iStock_sleepySnooze like your old self with the benefit of bioidentical hormone therapy.

A massive study of female employees of big corporations came out in March 2013. Researchers had collected data between 2000 and 2010, looking specifically at health care costs: medical, pharmacy, sick leave, disability, and workers’ comp. They also determined whether women had been diagnosed with menopause symptoms (DMS).

Ultimately, they collected data on just over 17,000 women who had symptoms and a roughly equal number of women without symptoms.

What they found didn’t come as a big surprise to me. On every parameter they measured, women in the DMS category had higher costs:

  • Medical costs: $4,315 vs. $2,972 per year
  • Pharmaceutical costs: $1,336 vs. $908 per year
  • Sick leave days: 3.57 vs. 3.3 per year

These numbers point to a concrete, serious cost for women who suffer from symptoms of menopause – not only in terms of costs to employers or health insurers, but in terms of costs to individual women. These numbers tell a story of women who are strongly challenged by troublesome symptoms at a time in their lives (all the women were aged 40+) where they could be thriving.

One of the most common symptoms of menopause is lack of quality sleep. And lack of sleep makes every other symptom of mEstrogen, a hormone that is produced in far lower quantities after menopause, is associated with more beneficial REM sleep. REM sleep improves important aspects of memory and other cognitive functions; lack of REM sleep may be one reason why women tend to notice feeling more “spacey” or forgetful as they transition into menopause. Adequate levels of estrogen also help women recover faster when they do miss sleep. And when hot flashes and night sweats are the reason for a woman’s sleeplessness, restoring estrogen levels with bioidentical estrogen therapy can eliminate the problem. enopause harder to bear. 

Sleep and Estrogen

Women are about twice as likely as men to complain of sleep problems. This is especially true after the age of 40. After 40, where once women slumbered peacefully through the night, they often find themselves having difficulty falling asleep; wake with a jolt in the middle of the night and can’t get back to sleep; or wake much earlier than they intended. Having to change sweat-soaked sheets isn’t an unusual reason for over-40 women’s inability to sink back into restful slumber.

A recent Harvard study found that raising levels of estradiol (the main estrogen in the body) improved mood in perimenopausal and menopausal women – mostly because it improved subjects’ sleep quality.

Estrogen can only be obtained by prescription. If you are postmenopausal and losing sleep, find a physician who will prescribe bioidentical estrogen and who will regularly check your symptoms and test your levels to ensure that the dosage and delivery method are right for you.

Before You Run Out to Get a Prescription for an Estrogen Patch…

…pause and consider: estrogen might be the last thing you need.

If you’re sleepless and have symptoms like mood swings, flushed cheeks, weight gain in your legs, buttocks and abdomen, fatigue, raging PMS, and lack of libido, but haven’t yet passed through menopause, you’re in a life stage called perimenopause. (For a full list of perimenopause symptoms, see below).

Your problem is more likely to be lack of progesterone, the hormone produced at ovulation.

During perimenopause, women may not ovulate in every cycle, and even when they do, they tend to make less progesterone than they once did. The ideal balance of estrogen to progesterone can get skewed. Estrogen can start to run the show, causing symptoms including insomnia.

Women in perimenopause who have symptoms like the ones listed above need supplemental progesterone. The best source is a topical cream, available over the counter. It’s applied several days each month during the ovulatory part of the cycle. If you visit a doctor who prescribes bioidentical hormones, he or she might choose to give you a progesterone capsule to take several days each month. As the liver metabolizes the progesterone pill (breaks it down), it produces a substance that encourages deep sleep.

Again, the key is: perimenopausal women can get better sleep with supplemental progesterone; and postmenopausal women may need both estrogen and progesterone. In my next blog post, I’ll help you better understand the ways in which estrogens and progesterone work together to promote better sleep and menopause symptom relief.

Perimenopause Symptoms to Look For

  • Worsening allergies
  • Breast tenderness
  • Cold hands and feet or sluggish metabolism (related to estrogen dominance’s effect on thyroid function)
  • Drop in libido
  • Agitated/anxious, depression
  • Dry eyes
  • Shortened or irregular menstrual cycles
  • Worsening PMS
  • Weight gain around abdomen/hips/thighs
  • Fatigue
  • Fibrocystic breasts
  • Brain fog
  • Hair loss
  • Headaches
  • Low blood sugar
  • Insomnia Irritability/mood swings
  • Water retention/bloating



Baker FC, Driver HS. Circadian rhythms, sleep, and the menstrual cycle. Sleep Med. 2007 Sep;8(6):613-22. Epub 2007 Mar 26.

Kleinman NL, Rohrbacker NJ, Bushmakin AG, Whiteley J, Lynch WD, Shah SN. Direct and indirect costs of women diagnosed with menopause symptoms. J Occup Environ Med. 2013 Apr;55(4):465-70. doi: 10.1097/JOM.0b013e3182820515.