Chronic Insomnia and Hormones

Chronic Insomnia and Hormones

Bonnie had always been able to enjoy a good nights sleep in the past. No matter how stressed she might be, she could count on laying her head on her pillow, falling asleep and waking up the next morning refreshed and rejuvenated. However, when she reached her mid 40’s, her periods started changing and she began experiencing sleep problems. First, she would just have insomnia the night before starting her period. As her periods became more irregular, she started waking up in the middle of the night around 2 or 3 am and would find herself wide awake and unable to go back to sleep. With so little sleep, she would be exhausted the next morning. 

Over-the-counter sleep aids would make her feel sluggish the following day. By the afternoon and early evening, she would be crashing. She came to see me on maximal doses of prescription sleep medicine and still was sleeping poorly.

Bonnie suffered from a very common sleep disorder that occurs at the time of perimenopause or menopause. It’s caused by declining levels of estrogen and/or progesterone. It is characterized by wakefulness in the middle of the night and can be very debilitating when it continues long-term. The typical patient with this type of insomnia often becomes addicted to prescription sleeping pills. Bonnie’s insomnia totally resolved after her estrogen and progesterone levels were normalized.

While menopause occurs in all women, insomnia does not uniformly affect all women and
therefore, women may not recognize that this is a low estrogen symptom. Furthermore, if the
insomnia has gone on for many years, other secondary conditions such as depression, anxiety,
chronic fatigue, fibromyalgia, sleep apnea and obesity may also develop.
 Patients are often
prescribed prescription medications such as antidepressants, Xanax, and Adderal for these
conditions! Antidepressants can lead to weight gain and Xanax and Adderal are addictive!
Doesn’t it make more sense to correct the underlying hormone imbalance that’s causing these
symptoms?

It’s important to emphasize that insomnia can result from endocrine problems in both men and
women. Disorders of thyroid hormone, testosterone, cortisol, and growth hormone can all
cause sleep disorders. Detecting a subtle endocrine imbalance may sometimes be difficult
requiring the expertise of an endocrinologist.
 
Sleep is a mysterious bodily process that is
absolutely essential to good health. We should not have to rely on a drug to make us sleep! We
do not have to be “taught” how to sleep. Every member of the animal kingdom has an
obligatory need for sleep. If humans go much more than 18 hours without sleep, they start
experiencing “microsleep” where they “zone out” from a few seconds to minutes. In fact, many
accidents occur when people are sleep-deprived – such as the infamous Exxon Valdez disaster
and the Chernobyl nuclear accident. Falling asleep while driving is responsible for at least
100,000 crashes, 40,000 injuries, and 1550 deaths per year.
 
People can also develop insomnia
from poor lifestyle choices. Overzealous Americans intent on squeezing more work, more fun,
more family time and more sheer activity into their lives often short-change their sleep.

What are ways to promote a good night’s sleep?

Try going to bed at the same time each night
and getting up at the same time. The body likes a regular schedule. Sleep in a cool, dark room –
use nightshades, white noise or a sleep mask if necessary. Avoid spicy food or caffeine-
containing foods in the evening. Finish eating at least 3 hours before bedtime. Many individuals
find that heavy intake of sugar or alcohol at dinner leads to restless sleep. Start winding down in
the evening. Do not engage in heavy exercise late at night. Don’t watch the 10 o’clock news or
read grisly books which cause mental over-stimulation. Individuals who can’t function without a
large dose of coffee in the morning are usually sleep-deprived.

Just how much sleep is enough sleep?

Individuals who consistently get less than seven or eight
hours of sleep per night are often sleep-deprived. Interestingly, people who need MORE than
eight hours of sleep may also have a sleep disorder. They need more than eight hours of sleep
because the sleep they are getting is poor quality sleep. People do not have less need for sleep
with aging. It’s just that sleep disorders are so common in older people that many think this is
“normal.” Most sleeping pills “knock you out” but do not promote normal sleep architecture.

If you are experiencing persistent insomnia, consider seeing an endocrinologist, a physician who
specializes in hormone disorders. Establishing hormone balance can lead to normal, refreshing
sleep which is the body’s own way of healing a myriad of health problems.

Flourless Brownie Recipe

IMG_1428
Ingredients:

4 oz unsweetened chocolate, chopped

½ cup honey

1/3 cup creamy roasted almond butter (unsweetened)

1 medium ripe avocado, pitted

2 large eggs, room temperature

1 TBSP coconut sugar

1 tsp baking soda

½ tsp sea salt

 

Preheat the oven to 350. Line an 8-inch-by-8-inch baking dish with parchment paper. In a small pot over very low heat, combine the chocolate, honey, and almond butter. Stir constantly until melted and smooth. Transfer to a food processor fitted with the steel blade. Scoop the avocado flesh into the food processor and add the remaining ingredients. Process until creamy and very smooth, about 1 minute. Transfer the batter to the parchment-lined pan and spread it out evenly. Bake for 25-30 minutes until a toothpick inserted comes out mostly clean or with a few moist crumbs attached. Cool completely, then refrigerate for 2 hours before cutting into 16 squares. Store the brownies in the refrigerator or freezer in an airtight container.

Testosterone: Achieving a Delicate Balance

Testosterone and women

 

When a woman goes through menopause and her ovaries stop producing estrogen and progesterone, the pituitary responds by increasing FSH, a hormone from the pituitary gland that has regulated these hormones throughout her reproductive life. However, when all the eggs have been depleted, no further estrogen or progesterone can be produced. Nonetheless, the pituitary, which is “hard-wired” to respond to low estrogen, continues to make increasingly higher levels of FSH.

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Feel Absolutely Empowered!

“Outliving Your Ovaries” is a must read for every woman. Not only because it demystifies so many controversial and conflicting views in treating menopause, but mostly because one can put that book down and feel absolutely empowered! Women can now have the intelligent and informed conversation with their doctors about their bodies that so many of us have struggled to have.

Menstruation: A Story of Myth and Misinformation

Menstruation: A Story of Myth and Misinformation

Every woman remembers her first menstrual period, the beginning of that awesome passage from girl to young woman. Some girls can’t wait for their period to start, while others feel afraid or anxious. But for me, it was a shattering experience.

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Why Is It Important To Measure Estrogen Blood Levels? Part 2 of 2

Why Is It Important To Measure Estradiol Blood Levels?

 

3. YOU CAN’T JUST GO BY “HOW YOU FEEL!”

I strongly endorse monitoring estradiol and testosterone blood levels to ensure appropriate dosage and effectiveness of hormone therapy. Monitoring estradiol levels in thousands of women since 1986 has led me to develop more precise hormone regimens producing blood levels comparable to a low physiologic range. As noted earlier, monitoring blood levels is especially important with topical therapy. Most post- menopausal women who see me initially have NEVER had their estrogen level checked!

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Why Is It Important To Measure Estrogen Blood Levels? Part 1 of 2

Why Is It Important To Measure Estradiol Blood Levels?

 

Many women who initially see me for menopause have never had their estradiol level checked. Their previous physician may have diagnosed menopause with an elevated FSH, but usually no further tests are done. I’d like to go through various reasons why I believe it is important to monitor estradiol levels.

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Natural Menopause

Natural Menopause

The average age for menopause is 50 to 55. I’ve seen an occasional woman who has regular monthly periods and then one month has her last period and never has another. However, this is the exception rather than the rule. Typically, women begin with perimenopausal symptoms in their forties. As a woman approaches the end of perimenopause, the periods become lighter and start to become more infrequent. She may skip several months without a period, and then finally the periods stop completely. When the decline in hormones occurs very gradually, a woman may not experience severe symptoms because her body has had time to compensate for the decline in estrogen and progesterone. Often the age of menopause is genetically determined and it is helpful to ask when an older sister or mother went through menopause. A catastrophic, stressful life event can bring on menopause earlier than expected.

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‘Outliving Your Ovaries’ Is a Book That Should Interest Every Member of The Human Race, Including Men!

Outliving Your Ovaries

 

“Outliving Your Ovaries is a book that should interest every member of the human race, including men. Most men have women in their lives (I have a wife, daughter, mother, sister, cousins, etc.) and most women have men in their lives who care about them. Women have a unique biology that I never understood before reading Dr. Johnson’s book.

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Thinking Outside The Box

Thinking Outside The Box

As a new physician, I thought I knew it all. However, I quickly learned in those first few years that medical school simply gives you the tools with which to evaluate the thousands of different patients you’ll see in your career. Even with those great tools, you must pursue ongoing medical education or you quickly become outdated. It’s definitely a stressful life, but gratifying when you find answers and relieve suffering. When faced with a sick patient for whom standard treatments are not working, physicians feel compelled to look for other options to relieve that patient’s suffering.

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MARINA JOHNSON
M.D., F.A.C.E.
MEDICAL DIRECTOR

BOARD CERTIFIED
IN ENDOCRINOLOGY
& METABOLISM AND
INTERNAL MEDICINE

10670 N Central Expressway
Suite 510
Dallas, Texas 75231-2111

214.574.4376 office
214.574.4377 fax

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