When a menopausal woman consults a physician, the most frequently heard complaint is insomnia. The ageing process reduces the quality and duration of sleep. In a menopausal woman, the reduction of hormones and its imbalance makes it worse. The biological and psychological changes that occur with menopause create stress, anxiety and depression that are all prime causes of insomnia.

Hot flashes and sweats are common problems with menopausal woman due to hormonal imbalance. When these symptoms happen at night, particularly in the early hours of the morning, it may result in chronic insomnia. A woman wakes up from sleep with hot flashes and is sweating. She finds it extremely difficult to go back to sleep again until she feels normal. Having vivid dreams and getting up with a pounding heart are also part of the problem. Sometimes, even if a woman does not wake up, she switches from a deep restorative stage to one of shallow depth. It is estimated that menopausal related insomnia affects 15 to 17 percent of all women.

Before blaming hormones, it is necessary to have a complete medical workup to detect other underlying causes of insomnia. These include physical and mental health disorders and life style related causes.

The only menopausal specific treatment for sleep problems is hormone replacement therapy. Different studies give conflicting conclusions. It is safe to say that the jury is still out. It may be that women react differently to hormone therapy and a short trial may determine whether it is right for an individual.

Sleep time habits that are useful are keeping the bedroom cool, warm baths, relaxation techniques like yoga and meditation, soft music, using the bed only for sleeping and getting into bed only when sleepy. Mild aerobic exercise early in the evening and consuming foods rich in tryptophan like milk, banana, fig, dates and tuna helps. Avoiding stimulants like caffeine, alcohol and nicotine and foods rich in tyramine like bacon, cheese, and sausage. A glass of wine can also help.

When the hormone level reaches a balance after sometime, though at a lower level, the problem should sort itself out if it is the menopause that caused it.