Need Help Sleeping Throught the Night

Updated on September 28, 2007
R.N. asks from Keller, TX
10 answers

I have been having a lot of problems with sleeping through the night. I have no problems getting to sleep, but I wake up around 1:00 am and am wide awake. By the time I fall asleep again, it is almost time for the alarm to go off. I have been getting maybe 3-4 hours a sleep every night for the past two weeks. It is becoming very difficult to function effectively on a daily basis. I am going through surgical menopause. I am on a daily allergy medicine, anti-depressant, and have acid-reflux. So, I have to watch any additional medicines I take (natural or not) so they do not conflict with each other. I take my calcium and vitamin E pills at nighttime. I've heard that is the best time to take those. I can't hardly take this anymore. My older sister is going through this same thing. We've talked to our mother, and she has gone through this non-sleeping thing since she hit menopause, and she is still going through it and she is 69 years old. It is hard to get your child off to school and then go to work and be expected to work efficiently, and then come home and do all the details that are expected of Mom & Wife. You go to sleep so tired and think, "as tired as I am, I'm going to sleep all night". And then the frustration when you wake up and look at your clock and it is only 1:15 am.
Does anyone have any ideas? I've talked to my doctor and she said she has never heard of "sleeping problems" being associated with menopause.

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So What Happened?

I want to thank everyone for their responses. I really appreciate all the great advice everyone was willing to share. I'm trying all the different possibilities, until I can find what will work out best for me. Right now, I am taking a Lunesta every fourth night so I know I can get one decent night's sleep. I still wake up in the middle of the night with this, but at least I can go back to sleep within the hour. I hope that out of all of the advice I got, something will work for me. Again, thank you so much for all of your responses.

Featured Answers

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

R.S.

answers from Dallas on

I have researched lots about insomnia because I have suffered with it off and on for 10 plus years. All the research says that if you go to sleep fine then wake up later in the night or early the next morning it is usually due to depression. I noticed you are on an antidepressant. Maybe you need to switch to another one. Maybe you are depressed and don't realize it. It is possible but you know best so think that over. I would much prefer to take a sleeping pill and sleep well than have insomnia. I know how terrible it is. Best of luck.

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Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

B.W.

answers from Dallas on

Hi R.:

My husband had sleep issues, he would go to sleep and then he would be wide awake at 1:00. This went on for about a year and it physically drained him. His doctor put him on Ambien and it seems to work great, he gets a good night sleep and he isn't groggy in the mornings from taking the pill. Maybe talk to your doctor about something like this. It's non habiting forming.

Good Luck,
B.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

J.W.

answers from Dallas on

Insomnia is definitely a part of menopause. IT is so frustrating to wakie up in the night - I'm so sorry you are having to deal with this. It does cound hormonal and hereditary - but those things can be changed with proper diet - since we all ate the way we were raised. There are several things you can do with your diet, and natural supplements. Find a good book or research on the internet about Natural HRT. Next, find a different doctor - one that believes in natural health too. Our bodies are capable of healing themselves with the right nutrition.
A few pointers are: 1500 mg of calcium with a magnesium in it - the ratio should be 2:1 (if you take 1000 mg of Calcium there should be 500 mg of magnisium). take Evening Primrose at night with a B-6. Exercise daily (walking 30 minutes in the daytime with sun - the vit D helps you absorb the calcium). Warm bath with epsom salts in it.
Take 5 HTP at night on empty stomach - start with 50 mg and work up over the next week to 300 mg. Find one that has Valerian in it too.
Take 30-50 mg of Soy -- not too much. Common menopause symptoms such as mood swings and hot flashes, insomnia, depression, diminished sexual vitality and decreased bone mass may be effectively managed by drinking a cup of soy milk and eating four ounces of firm or soft low-fat tofu each day. (Tofu is soybean curd and an excellent substitute for animal protein. Use it in salads, vegetable stir fries, soups, or braise it with vegetables and serve over rice.)

Avoid caffeine, alcohol, sugar, and diet sodas.

a few more tips from the internet ...
Natural Menopause 8 Natural Alternatives to Reduce the Symptoms of Menopause
From Tracee Cornforth,
Menopause occurs at the natural end of every woman's reproductive life. So why not treat it in a natural way? Hormone replacement therapy (HRT) was long the standard treatment for menopause, however, since we now know that traditional HRT using synthetic estrogen and progestins increases the risk of breast cancer and heart disease, many women and healthcare providers are no longer routinely asking for or prescribing traditional estrogen replacement therapy.
More and more women, every day, are turning to natural alternative treatments to treat the symptoms they experience during menopause including hot flashes, night sweats, and mood swings. Try the following tips to ease your symptoms of menopause:
• Your diet is an important tool that you can use to help control your menopausal symptoms.
Foods to avoid include high amounts of caffeine in any foods, and carbonated beverages which contain phosphorous and can increase bone loss. Also, limit your consumption of commercially raised meats including beef, pork, and chicken because these meats contain a high amount of saturated fats and decrease the body's ability to metabolize estrogen. Excessive sugar intake also limits your liver's ability to metabolize estrogen and impairs the immune system.

Increase your intake of foods that contain phytoestrogens including soy. Other foods that you should include in your diet include grains ,oats, wheat, brown rice, tofu, almonds, cashews, and fresh fruits and vegetables.
• According to research published by the Journal of the British Menopause Society, red clover isoflavone supplements, used in controlled studies, have been shown to have a significant positive effect on the rate of bone loss, improve cardiovascular health, and may offer some protective effect against breast and endometrial cancer. There is also evidence which suggests that red clover isoflavones decrease the incidence of hot flashes, one of the most common vasomotor complaints experienced by peri-menopausal and menopausal women. In one study, after 8 weeks using Promensil 40mg daily participants experienced a 58% decrease in the number of hot flashes experienced; study participants also experienced a significant reduction in the severity of night sweats. Promensil is a dietary supplement that is available over-the-counter, without a prescription, at retail grocery, drug, and health food stores.
• Lactobacillus acidophilus and Bifidus (the "good" bacteria in our intestines) cultures are important for women during menopause to help with metabolism and utilization of estrogen, and some believe these "good" bacteria help reduce the occurrence of yeast infections. These can be found in various nutritional formulas on the market.
• In his book, Medicinal Herbal Therapy: A Pharmacist's Viewpoint, registered pharmacist Steven G. Ottariano says that certain vitamins and minerals can provide particular benefits to menopausal women. These include Vitamin E (400 to 800 IU daily) to help reduce hot flashes and night sweats; Calcium (1500 mg daily)--the best type of calcium is not calcium carbonate which may not be fully absorbed, but microcrystalline calcium hydroxyapatite calcium (MCHC) or calcium citrate; Magnesium (500 mg to 750 mg daily) is essential to help with the absorption of calcium; Vitamin C (1,000 mg to 2,000 mg daily) helps absorption of Vitamin E and decreases capillary fragility.
• Also recommended by Pharmacist Ottariano is Black Cohosh (20 mg to 60 mg, 3 times daily) which is a phytoestrogen that helps many women manage menopause symptoms. There are a number of Black Cohosh products on the market for menopause including Remifemin. However it's important to note (as I have learned through my personal experience) that women with surgical menopause may not find phytoestrogens as helpful as those who experience natural menopause. Other herbs recommended as potentially beneficial by Ottariano include Dong Quai (500 mg to 1000 mg, 2 or 3 times daily), Evening Primrose Oil (500 mg 3 or 4 times daily), Ginseng (100 mg to 500 mg, 3 times daily), and Vitex Agnus Castus (175 mg daily).

The Facts About Bio-Identical or Natural Hormone Replacement Therapy
[ul][li]Natural estrogen compounds are available by prescription from compounding pharmacists. These types of estrogen are bio-identical -- they are chemically equal to the estrogen produced naturally in your body. There are 3 types of estrogens commonly used in bio-identical hormone replacement therapy. These are: Estrone (E[sub]1[/sub] Estradiol (E[sub]2[/sub]), and Estriol (E[sub]3[/sub]). Estrone and estradiol cause most of the risks associated with estrogen use. Natural or bio-identical estrogen compounds are prepared in any combination or number of these 3 types of estrogen; the most common formulation is 10 percent Estrone, 10 percent Estradiol, and 80 percent Estriol--called Tri-estrogen or Tri-est. A two estrogen bio-identical compound is called bi-estrogen.[br] [br] [li]Natural progesterone is an important component in menopausal symptom management for many women. It's available over-the-counter in products such as Pro-Gest, in compounded prescriptions, and a pharmaceutical called Prometrium. The benefit of using a cream product over an oral form is that you need a much lower dose because it does not have to be metabolized by the liver. Progestins such as Provera are not natural progesterone but a synthetic version which is not chemically equivalent to the progesterone produced by the body. Natural progesterone causes virtually no side effects--progestins cause side effects that include irregular bleeding and fluid retention.[br] [br] [li]Of course, don't forget to get plenty of regular exercise. Exercise is probably the single most important thing a woman can do to improve her overall health and well-being throughout her life. Regular exercise (at least 3 or 4 days a week) helps prevent and reduce bone loss, and plays a key role in reducing your risk of many types of cancer, as well as heart disease. [/ul] [p]Although these suggestions work for many women, remember every woman is different and it may take some time for you to find which treatments, or combination of treatments, work best for you. Always inform your healthcare provider of any natural alternative treatments you are using--this includes all vitamins, herbs, creams,

Alternative, Natural and Integrative Approaches For the Treatment of Menopause
Many women realize that drugs are not the only answer for a woman during menopause. Diet, lifestyle changes, and Alternative Medicine have been proven for centuries throughout the world to benefit a woman's overall health, even enhancing the effectiveness of conventional medical treatment during menopause and into the later years.
Conventional and alternative medicine have same goal- to relieve a woman's discomfort during the transitional years of menopause and help her to achieve optimal health during menopause and into her later years of life. The differences between conventional and alternative medicine begin with their approaches.
Conventional medicine often considers menopause as a hormone-deficiency disorder and attempts to correct the imbalances that develop within a woman's hormonal system during and after menopause.
The alternative medical approach focuses on strengthening the female body by encouraging it to balance, regulate, and normalize itself during the transition to menopause. Alternative treatments during menopause usually favor non-drug therapies.
They shift the emphasis from HRT to natural ways of encouraging the body to balance and heal itself. They focus on dietary, nutritional, and lifestyle changes supplemented by therapies such as acupuncture, herbs, and homeopathic remedies that have been shown to be effective.
Specific dietary and nutritional changes with nutritional and herbal supplements have been shown to alleviate the discomforts of menopause: hot flashes, night sweats, heart palpitations, and vaginal dryness, as well as to reduce the risk of osteoporosis and heart disease. Natural therapies avoid side effects and the risks of prescription hormone replacement.
Alternative treatments have been shown to enhance the effects of HRT by reducing dosage requirements, thus alleviating the health risks associated with HRT or even eliminating some side effects. In some women they have been shown to eliminate the need for HRT altogether. Alternative Medicine tend to work very slow. So, it may take weeks or months to see any effect. It also needs serious commitment on the part of the patient to stay with the therapy.
Alternative Medicine for Menopause
Herbal medicine
The idea that certain herbs might reduce hot flashes and treat other menopausal symptoms and conditions hardly seems far-fetched when you consider how much of our modern Pharmacopoeia is based on botanical compounds. For example, the root of a wild Mexican yam has been used as a progesterone source for the birth control pill. Soybean is the main active ingredient in Provera, the top-selling HRT progestin.
It is generally known that certain plant compounds can produce progestational and estrogenic effects on humans. Note that some herbs, just like processed drugs, can exacerbate certain medical conditions and that improper doses can have the wrong effect or no effect at all. In some cases, many different varieties of a particular herb exist (ginseng, for example), each of which may produce a different effect.
Two of the herbal roots most frequently cited for hot flash relief are dong quai and ginseng. Both substances, alternative practitioners believe, quell flashes by putting mild plant estrogens or plant hormones back into the system, which reportedly help to offset menopause's estrogen deficit. Other hot flash herbal remedies often prescribed include black cohosh, motherwort, caste tree or vitex, chickweed, hawthorn berries, and dandelion.
Just as it's not a good idea for a woman with an intact uterus to take pharmaceutical estrogens alone because of the increased risk for uterine cancer, using a single herb for hot flash relief may not be wise, caution many herbalists. In some herbs, the active ingredient is thought to be more progesterone-like; in others, more estrogen-like. For women with hot flashes who have a uterus, the herbalist may prescribe not only dong quai, an estrogen precursor, but also licorice root, a progesterone precursor. Herbs are often prescribed in response to the needs of the whole person, not a specific condition.
See Also: Traditional Chinese Medicine for Menopause for a description of the herbs commonly used in TCM.
Studies from around the world support the use of many natural alternatives to hormone replacement therapy. For example, a black cohosh extract can reverse all symptoms related to menopause within four weeks. Natural progesterone creams are the single most important natural substitutes for synthetic treatment of menopausal symptoms. Progesterone cream also promotes a more efficient use of the thyroid hormone by the body, and reverses osteoporosis, protects against breast cancer, decreases fibrocystic breast disease and reduces the incidence of ovarian cysts. It prevents fluid retention, fat deposits, vaginal dryness and urinary bladder infections.
Women who suffer from both stress and a loss of libido will benefit from this herbal remedy. Natural progesterone cream is absorbed through the skin and goes directly to where it is needed by the body. Apply it to soft, fatty-tissue areas such as breasts, underarms, inner thighs or abdomen. Absorption should take three to five minutes. If it is absorbed in less than two minutes, increase the amount of the cream to 3/4 tsp. until absorption exceeds two minutes, then return to 1/2 tsp. twice daily for twelve to fifteen days of the month. The cream also helps dry skin and brown spots on hands and arms.
Diets that regularly contain estrogenic plant components also may help stem hot flashes by adding to estrogen levels in the body. Researchers speculate that some plant factors obtained through diet might also reduce the risk for cancer: by binding to and blocking estrogen receptors, thus diminishing the effects of incoming natural estrogen that other- wise might lead to tumor growth. (Tamoxifen, an estrogenlike compound and a treatment for breast cancer, is thought to work in this manner.)
Researchers also speculate that the fibrous part of plants (lignin) may work to absorb excess estrogen in the system, helping to excrete it. Thus there would be less active estrogen in the system to perpetuate cellular overgrowth.
One of the few double-blind, placebo-controlled studies to investigate the effects of menopausal herbal treatment-with positive results-was led by Tori Hudson and Leanna Standish, naturopathic physicians, in 1993. When the study began, each of the participants was experiencing one or more menopausal symptoms. While one group was given a placebo, a second group received formulas containing herbs thought to ease menopausal symptoms: licorice, burdock, Mexican wild yam, dong quai, and motherwort. After three months' time, 71 percent of the group on herbs reported relief of all menopausal symptoms in comparison to 17 percent in the placebo group. Relieved symptoms included hot flashes, vaginal dryness, mood changes, and insomnia.
The study's major limitation was its small number of participants-13 women. Yet Hudson maintains, "The symptom relief in the group taking herbs was clearly there, well beyond the range of a placebo effect."
Herbs typically used to treat menstrual irregularity, hot flashes and vaginal discomfort include:
Blue cohosh (Caulophyllum thalictroides).
Chaste tree (Vitex agnus-castus).
Damask rose (Rosa damascene).
Golden seal (Hydrastis canadenis).
Ladies mantle Wchemilla vulgaris).
Motherwort (Leonurus cardiaca).
Sage (Salvia officinalis).
Vervain (Verbena officinalis).
Herbal Tea for Menopausal Symptoms
6 tbsp. Chamomile flowers
6 tbsp. Lemon balm leaves
6 tbsp. St. John's wort, tops
3 tbsp. Lavender flowers
2 tbsp. Orange flowers
2 tbsp. Rose hips, skin only
1 tbsp. Valerian roots
Pour 1 cup of boiling water over 3 tsp. of this blend, steep for five minutes; strain and drink 2-3 cups daily for four weeks.
Alternative Medicine for Menopause
Food/Diet
Certain foods or nutrient deficiencies are known to trigger or exacerbate symptoms of menopause. Food also may boost the body's tolerance for fluctuating hormone levels. The root of a wild Mexican yam has been used as a progesterone source for the birth control pill.
See also:
Foods Containing Natural Estrogens
Estrogen Inhibiting Foods
Soy
Eating soy and its isoflavones are the most popular natural way to increase estrogen. Soybean products such as tofu contain natural plant estrogens (called phytoestrogens) that may reduce menopausal symptoms. Soybean is the main active ingredient in Provera, the top-selling HRT progestin in the USA. Soy, like hormone replacement, appears to lower cholesterol and reduce bone loss in postmenopausal women. Phytoestrogens are also found in lima beans, berries, and several other foods.
It's been scientifically proven that women can minimize, and perhaps eliminate, menopausal hot flashes and mood swings by incorporating soy foods into their diets. Italian researchers found that isolated soy protein can be used in place of hormone replacement therapy. Investigators at the University of Bologna found that women receiving a soy supplement realized a reduction of 45 percent in hot flashes. Other women in the study, who were given a placebo, reported a 30 percent reduction. It was suggested that the reduction in the incidence of hot flashes by soy group was due to the phytoestrogens found naturally in soy.
All women in the study were aged 45 to 62. Those receiving the soy supplement took 60 grams each day over a 12-week period.
Research shows that Japanese women, who regularly consume soy products rather than animal protein, report markedly fewer menopausal symptoms than American women. Japanese women also have only one-fourth as much breast cancer as American women.
Substituting soy protein for animal protein can help slash breast cancer risk at any age because of its genistein content. Genistein is a chemical that blocks an enzyme that turns on cancer genes and inhibits the growth of new blood vessels needed to feed growing cancers. The average Asian woman eats about 50 to 75 milligrams of genistein a day -- the amount in about one serving of four ounces of firm or soft tofu.
Studies also show that eating a soy-rich diet can help build bone mass. This is because eating animal protein washes away much more calcium out of the body through the urine than consuming soy protein.
One study showed that women eating meat lost 50 milligrams more calcium per day than when they ate the same amount of protein in soy milk. This is very significant. Difference of 50 mg calcium loss a day can translate to substantial loss of bone mass when we spread it over a 20 year period.
Common menopause symptoms such as mood swings and hot flashes, insomnia, depression, diminished sexual vitality and decreased bone mass may be effectively managed by drinking a cup of soy milk and eating four ounces of firm or soft low-fat tofu each day. (Tofu is soybean curd and an excellent substitute for animal protein. Use it in salads, vegetable stir fries, soups, or braise it with vegetables and serve over rice.)
There is some conflicts in the laboratory and animal studies regarding effectiveness of soy supplements in reducing breast cancer. Some studies found that soy isoflavones act as anticancer agents and others reported that the isoflavones may promote some breast tumors. It is possible that isoflavones do both. Some scientists theorize that when eaten early in life, as in Japan, foods with soy in them may help prevent cancer. However, the benefits may not be there when they are eaten later in life.
Scientists from Tufts University School of Medicine suggested that the phytoestrogens hasten the maturation of breast cells in young women, and once they're mature, they're less susceptible to the effects of carcinogens. Soy, when added to the estrogen that is normally present in young women, may make breast cells mature at a much faster rate and protect against cancer. However, girls who do not consume soy are not similarly protected, because without soy, levels of estrogen are too low to help mature breast cells.
Many American women are introducing soy into the diet late in life, or are bypassing the tofu and going directly to supplements that contain concentrated doses of soy protein or isoflavones. This high-level, late-in-life consumption, these scientists say, may promote cancer.
It's wise to use soy foods, like soy milk and tofu, in moderate amounts in your diet. But it may not be a good idea to use soy supplements or soy proteins or the isolated isoflavone pills before we know their effects conclusively.
Isoflavones are a hundred to a thousand times less potent than the estrogen used in hormone replacement therapy. However, some capsules contain as much as 500 milligrams of isoflavones, while the average daily intake in Japan is 25 to 50 milligrams. Thus one can easily consume hundreds of times the ideal amount from the supplements on the market far more than what Japanese women consume
Water
A good preventive measure is drinking at least eight glasses of purified water per day for hot flashes and vaginal dryness.
Certain foods may trigger hot flashes, mood swings, vaginal discomforts, and other menopausal symptoms. These culprits include sugar, caffeine, alcohol, refined foods, and spicy foods. Keeping a diary that notes symptoms and food intake can be helpful in pinpointing which foods may be provoking which symptoms.

Foods to Eat
A low-fat, high-fiber diet will help the body to adjust more easily to changing hormonal levels.
Whole grains
Fresh vegetables
Beans
Seaweed
Miso
Tofu and tempeh
Seeds and nuts (especially sunflower seeds)
According to Chinese medicine, the following foods will build the yin:
Wheat germ and wheat germ oil
Mung beans and sprouts
Tofu
String beans
Black beans
Kidney beans
Barley
Black sesame seeds
Royal jelly tonifies the female hormonal system. A normal dose is just 100-400 milligrams daily.
Foods that contain phytoestrogens help prevent hot flashes and other symptoms of estrogen depletion:
Tofu and other soy products
Yams
Carrots
Apples
Potatoes
Foods rich in calcium help prevent osteoporosis:
Sesame seeds
Almonds
Low-fat yogurt
Dark, leafy greens, such as kale, collards, and broccoli
Sardines
See also: Foods Containing Natural Estrogens

Foods to Avoid
Animal foods
Fat found in fried foods, dairy products, nut butters, etc.
Sugar and refined carbohydrates contribute to mood swings.
Caffeine can cause hot flashes.
Alcohol can cause hot flashes.
Tobacco
See also: Estrogen Inhibiting Foods

Osteoporosis
Generally speaking, for healthy bones, women require 800 to 1,000 milligrams of calcium daily. During pregnancy, lactation, and menopause, calcium needs increase to 1,000 to 1,500 milligrams daily. To absorb calcium, your body needs Vitamin D. Vitamin D helps the small intestine absorb calcium and paves the way for calcium's uptake by bone.
Good food sources of calcium include dairy products, salmon, tuna, sardines (with the bones), green leafy vegetables, and tofu. One of the best food sources of calcium is milk. A cup of milk daily will give you a good start to meeting your calcium requirements. If you are on a dairy-free diet, you may choose calcium-enriched soy milk instead. Some soy milks are calcium enriched, while others are low in calcium, so read labels to be sure the product you choose is a good source of calcium.
Avoid eating food that can steal minerals from your bones. Keep your consumption of protein from animal sources (meat, fish, dairy products) to no more than 50 grams daily. Avoid foods that contain phosphorus or phosphate additives. These include many processed foods and fizzy soft drinks. If you consume beverages containing alcohol or caffeine, either eliminate these items from your diet or keep your consumption to a moderate or low level.
Many substances from land and sea can help nourish bone. Among those recommended by naturalists are various seaweeds (hijiki and kombu, for example), land weeds (dandelion and nettles), the herb horsetail, microcrystalline hydroxyapatite (a whole-bone extract), and calcium-rich oatstraw. Kelp is one of the most calcium-rich plants in nature. Anecdotal reports also suggest that progesterone cream derived from wild yams can slow bone loss and reduce fractures.

Diet for Urogenital Conditions
A report published in 1994 revived interest in cranberry juice to prevent urinary tract infections.
In the first large-scale controlled study of its kind, researchers from the Harvard Medical School studied 153 women over age 65. One randomly assigned group drank ten ounces a day of a low-cal cranberry juice cocktail. A second randomly-assigned group drank the same quantity of a drink that was not a juice, but tasted like a juice. After six months, the cranberry juice drinkers had a 58 percent reduction in their risk of having bacteria and white blood cells (a sign of infection) in their urine compared to the placebo group.
The juice drinkers' urine was no more acidic than the non-juice drinkers', suggesting that cranberry juice's acidity is not what it controls harmful bacteria as some had previously suggested. Cranberry juice may make it harder for bacteria to stick to the bladder's inner wall and helps flush out bacteria in the urine. Therefore, while cranberry juice can help prevent infections, it shouldn't be used as a substitute for antibiotics with a urinary tract infection that is producing symptoms. Along with cranberry, other members of the vaccinium family-for example, blueberry and bilberry-may also cut down on urinary tract infections.
It has also been suggested that cranberry juice can reduce incontinence. We cannot find any evidence supporting this. However, other foods are thought to influence incontinence. Spices and spicy foods can irritate urgency problems, as can caffeine, alcohol, and acidic foods like tomatoes and citrus fruits. Smoking is thought to substantially raise the risk of developing incontinence by decreasing a woman's total circulating estrogens, which can worsen urogenital atrophy. The coughing associated with smoking also can weaken pelvic muscles that support bladder function.
Without doubt, exercise is the most important alternative therapy available to the menopausal woman. Exercise allows you to control your body and emotions by using your internal resources. Each time you exercise, your adrenal glands are stimulated to convert the male hormone androstenedione into estrogen. A minimum of four 30-minute exercise sessions a week will be enough to keep you "topped off' with estrogen. As you grow older, your cardio-respiratory fitness, your strength, and your flexibility begin to decline, but for people who remain active, they decrease at a lower rate (an average of five percent per decade after the age of 20, as opposed to nine percent per decade).
The Benefits Of Regular Exercise

Your cells receive more oxygen, which improves blood circulation, creates energy, and improves your ability to handle stress.
Exercise can help you deal with depression and improve your sense of well - being.
Improved health will add year's to your life.
Constipation may decrease or disappear.
You sleep better.
You have an easier time controlling your weight, because regular exercise helps to bum calories, diminish your appetite, and speed your body’s metabolism.
Your bones become stronger, helping prevent osteoporosis.
Your risk of heart disease declines.
Lung function and endurance improve.
Your chances of getting colon cancer decrease.
Your risk of developing adult-onset diabetes decreases, as exercise improves your body’s ability to use sugar in the blood.
Joint stiffness, arthritis, and low-back pain lessen.
Maintenance of muscle strength.
Higher levels of the healthy type of cholesterol in the blood.
A more efficient immune system.
Reduced body fat.
Better appetite control.
Increased mental agility.
Fewer headaches.
Study Verifies Effectiveness of Exercise
Researchers in Sweden designed a study to determine the effect of regular physical exercise on the frequency of hot flashes. In the study, the frequency of moderate and severe hot flashes was investigated in seventy-nine postmenopausal women who took part in physical exercise on a regular basis and was compared to that in a control group of 866 postmenopausal women between fifty-two and fifty-four years old.
The study clearly demonstrated that regular physical exercise decreased the frequency and severity of hot flashes. The women in the exercising group passed through a natural menopause without the use of hormone replacement therapy. The physically active women who had no hot flashes whatsoever spent an average of 3.5 hours per week exercising, while women who exercised less than this amount were more likely to have hot flashes. Similar results, including mood elevation in pre-, peri-, and postmenopausal exercising versus sedentary women, have been reported in other studies. The benefits of exercise were experienced in women both on and off HRT.
Regular Exercise Can Help You Cope With Effects of Menopause
Regular exercise benefits the heart and bones, helps regulate weight, and contributes to a sense of overall well-being and improvement in mood. Sedentary people are far more prone to coronary heart disease, obesity, high blood pressure, diabetes, and osteoporosis. Sedentary women may also suffer more from chronic back pain, stiffness, insomnia, and irregularity. They often have poor circulation, weak muscles, shortness of breath, and loss of bone mass. Depression can also be a problem. Women who regularly walk, jog, swim, bike, dance, or perform some other aerobic activity can more easily circumvent these problems and also achieve higher HDL cholesterol levels. Studies show that women performing aerobic activity or muscle-strength training reduced mortality from cardio vascular disease and cancer.
Lack of Exercise Makes You Susceptible to Osteoporosis
Lack of exercise affects bone health too. Bones diminish in size and strength with disuse. Weight-bearing exercise (walking, running) will help increase bone mass. Exercise stimulates the cells responsible for generating new bone to work overtime. Research studies have shown that bone tissue lost from lack of use can be rebuilt with weight-bearing activity. Studies of athletes show they have greater bone mass compared to non-athletes at the sites related to their sport. In postmenopausal women, moderate exercise preserves bone mass in the spine helping reduce the risk of fractures.
Exercise As A Mental Tonic
Regular exercise may also have a significant effect on our mental agility by increasing the amount of oxygen supplied to the brain. In a comparison of sedentary older women and older women who got regular exercise, after four months the exercising group processed information faster in tests. This effect of exercise is particularly marked in older people.
Apart from increasing the oxygen supply to the brain, exercise may also slow down the loss of dopamine in the brain. Dopamine is a neurotransmitter that helps to prevent the shaking and stiffness that can come with old age. A severe shortage of dopamine results in the exaggerated tremors of Parkinson's disease. Dopamine decreases in the brain by about one percent a year from our mid-20s, and if we lived to be a 100 years old, we would all appear to have Parkinson's disease. Since exercise can slow down dopamine loss, it is particularly beneficial as we grow older. Exercise can also prevent our reaction times from slowing down.
Experts think exercise helps because it raises blood levels of endorphins. They are involved in the body's positive response to stress. The mood-heightening effect can last for several hours, according to some endocrinologists.
These 'feel-good' biochemicals drop off when estrogen is low. Endorphins also play a role in the body's ability to regulate temperature. Regular physical exercise may increase endorphin activity and so diminish the frequency of hot flashes. In one Swedish study, severe hot flashes and night sweats were only half as common among women past the age of menopause who were physically active.
You may prefer a game such as tennis, badminton, or squash, all of which offer the added attraction of meeting and socializing with people. Likewise, joining any exercise class can provide a social aspect that may encourage you to exercise regularly. Less rigorous and more traditional forms of exercise, such as walking and swimming, offer viable alternatives and will keep the body fit and supple.
Recently, there has been a move away from aerobic training toward strength training and weight bearing exercise. Research suggests that any exercise involving weights can delay loss of bone and muscle tissue, which is a natural consequence of aging. Weight-bearing exercise also helps to normalize the flow of sugar from the blood into muscle tissue, where it can be properly metabolized. This may lower the risk of diabetes and heart disease.
Before starting your program of exercises, consult a physician. An exercise program should start slowly and build up to more strenuous activities. Women who already have osteoporosis of the spine should be careful about exercise that jolts or puts weight on the back, as it could cause a fracture.
Excessive Exercise
Although most of us don't get enough exercise, a small percentage of women become psychologically addicted to exercise. They feel the need to train every day and feel guilty if they miss a single session. Excessive exercise is as bad as no exercise at all. It can affect every facet of your life. When you train too much, you can experience mood swings and problems with sleep and appetite. You're also more susceptible to colds and injuries, as intense physical exercise can lower the integrity of the immune system.
If you think you are a compulsive exerciser or that you are training excessively, it may help to know in physiological terms how fit you are. Compare your physical fitness level with the published data on the desirable level and your target level. If you feel your need to exercise is compulsive, or that it is accompanied by anxiety and depression, you should seek medical help. An exercise addiction is as serious as any other compulsive form of behavior.
When To Stop Exercising
Warning: Never ignore the symptoms of possible over exercise, which could mean that you are having a heart attack or some other medical emergency. Stop exercising immediately if you have any of these symptoms:

Nausea
Blurred vision
Severe shortness of breath
Faintness or fainting
Pain or pressure in your chest
Pain in your neck, jaw, or down your left arm
Palpitations (a disturbing feeling that your heart is beating irregularly, more strongly, or more rapidly than normal)
If you injure yourself, stop exercising immediately. Trying to "work through" the pain could cause more damage to injured tissues. If you have a strain, sprain, or muscle pull, rest the injury for a few days and follow the RICE (rest, ice, compression, and elevation) routine. If you think the injury might be serious, talk to your doctor as soon as possible. If you think you have broken a bone, go to your hospital's emergency department
Pelvic Exercises for Bladder Control: Kegel Exercises
If you have incontinence caused by weakened pelvic floor muscles, strengthening those muscles through exercise can improve bladder control. For women with stress incontinence, tensing the muscles located around the vaginal opening and anus a set number of times each day (ten times in a row at least six times a day) can bring positive results within eight weeks. This exercise works even for older women.
Exercises for incontinence are often referred to as the Kegel exercises, named after Dr. Arnold Kegel, the surgeon who developed this therapy.
Kegel Exercises
These exercises strengthen the muscles of the pelvic floor. Also improve sexual functioning and decrease urinary incontinence.
They involve tensing and relaxing the pubococcygeal muscles around the area of the urethra, vagina and anus.
You can identify pubococcygeal muscles in one of the following ways:
Begin to urinate and then stop. The same muscle you use to control urination is the muscle that you will contract then relax during the Kegel exercises.
Inserting a tampon and squeeze around it. These muscles are the ones used in the exercise.

Procedure
Hold pubococcygeal muscle for at least five to ten seconds and then release it slowly. After mastering the slow Kegel exercise, you should also do a series of rapid ones. They should be repeated ten to fifteen times, and the whole session should be repeated three to five times per day.
Kegel exercises can be done at any time of the day since they are invisible to the observer. Women can integrate Kegel exercise into any part of their daily routine-like when you are on the elevator, or driving or talking on the phone, or while taking a shower. Repetition is very important and many women have found that these exercises have had a positive impact on their sex fife.
Advantages of the Kegel Exercises

By developing the muscles around the vaginal area, the woman can have more control and pleasure during the sexual encounter.
Kegel exercises can tone up muscles and stop incontinence.
Kegel exercises can build up the muscles in order to counteract any muscle loosening that occurs as a result of menopause.
Doing your Kegels faithfully can restore your pelvic floor muscles enough that a sneeze or heavy lifting won't cause urination. A key point in this training-which can also improve some cases of urge incontinence-is that it can work for the properly selected patient so long as exercises are done regularly and consistently. You should consult a health-care professional for a detailed exercise program.
Kegel exercises in combination with low-dose estrogens (from natural sources or through HRT) is an effective therapy for incontinence. Estrogens replenish the cellular surface of the urinary opening, the base of the bladder, and the lining of the urinary passage. The exercise build up muscles. The combination is effective in the closure of the bladder so that urine will not leak out.
Exercises for Osteoporosis
Regular exercise keeps bone primed and helps prevent bone deterioration. How it accomplishes this feat is still being examined. Exercise may be directly affecting bone by stimulating metabolic hormones that influence such growth. There's considerable evidence that exercise also indirectly affects bone by applying force on the muscles connected to bone. The more a muscle is moved, the more electromagnetic resistance develops between muscle and bone, and the more bone stays primed in response to that stress. When bone isn't stressed by muscle, it can break down rapidly.
The familiar advice for postmenopausal women is: "Use it or lose it." Any physical activity is better than none at all.
When bone density increases, to whatever degree, the greatest buildup occurs in those locations most influenced by exercise. Another observation was that when exercise contributes to bone buildup, the body appears to reach a plateau after which further exercise does not increase bone density.
Even low-key physical activity such as walking or gardening will benefit your musculoskeletal system, while also enhancing blood flow that can stimulate the uptake of bone-building nutrients. Aim to exercise for at least twenty minutes, three days a week; you're under no pressure to run a seven- minute mile.
Unfortunately, few studies to date tell us exactly what type of exercise best benefits bone. Some therapists recommend weight-bearing and resistance-oriented exercises. With weight-bearing exercises, your body weight serves as the load to strengthen muscles and bone, in comparison to resistance training, which makes use of an external load. Weight-bearing exercises include walking and running (hence treadmills and stair climbers), jumping rope, and doing horizontal push-ups. Pedaling a stationary bike is considered a light weight-bearing exercise. Examples of resistance training are weight-bearing aerobics (as opposed to regular aerobics), the lifting of weights, and the pulling and pushing that Nautilus and other equipment provide. The theory is, the more resistance your body encounters, the greater therapeutic benefit for the muscle- bone framework. Some professionals don't recommend resistance training, especially for middle-aged and older individuals, since it can exacerbate back, joint, and muscle problems.
Exercises that put less weight on bones, such as swimming, badminton, or bicycling on flat turf, may not be as effective. "Swimming amounts to non impact exercise and it's been clearly shown not to improve bone density.
A study done by researchers at the USDA Human Nutrition Research Center on Aging at Tufts University in Boston has signaled that weight lifting can bear impressive bone-related results for certain post- menopausal women. Twice weekly, the formerly sedentary participants used pneumatic resistance machines for forty- five-minute workouts. After a year of training, their hip and back muscles had strengthened by 36 to 76 percent. Their leg and spine bone density increased by 1 percent; their balance improved by 14 percent. In another group of comparably aged women (ages 50 to 70) who remained sedentary, bone density declined as did balance abilities.
For older women, exercise reduces fractures not only by fortifying bone but also by noticeably improving balance, gait, coordination, and response time so that people are less apt to fall and fracture a hip or wrist. If they do fall, they're better able to break their fall, perhaps spraining a wrist but averting a broken hip, an injury that causes complications resulting in death in 15 percent of cases among the elderly. Overall, the strengthening of muscles can simply help the elderly to be more self-sufficient-to do such basic things as get out of a chair or walk to the mailbox.
Exercise among the elderly is highly beneficial and safe, provided an individual has no extreme medical problems. Studies have shown that after a few months of high-intensity workouts, frail individuals can regain significant muscle power in their arms, legs, and abdomen, and improve their mobility. In one such study elderly women and men who participated in this study doubled their lower-body muscle strength after a ten-week exercise program. The average age of the participants was 87.
It was concluded that routine exercise can be even better for bone than estrogen replacement. Whereas estrogens serve only to safeguard bone density, exercise can maintain bone density as well as improve muscle mass, muscle strength, and balance.
Experts often recommend a three-part exercise regimen for postmenopausal women of any age, particularly those whose bones show signs of osteoporosis. The regimen includes:

A walking program that progressively builds walking time up to twenty to thirty minutes a day;
Weight-strength exercises that tone the legs and arms; and
Posture training that strengthens the back and teaches a person the best positions for sitting, bending, and lifting.
The specific guidelines of such a regimen are adjusted to meet an individual's needs.
Although exercise is very beneficial for osteoporosis, you should not depend on it alone to manage it. Diet and nutrition, especially calcium and vitamin D, are very important. If your body shows signs of osteoporosis, consult your doctor to determine how to integrate other treatment options to improve your condition.(Source: Isaac Schiff, MD., Menopause, Random House

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J.C.

answers from Dallas on

If I take my allergy pill too late in the day in keeps me up at night. I do best taking it first thing in the morning. Also I agree with the other response that Ambien can help. Good luck.

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A.K.

answers from Dallas on

What time of day are you taking your anti-depressant? I would call the doctor - some anti-depresants can cause insomnia and some you should take at particular times of day.

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C.P.

answers from Dallas on

Although I'm not going through menopause, I do completely empathize with the bouts of insomnia. I've been battling that on and off for years. I've had that problem when I wake up and can't go back to sleep. But lately, I just have a hard time falling asleep...I just lie in bed and wait to start dreaming. Well, I've realized that part of it is that I'm trying too hard.

I bought a book called "No More Sleepless Nights". It also contains a work book that allows you to take notes on your daily habits, nighttime routine, and chart the quality of sleep you get each night. This was highly recommended from someone I talked to at the North Texas Sleep Center. The guy I talked to over there was very nice, and this is what else he told me:

1. Studies have proven that every single mammal gets REM sleep, every single night, NO MATTER WHAT. REM sleep is part of the cycle that allows your brain to completely restore itself. So, as long as you lie down every night, you will get some sleep. If you wake up tired, that just means that you probably didn't get enough REM sleep. But, rest assured, your body will catch up on REM sleep in the future. That piece of info has helped me tremendously.

2. "Sleeplessness will lead to sleepiness and sleep", according to "No More Sleepless Nights".

3. Your body will make sure it gets the rest it needs, when it needs it.

4. The book also says that the only way you will sleep is if you go to bed not caring whether or not you do (get sleep).

This book also has some tips on establishing a nighttime routine, as well as mind games that help you fall asleep.

One of the main points in this book is to not be afraid of or stress out about insomnia. Although you may be tired, you will find a way to function the next day.

Good luck, and may the Sandman visit you (and me, and everyone else) tonight! :-)

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D.L.

answers from Dallas on

Hi R., I just recently discovered that my antidepressant was causing me not to sleep. I had been on prozac for about 4 years, and did experience occassional insomnia, but it had gotten to the point of every night!! Do research on my on and not taking it -- I slept, but I obviously still needed the medication during the day... My DR switched me to effexor XR and now things are much better.... Good Luck .....

D.

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J.L.

answers from Dallas on

You may want to try some sleepy time tea by Celestial Seasonings. That should help you stay sleep throughout the night. If that doesn't work, you might want to see if you can squeeze in an exercise routine. It seems as if you're a pretty busy person. If you have a lot of stuff on your mind when you're trying to sleep, it will cause you to wake up in the middle of the night. Try to start relaxing one hour or 30 minutes (whatever time is good for you) before your bedtime. Hope this helps. Good luck.

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J.S.

answers from Dallas on

Hi, R....

My husband and I found an excellent sleep disorders specialist. We live in Carrollton, and our dr is in Dallas, but I'm sure there is a good one in Fort Worth, too. I would recommend that you call one and make an appt. You should be given a survey about your sleeping habits, and s/he can then determine if you need to have a sleep study done. My sleep study showed that I have narcolepsy, which was/is just leaving me exhausted *all* the time, no matter how much sleep I get! (I'm on a Rx for it, and it is helping quite a bit, but I may have to adjust my dosage again.)
Feel free to email me if you have any more questions ~ ____@____.com

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M.B.

answers from Dallas on

If you're going through surgically induced menopause, it seems to me that the sleep is related to hormonal issues. Are you not taking any natural replacement hormones. I would find a doctor ASAP to test all your hormone levels. Dr. Margaret Christensen is quite good but does not take insurance:
http://www.christensencenter.com/ (but IMHO, it's well worth the expense as she follows Dr. Northrup's approach to women's health care (if you're not familiar with Dr. Northrup, look for her books at your library, especially "The Wisdom of Menopause").

Also, if you have reflux, you should be tested for celiac/gluten intolerance (that is a symptom, along with depression). Dr. Christensen tests all her patients for that as it is highly underdiagnosed and almost never picked up by conventional docs. She uses www.enterolab.com

My experience with the sleeping problems (i.e., being wide awake early in the morning like that) was due to adrenal stress - I had abnormally high levels of cortisol at nite. These problems were only apparent through a saliva test as my morning levels were abnormally low (so convential blood tests and 24 hour urine tests made them appear normal).

Your doctor is absolutely clueless if they've not heard of sleep problems and menopause. Just google and you'll find lots of info: http://womenshealth.about.com/od/menopauseandsleepissues/...

Please do yourself a huge favor and find a new doctor. Note also that your depression can also be related to hormonal issues.

As you've noted yourself, there's definitely a genetic relationship associated with your issues since both your sister and mother suffered the same problems. That celiac/gluten intolerance I mentioned is genetic and I found that both my mother and sister have the same issue. My sister and I both have experienced greatly improved health (including resolution of hormonal issues) following that diet.

Be well,
M. B.

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