The Role of Cortisol in Chronic Insomnia in Perimenopause
Chronic insomnia is one of the most debilitating symptoms of perimenopause for a lot of women. In addition to making the other symptoms unbearable, chronic insomnia has dangerous health implications: obesity, diabetes, hyper-tension, heart disease, depression, impaired immune function, and believe it or not, an increased risk for alcoholism.
Why alcoholism? Studies have shown that people who do not sleep well may self-medicate with alcohol to induce sleep. When you are desperate for relief, you will do almost anything to sleep. During my years of perimenopause, I regularly took the prescription sleep-aid Ambien, which, by the way, I don’t recommend at all.
It only marginally helped me sleep, and it actually did more harm than good in terms of disrupting my natural sleep rhythms. I also became psychologically dependent, and experienced some of the weird side effects, which are common with Ambien use.
Why do so many women suffer with insomnia in perimenopause?
In addition to an imbalance of the sex hormones estrogen and progesterone during perimenopause, a lot of women suffer with high levels of the stress hormone cortisol, which can contribute significantly to chronic insomnia.
Released by the adrenal glands during the “fight or flight” response, cortisol, is a powerful chemical which, along with adrenaline, is highly effective in preserving and protecting the body during times of stress. When cortisol levels are out of balance, however, it can wreak havoc on the nervous system, and have a very deleterious effect on the body.
High levels of cortisol interfere with restorative REM sleep, and interrupt sleep rhythms; which is why so many women in perimenopause report that they are able to fall asleep, but they cannot stay asleep. High cortisol levels can also cause racing, panicky thoughts, heart palpitations, and even panic attacks. Even if you are suffering from exhaustion and burnout, with high levels of cortisol in your body, you will not be able to sleep. Women often describe this feeling as “tired but wired.”
How to Lower Cortisol Naturally
Because cortisol is released in response to stress, the obvious place to begin when addressing high cortisol levels is to reduce stress. However, this is often easier said than done for women in perimenopause. With careers, teens at home, aging parents to care for, and marriages all making demands on our time, just trying to figure out where to begin can be stressful enough. After all, you can’t just turn off your life. But you can let go of some things, and you can also say no to others.
If you are a Type-A, high-achieving, perfectionist personality for example, you can learn to live with “good enough,” especially if your health and wellness is depending on it.
Diet, Exercise & Supplements to Reduce Cortisol
Committing to 30 minutes a day of some type of exercise is an excellent way to reduce stress and lower cortisol. A low-glycemic index diet (which includes complex carbohydrates) helps to control blood glucose levels, and as a result, has also been shown to reduce cortisol levels as well.
Nutritional supplements which support healthy adrenal gland function can also be helpful. DHEA (Dehydroepiandrosterone), also produced by the adrenal glands, is the biological antidote to high cortisol. The adrenal glands release DHEA to lower and counter the negative effects of cortisol.
Because of the powerful mitigating effect DHEA has on cortisol, it is often used as a supplement to improve sleep. On a personal note, I take 50 mg of DHEA, in addition to 5 mg of melatonin, and bioidentical progesterone for sleep. I definitely sleep well, and feel rested the next day.
However, it is important to point out that DHEA is also the biological building block to the production of estrogen and testosterone. For women in perimenopause who are concerned with excess estrogen, it is strongly advised that you do not take DHEA without consulting your physician first.
Magnolia Miller is a certified healthcare consumer advocate in women’s health and a women’s freelance health writer and blogger at The Perimenopause Blog.