{"id":10415,"date":"2025-10-21T18:41:11","date_gmt":"2025-10-21T18:41:11","guid":{"rendered":"https:\/\/www.truthforhealth.org\/?p=10415"},"modified":"2025-10-21T18:41:11","modified_gmt":"2025-10-21T18:41:11","slug":"dr-vliets-health-tip-a-hidden-culprit-in-insomnia-plaguing-women","status":"publish","type":"post","link":"https:\/\/www.truthforhealth.org\/es\/2025\/10\/dr-vliets-health-tip-a-hidden-culprit-in-insomnia-plaguing-women\/","title":{"rendered":"Dr. Vliet\u2019s Health Tip: A Hidden Culprit in Insomnia Plaguing Women"},"content":{"rendered":"\n\n\n
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I had always slept really well, never had any problems falling asleep, sleeping soundly, staying asleep, and waking up feeling rested\u2026until I hit about age 35!\u00a0 <\/em>Suddenly, for no apparent reason, and no noticeable change in stress or my thyroid status, I began having very restless, fragmented sleep, waking up multiple times a night with my heart racing and it would take awhile to go back to sleep \u2013 then it would happen over and over, waking up, looking at the clock, heart pounding, going back to sleep, then waking up again.\u00a0 I started feeling exhausted without good quality sleep.\u00a0 I had all kinds of medical evaluations, including EKG, stress test, and a Holter monitor to check for heart problems \u2013 but nothing was found.<\/p>\n

Finally, after a series of herniated disks and cervical spine surgeries unusual for my age and overall health and fitness, an astute internal medical doctor had me sent to a fertility doctor to check my ovarian hormone levels! BINGO! Insomnia culprit found! Several miles a day for my exercise and unbeknownst to me had suppressed my ovarian hormone production to the point that my estradiol was too low! This led to disruption of the sleep regulatory center in the brain, that is regulated by estradiol from our ovaries!\u00a0 Since I was doing a lot of work with ovarian hormone cycles and the imbalances that led to PMS karma, PCOS karma endometriosis and other reproductive disorders. The connection immediately made sense to me. It just wasn\u2019t I was thinking about for myself.<\/p>\n

Although I was not trying to get pregnant the fertility doctor was the specialist who understood hormone levels and complications that happen when levels are too low.\u00a0 He recommended that I try using a transdermal patch with the FDA-approved bioidentical estradiol hormone to supplement ovarian production. Within 10 days on the estradiol patch, I felt like a new person, my sleep had returned to normal, my foggy brain felt clear and sharp, my energy was back to normal and I felt like a new person! My old self was back!\u00a0 It was like a miracle.<\/p>\n

From that day forward, I have known and experienced firsthand the validity of the brain science that showed estradiol\u2019s powerful role in regulating sleep and many other brain functions.\u00a0 Evaluating women\u2019s ovarian hormone levels with state-of-the-art gold standard blood tests has been an ongoing part of my medical practice ever since, and I have discussed this in depth in all my books.\u00a0 I have seen this same overlooked connection work similar miracles in thousands of my patients over the last 45 years of this work as we worked together to restore optimal estradiol in women of many ages who had levels below the threshold needed to maintain normal sleep regulation.<\/p>\n

Most women think, and are told by doctors, that stress or thyroid problems are the biggest causes of insomnia and fatigue.\u00a0 They are usually given sleeping pills, melatonin, and\/or antidepressants. Those Rx just make the problem worse over time.\u00a0 And, that is a seriously incomplete picture of what really causes far more sleep problems for women over 30! Chronic sleep disruption and loss of sleep then leads to daytime fatigue, memory and concentration difficulties, mood problems, muscle pain syndromes and a host of other health problems as I talked about in my health tip Stress: The Hidden Culprit in Insomnia & Anxiety<\/strong><\/a>. Lack of sleep sets up a vicious cycle of increased stress that in turn further suppresses ovarian hormone production, then falling estradiol directly contribute to insomnia and also increases the stress response that also disrupts sleep,\u00a0 which then decreases estradiol levels even more,\u00a0 which negatively affects the\u00a0 quality of sleep, further aggravating the stress response\u2026it goes round and round in a never-ending vicious cycle.\u00a0 Just describing this makes me tired!<\/p>\n

The decline in estradiol (E2), <\/em>our primary premenopausal estrogen, <\/em>affects nearly every major body system, especially the brain.\u00a0 This is the primary active estrogen at brain centers that regulate sleep, pain, mood, memory, concnetration, focus, appetite, thirst, and sex drive.\u00a0 Other estrogens have different functions and don\u2019t affect the brain centers\u00a0 like we see with estradiol: estrone (E1) is primary a storage form of estrogen in body fat, estriol (E3) is made by the placenta during pregnancy and mainly has benefits on vagina\/urogential tissues, estretrol (E4) is only made by the fetal liver during a full term pregnancy, and has quite a few immunological benefits for mother and baby.\u00a0 None of these other estrogens play a major role in sleep regulation.<\/p>\n

Disrupted sleep is the earliest <\/em>hallmark change of estradiol decline, and it occurs long before other symptoms like hot flashes, vaginal dryness or irrgular menses. Estradiol decline can begin in the early 30s depending on many risk factors I describe in my book It\u2019s My Ovaries, Stupid!<\/u><\/em><\/a>\u00a0\u00a0<\/strong>Estradiol decline happens more rapidly in our 40s as we lose ovarian follicles as we approach menopause.\u00a0 Estradiol drops even more sharply and problems with insomnia increase dramatically when menopause actually hits, defined as the end of monthly periods.<\/p>\n

Common Sleep Disorders that Increase After Menopause<\/strong>
\nThere are other sleep disorders that hit menopausal women in greater numbers if they are are not using optimal estradiol therapy to restore what is lost at menopause. When the ovaries no longer cycle at menopause, we lose our ovarian estadiol and progesterone, often without a loss in testosterone, so the normal female balance is disrupted.\u00a0 The imbalance in estrogen\/progesterone and androgens leads to shifts in circadian rhythm, and a whole cascade of metabolic, endocrine, immune and neurologic changes.<\/p>\n

1. Insomnia<\/strong>
\nInsomnia is the most frequently reported sleep disorder after menopause, affecting up to 60% of women. It is characterized by difficulty falling or staying asleep, early awakenings, and non-restorative sleep. Many women develop chronic insomnia that persists even years after menopause.\u00a0 Taking sleeping pills just makes the problem worse, because they create dependency and alter the normal stages of the sleep cycle.<\/p>\n

2. Obstructive Sleep Apnea (OSA)<\/strong>
\nThe prevalence of obstructive sleep apnea increases dramatically after menopause\u2014from less than 20% in premenopausal women to between 47% and 67% post-menopause. Symptoms include snoring, gasping for breath, multiple awakenings due to apnea spells, increased cortisol, increased middle body weight gain, increased risk of diabetes and high blood pressure, mood changes, and daytime fatigue.<\/p>\n

3. Restless Legs Syndrome (RLS)<\/strong>
\nMore than half of postmenopausal women experience restless legs syndrome<\/em>, characterized by uncomfortable leg sensations, twitching and kicking throughout the night, and an urge to move at night. Hormonal changes may influence dopamine and iron metabolism, both implicated in RLS pathophysiology. The condition markedly disrupts sleep and often coexists with insomnia. It can be dramatically reduced with estradiol therapy and restoring ferritin (marker of iron stores) to levels above 100.\u00a0 Doctors rarely check ferritin levels and really need to since most women have chronically low ferritin due to years of menstraul blood loss and iron depletion\/low iron stores.<\/p>\n

4. Periodic Limb Movement Disorder (PLMD)<\/strong>
\nPLMD involves repetitive, involuntary leg movements during sleep, typically every 20\u201340 seconds. It frequently co-occurs with RLS and contributes to nighttime awakenings. Its prevalence rises with age and is more common in postmenopausal women, possibly related to altered dopaminergic signaling.<\/p>\n

Estradiol\u2019s Role in Sleep Regulation<\/strong>
\nEstradiol decline causes significant physiological and neurological changes, which include the following:<\/p>\n