By Shyama S. Mathews, MD
If you’re going through menopause and finding it harder to sleep — or harder to zip up your jeans — you are not alone.
Hormonal changes during this transition can affect many areas of your health, but for a lot of women two of the most common and frustrating symptoms are sleep disturbances and weight gain.
Fortunately, there are several things you can do to help your sleep and your waistline.
About Menopause
Menopause marks the end of a woman’s menstrual cycles and is diagnosed after 12 consecutive months without a period.
The average age of reaching menopause is 51, though it can happen earlier or later.
Leading up to that point — usually starting in the mid-40s — is perimenopause, which is when hormone levels are changing and you typically start experiencing symptoms.
Some women may have few if any symptoms, while others experience the full spectrum, including sleep issues and weight gain.
Poor Sleep
During menopause, your body experiences drops in estrogen and progesterone. These hormones help regulate sleep, so when they fluctuate or decrease, your sleep can suffer.
Sleep-related symptoms of menopause include:
- Night sweats and hot flashes. These sudden waves of heat, often followed by chills, can jolt you awake multiple times a night. They’re caused by the body’s response to lower estrogen levels, which affects how your brain regulates temperature.
- Insomnia and trouble staying asleep. Many women report lying awake for hours or waking frequently. Hormonal shifts can increase anxiety or cause restlessness, making it harder to fall or stay asleep.
- Sleep apnea. Sleep apnea occurs in higher rates in postmenopausal women and can be related to a drop in estrogen and progesterone as well as weight gain.
Over time, poor sleep can increase your risk for a range of health conditions, including heart disease, diabetes, and certain mood disorders like depression and anxiety.
Expanding Waistline
Similarly, hormonal shifts during menopause can also affect your weight.
As estrogen levels decline, your body changes where and how it stores fat. Instead around your hips and thighs, fat starts to settle in your abdomen.
Additionally, as you age, your metabolism starts to slow down, meaning you burn fewer calories at rest. At the same time, muscle mass starts to decline, which further lowers metabolism.
Further, poor sleep can affect the hormones that regulate appetite and can make it more difficult to resist cravings, and stress can increase cortisol, which is linked to belly fat and cravings for high-sugar, high-fat foods.
All these combined, can lead to weight gain and body changes.
Talk to Your Doctor
Hormonal changes associated with menopause can last several years, so if you are experiencing symptoms that are impacting your quality of life, see your doctor for a diagnosis and treatment.
A variety of treatment options are available ranging from lifestyle changes to medications to hormone replacement therapy.
Just as it sounds, hormone replacement therapy works to replace the estrogen and progesterone your body stops producing during menopause, which helps to relieve symptoms. There are several types and delivery methods, and though safe and effective for most women, it is important to talk with your doctor about what is right for you.
In addition to considering hormone replacement therapy, the following tips can help you get better sleep and manage your weight during menopause:
For Better Sleep
- Cool down your bedroom. Use light bedding, fans, or cooling pillows to help manage night sweats. Wear light, breathable pajamas.
- Stick to a sleep schedule. Going to bed and waking up at the same time every day helps regulate your body clock.
- Avoid caffeine and alcohol — especially in the evening. They can worsen hot flashes and interrupt sleep cycles.
- Practice relaxation techniques. Try yoga, deep breathing, or mindfulness meditation before bed.
- Consider mental health therapy. Cognitive behavioral therapy can help manage stress and regulate mood, which can lead to better sleep.
If frequent night sweats are disrupting your sleep, talk to your provider about hormonal or nonhormonal prescription options to treat hot flashes and night sweats.
Additionally, many women report that using supplements such as evening primrose, ashwagandha or black cohosh, help with sleep. However, their effectiveness has not been scientifically proven.
To Manage Weight
- Focus on strength training. Muscle mass naturally declines with age. Lifting weights or doing bodyweight exercises helps preserve muscle and boosts metabolism.
- Eat more protein. Eating protein helps you stay full longer and aids in building and repairing muscle.
- Reduce sugar and refined carbohydrates. Reducing foods high in sugar – especially processed foods — can help manage weight.
- Don’t skip meals. Skipping meals can backfire, leading to overeating or blood sugar dips.
- Manage stress. Chronic stress can increase cortisol which in turn can increase belly fat. Try exercising, yoga, journaling, getting outside in nature or talking to a therapist.
- Get moving. Even light daily movement such as walking 30 minutes can help prevent weight gain and improve sleep.
- Try not to focus on the number. It can be hard not to focus on the number on the scale, but the more important thing is to stay strong and healthy as you get older.
Penn Medicine Princeton Health offers comprehensive care for women, including care for menopause symptoms and other conditions associated with menopause.
Every woman experiences menopause differently. Specialists, including menopause certified practitioners, at Penn Medicine Princeton Health learn about your unique experience and tailor treatments to meet your specific needs.
To find a physician with Penn Medicine Princeton Health call (888) 742-7496 or visit www.princetonhcs.org.
Shyama S. Mathews, MD, is a board certified gynecologist, minimally invasive gynecologic surgeon, and menopause certified practitioner. She is a member of the medical staff at Penn Medicine Princeton Health.
