressful environment.
You can read more about psychology and how it can affect sex hormone function in this post: psychological stress and hypothalamic amenorrhea.
Female hormones and insomnia: metabolic stress
High amounts of physical stress like under-eating, over-exercising, low fat or low carb diets, intermittent fasting, dramatic weight loss or low body fat percentage can all cause estrogen levels to drop precipitously.
It is super important for the female body to feel relaxed and fed. If it does not feel fed, it will think that it is starving. And if it thinks that it is starving, it will stop producing reproductive hormones, so as to stop you from becoming pregnant at a time in which it may be dangerous.
All sorts of activities that involve undereating of some sort – whether from calorie counting or chornic dieting – thus become a threat to your ability to sleep, especially if they are a chronic problem.
You can read more about the threat of starvation to female sex hormones in this post: metabolic stress and hypothalamic amenorrhea.
Female hormones and insomnia: fluctations with the menstrual cycle
Women of reproductive age often experience fluctations in their ability to sleep on a monthly basis. I know that I certainly do.
When?
Most women report most difficulty sleeping in the day or two before menstruation, and during the first days of menstruation.
This is because these are the days in which estrogen levels are the lowest.
On day 1, the day of bleeding, all sex hormone levels are very low. Over the course of the next two weeks, before ovulation, estrogen levels rise. After ovulation, estrogen and progesterone levels fluctuate. Sometimes during this phase, progesterone levels may be elevated enough in order to off set any benefits from the estrogen, but usually the estrogen is strong enough to enable you to sleep.
At the end of the cycle leading up to the days of bleeding, however, most hormone levels are back down very low, including estrogen, making sleep difficult during these days and in the days that follow.
Female hormones and insomnia: menopause
Menopause is infamous for causing insomnia. Hot flashes often play a role in this, but even without hot flashes many women and toss and turn for years.
Menopause causes insomnia because the ovaries stop producing estrogen and progesterone at this time. Very often, after menopause the body readjusts to low estrogen levels and more easily picks up on a light estrogen signal. But it can take a significant amount of time for that to happen, which can be super problematic if you enjoy sleeping.
One solution to this problem is to try hormone replacement therapy. I am not an expert in pharmaceutical solutions to menopause, however – so I cannot in good conscience recommend particular brands or dosages. I will say that I think a low dose for a short period of time is probably okay and will not cause any problems, though HRT can cause symptoms such as breakthrough bleeding and is also under investigation for being linked to incidences of female cancers such as breast cancer.
One more natural solution is to experiment with phytoestrogens like legumes (chick peas, black beans), nuts (macademia nuts, cashews), small amounts of soy or flax in your diet, or even moderate alcohol consumption. These foods act like estrogen in the body and may be able to help give your sleep the estrogenic edge you need. Each woman’s body is different so you won’t know how these affect you until you give them a shot.
I recommend starting with one bowl of chickpeas a day if you are coming from a ‘clean’ paleo diet, and with something a bit more robust, like a tablespoon of flax, a day if you are coming from a Standard American Diet. The reason there is a difference in those recommendations is that women who have been ‘clean paleo’ will be more sensitive to phytoestrogens than ones who regularly consume them as a part of the SAD.
You will also want to make sure you are eating at least 40 grams of fat a day so your body has all the fat it needs to make estrogen, as well as at least 50 grams of carbohydrate (100 for women who are still of reproductive age), to keep your metabolism, thyroid, and reproductive hormones burning strong.
For more on some recommendations I make for menopause, check out this post on menopause and hot flashes.
Other hormones, systems, and insomnia
Of course, there are other hormone problems that can cause insomnia. Disorders of testosterone production, growth hormone production, and thyroid hormone – especially if hyperthyroid – can all have a negative effect on your ability to sleep.
Plus of course there are many other causes of insomnia beyond hormones. Neurotransmitter imbalances, electrolyte imbalances, stimulating substances like caffeine or MSG, blood sugar spikes, stress, anxiety, and dysregulated circadian rhythms can all be significant problems. I have suffered from each of these in my own journey with insomnia.
Nevertheless, the menstrual cycle, menopause, and the sensitivity of the female body to stress are all very common reasons that women lose sleep. And it all boils down to one thing: estrogen.
Estrogen, estrogen, estrogen.
Working on correcting or taking care of the estrogen-lowering issues discussed above can and will go a long way towards soothing your insomnia needs.
And, as ever, I am super curious as to what you think! Do you have experience with female hormones and insomnia? What things have worked for your insomnia?
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Thank you so much for this post. I’m currently recovering from hypothalamic amenorrhea and am set to get my period for the third time in over two years today! Last night I could NOT fall asleep and was stressing over it for a long time. I have had trouble falling asleep in the past, and can definitely say that I have a huge fear of lying awake at night without being able to sleep because of it. It was just really great to hear that this is actually pretty normal for women to not be able to sleep the few days before menstruation begins. Also an indicator that I should be getting my period soon! That’s truly what I’m most happy about. Keep doing what you’re doing. I love it. I love you. Thank you!
SUPER NORMAL. 🙂
<3 <3 <3 And don't worry about your sleeplessness... trust me, I am there with you. I have had many completely sleepless nights. It might make life more challenging, but you do survive, and sleep always makes its way back in the end.
I would love to see a post on specifically how to go about raising estrogen. I’m a 24 year old female and for some reason I haven’t menstruated in 3 years. My last few hormone labs show my estrogen levels to be pretty abysmally low. I’ve gained a good amount of fat over the last year in the hopes that that would up my estrogen levels and restore my menstration but no such luck yet.
I’ve also suffered, especially recently with insomona and it’s making my life a bit difficult lately. Thanks so much for always being so honest and sharing your excellent research. Looking forward to seeing that post on raising estrogen! ;). Thanks Stephanie!
Ack. It’s not easy. I’m in the same boat. Weight gain, stress reduction, maybe playing with phytoestrogens… alcohol. I can promise you I’m busy looking for other solutions, too.. 🙂
Hi Stefani
I love your work and your energy, thank you for all you do for us – paleo women. Just an observation in regards to this blog – I couldn’t find any mentioning about the role of low progesterone in sleep quality. I always thought it’s low progesterone, often during peri-menopause years, is to blame for poor sleep. What are your thoughts on low progesterone and sleep?
Also, you suggest trying HRT. Do you mean bio-identical hormones? I would personally only consider bio-identical hormones and would not touch synthetic HRT.
Thank you
Irina 🙂
Hi Irina,
Yes, I did mean bioidentical hormones as HRT… I suppose there is a difference now that you mention it, though I always just assume that if you are going to do hormones then bio-identically is the way to do it. In either case the health related implications are not all that clear.
I suppose it’s possible that progesterone can become so low so as to cause sleep problems, though I don’t know any mechanisms by which that could happen off of the top of my head. I’ll do some reading. Estrogen is definitely considered in the literature to be more of a problem, and we see that a lot in women who struggle with PMS and other menstrual symptoms.
Great article. I have been suffering from insomnia the last year, and its definitely hormonal. After a stressful year, I feel like all my hormones have been thrown out of wack. Including my cortisol and thyroid. On the road to hopefully getting my sleep back without the need for sleeping pills. Reassuring to know I’m not just going crazy, and others are going through it too!
yes. lots and lots of patience. lots. sleep takes longer to work on than almost anything else, but it does it better 🙂
Hi Stefanie, thank you for all your work, I am recovering from anorexia. I restarted gaining back my periods and sleep at night after I started eating more garbanzo beans. However, my blood sugars are higher ( fasting about 105-110) in the week prior to my periods. Other time they are about 80-90 in morning. Any ideas? Thank you so much! Love all your podcasts and blogs!
I talk about this in a blog I recently wrote on carb cycling. Blood sugar and insulin levels are definitely higher at that time of the month. You can either be fine with that or if you want your levels to come down you could simply try to be a bit lower carb at that time, or do some insulin-sensitizing high intensity exercises 🙂
Our livers tend to dump glucose into our blood in the mornings to help us get up and get moving since we’ve generally been fasting for 10+ hours. Those numbers don’t seem too bad for morning but that’s a very limited scopeof infoto consider too. You might benefit from a little raw, local honey in your tea before bed to help you through the night. If your A1C is high also, you might need to reconsider the number of carbs you’re eating every day (assuming you’re already eating a clean Paleo diet).
<3
Hi Stefani, I wanted to let you and others know what has helped my menopausal/estrogen dominance-induced insomnia and chronic hair loss, both of which I think were caused by my gynaecologist putting me back on the birth control pill (Qlaira) at the age of 48, for more than 4 years. Despite my doctor’s protests that Qlaira was “a lovely pill with no side effects”, I am now absolutely certain that it was Qlaira that put me into a state of estrogen dominance, causing chronic insomnia and hair loss. I quit the pill about 2 months ago and, no thanks to any doctor, only to my husband’s tireless internet research, started on a natural progesterone cream about a month ago. The improvement in my state of health and mind is already enormous. I am happier and calmer, sleep is greatly improved and the hair loss is back to normal now, which is a huge relief as I have lost at least 50% of my hair, no joke for a 53 year old woman. Pathologists tests revealed that my progesterone level was low, but that my estrogen level was on the low side of normal, i.e. definitely not high. Nevertheless, I was still in a state of estrogen dominance, which shows that it doesn’t matter how low estrogen levels are, if the progesterone level is too low, you will still have estrogen dominance. It is the balance of estrogen and progesterone that is important. Needless to say, my confidence in “modern medicine” is at an all time low. I realise that we are all different and that not everyone will benefit from natural progesterone cream, but I don’t want to be without it for a very long time to come. I am flabbergasted that all one reads is how women need estrogen during menopause. Bollocks, in my opinion. What about the all-important and forgotten calming, anti-cancer hormone, progesterone? Estrogen is an excitatory and inflammatory hormone. Once again it is clear to me that the medical profession is driven by money and greed. The more prescriptions that doctors can write out for the vile and cruelly-obtained Premarin (and others), the more doctors’ pockets are lined with kick-backs from pharmaceutical companies. My advice to all women is to never go the HRT route. If anything, opt for bio-identical hormones, or better still, natural progesterone cream – no doctor’s appointment or prescription needed. Thanks for posting such interesting information. As you say, it is difficult to find good information on hormone imbalance and insomnia.
This is great news… thanks for sharing. I’ll do some more digging on the interplay between estrogen and progesterone for sleep 🙂
I had been struggling with chronic debilitating insomnia for the last couple of years. Recently I came across something that made a world of difference for me. I read an article about the benefits of limiting your eating to a shorter time frame each day. For several reasons I decided to try it for a month. I chose primarily paleo foods like meats, vegetables and plenty of healthy fats, and I only ate between 12:00 and 5:00 in the afternoon. I ate a lot of nutrient dense good food every day but only between noon and 5:00. By the end of the first week my insomnia issues were eliminated. I had no idea when I tried this shorter eating “window” that it would positively affect my sleep patterns. Now when I go to bed at night, I fall asleep and I stay asleep. Occasionally when I do wake up during the night, I just go back to sleep. I’m talking about deep, restful sleep. It’s amazing and life changing. In the last few weeks I’ve strayed from the shorter eating window, but my ability to sleep soundly is still just fine. I’m astounded by the difference it made for me, and it’s a simple experiment to try for anyone who is struggling with sleep issues.
Last night I had record-breaking insomnia. I googled “increased estrogen, insomnia.” This article surprisingly claimed the opposite of what I am experiencing. Whenever I take a dose of estrogen, I experience terrible insomnia. I’m 53 taking estrogen suppositories. I thought you should know my experience for your research. Thanks for the article.
yeah this is very good, thank you. it is possible that your estrogen is drowning out your progesterone too much. have you tried a lower dose?
For me the problem with managing post menopausal insomnia is progesterone. I sleep fine with estrogen but then get estrogen dominant and my hair starts falling out. Taking progesterone wven as low as 20 mg/day whether by cream or natural progesterone pills corrects this but eventually raises my cortisol levels so my insomnia becomes severe.
very insightful, thank you for sharing <3
Curious about how you are doing? I have severe insomnia, not sleeping at all most nights. Added bio progesterone but feel like cortisol levels spiked and negated affects. Everything I try stops working. Quality of life is poor. HAve you found anything that helps?
<3
Try GABA.
GABA as a supplement cannot cross the blood brain barrier unless it is leaky. Some doctors in fact use taking GABA as a test to see if someone has a leaky blood brain barrier. So it could work for you but also perhaps not; certain things that help the body make or support gaba action in the brain hwoever such as magnesium threonate or valerian root do not require deficiencies in the blood brain barrier to work
I just want to thank you for this post. One of the hardest things about perimenopausal insomnia is feeling so alone with. Everyone around me seems to be sleeping like babies! But seeing this post is grounding, and a reality check. I just got a low-dose estrogen patch, and I am using a progesterone cream starting on day 8. Not sure what the right hormone cocktail is for me yet.
Yes! Hormones matter. Currently I find that I only get about half a night’s sleep around the start of my period–and this is when hormone levels are lowest. It’s real and I’m with you! Good luck and do please keep us posted on your progress <3
Hello,
I am having some issues which I am beginning to think may be hormone related. Are there reliable tests to tell?
True Health Labs is a high quality company 🙂
I’ve been under endrochronology care for 10 years because of a small pituitary tumor. The last few months, my insomnia has been horrible, and I went to see my endrochronologist. He blunty told me hormones don’t have anything to do with insomnia and I should see a sleep disorder doctor. I’m still shocked, and am wondering whether to see a gynecologist. Magnesium, melatonin, nothing works anymore, even in combination. Suggestions? I really need to sleep!
I am not sure he’s right. Hormones can affect sleep. There could be something else — have you changed your diet or lifestyle habits AT ALL in that time?
Stefani- I have 3 kids 3 and under. I have terrible insomnia and have had it for years. Some nights I just won’t ever go to sleep. I’m not sleeping in or napping during the day. I am convinced this hormone related. How do I get tested? My OB?
Yes, your OB. 🙂 Look for estradiol and progesterone levels. Why are you convinced it’s hormones? It very well could be, but there are many other potential causes such as magnesium deficiency, caffeine or soy sauce or processed food intake (which often has MSG in it, which can cause insomnia), excessive exposure to blue light, and etc. Just wanting to help you address from as many angles as possible <3
I can truly relate. I’ve suffered bouts of sleeplessness for years now. The physical as well as psychological affects are debilitating. I’ve worked with bio-identical hormones but haven’t felt benefitted. I think you have to be very careful when experimenting with hormones. There’s a delicate synergy that can become more complex with time. Ultimately, a holistic approach seems the safest route unless you’ve had an advanced endocrine/hormone evaluation by a qualified specialist with a successful track record. I’m going to give Female Fuzion (Global Healing Center) a try. It seems to be helping a lot of women.
I agree! I hope you find something that works <3
I have been dealing with insomnia for the last 20 years, since going through menopause. For the past 4 years I have been using cannabis edibles which work wonderfully for sleep but restricts my ability to travel outside of Canada. I am thinking of trying the progesterone pill or the cream. Has anyone tried these and gotten good results.
I’m glad you at least found something to help 🙂 🙂
Hi,
I am 52, have cycles every month. But have horrible body aches from days 4 to 15 give or take. I wake up every 2 hours.
I have been taking a supplement with Soy, Magnolia Bark and Black Cohosh. It worked for about 6 weeks before the digestive issues set in and the zombie like feeling from the MAgnolia Bark. I cut the supplement in half. Didn’t make much of a difference.
I have used, in very small amounts a estrogen get, which is .25mg, divided over 3 days during days 3 to 5 that made a huge difference in the body aches and mental clarity. That is when my estrogen is at it’s lowest. The problem is I can’t tolerate Progesterone on any levels any more. It makes me anxious, my hands and feet swell and it takes weeks to rid my body of it. It was the bio identical stuff.
I have had every blood test under the sun and it all points back to an estrogen problem.
I have been taking Magnesium for years. The Taurine did not offer any help with the sleep or calm.
I am about to completely stop the supplement of soy, magnolia bark and black cohosh due to the digestive issue, (constipation and zombie feeling) but fear the horrible 2 weeks of body aches that will come back. Any ideas? I am desperate for sleep and normal brain function.
Progesterone and estrogen interact with all systems in the body, including the immune and histamine systems. have you considered looking into inflammatory regulation via anti-histamines or anti-inflammatory supplements such as high quality omega 3 fish oils and etc?