Symptoms - Elektra Health

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Common Symptoms

Every woman’s experience is distinct; while some symptoms may disrupt your life rather significantly, others may go largely unnoticed.

The science

“Sleep problems” is an umbrella term doctors use to describe what many women experience during the menopausal transition.

It encompasses everything from trouble falling asleep to the inability to stay asleep. Disorders such as chronic obstructive sleep apnea also qualify, which we’ll dive into in more detail below.

While hormones can play a role in sleep, not all sleep issues women experience during menopause are due to menopause-related hormones. We can’t underestimate all of the other factors that come into play: aging, stress, diet, behaviors. It’s no wonder so many women report sleep issues, even those who slept like babies for their entire adult lives.

Why does menopause affect sleep?

Hormonally speaking, there are two forces that can create the perfect storm: menopause and aging.

  • Decreased melatonin

Our bodies use this natural hormone to regulate the circadian sleep-wake cycle. When levels decrease with aging, it affects the regulation of our internal clocks.

  • Increased cortisol

Cortisol is a key stress hormone, and when levels increase due to aging and stress, it can prevent quality sleep.

  • Decreased serotonin

When we age, the “happy hormone” our bodies use as a mood stabilizer decreases, which may be a risk factor for anxiety and depression (both of which inhibit sleep).

  • Decreased estrogen

Estrogen works behind the scenes to decrease sleep latency (aka the amount of time it takes to fall asleep) and the number of times you wake up throughout the night — in addition to increasing total sleep time. Estrogen affects serotonin too, so less estrogen means less serotonin. It also regulates our body temperatures at night. Unfortunately, as you know, estrogen levels only decrease during menopause. (*facepalm*)

  • Decreased progesterone

In early perimenopause, progesterone drops even faster than estrogen does and, due to its relaxing functions, can lead to disrupted sleep, especially sleep fragmentation.

Fluctuating hormone levels, in turn, cause things like hot flashes, night sweats, depression, anxiety, and stress, which also impact sleep.

It’s a classic catch-22. You need a good night’s sleep (7-9 hours, to be exact) to feel better, but the hormonal powers that be aren’t in your favor, which makes it feel like you quite literally can’t sleep well. And when you don’t sleep well, it only exacerbates a whole slew of other menopause symptoms (low libido, weight gain, anxiety).

So if you’re thinking, this is SO unfair, we’d be right there with ya. But we’d also tell you that there are specific, totally doable ways to improve your sleep and overall quality of life that center around behavioral change and rethinking routines.


For the first time in my life, some days I felt like I literally couldn’t get out of bed in the morning. At the time, I didn’t realize it was menopause related.

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