Sleep problems often develop for women as they enter menopause, and for some, it’s the first time in their lives sleep has been an issue. A number of factors can contribute to insomnia, trouble falling asleep and staying asleep, and early waking and the impact of poor sleep on daily activities can be disruptive. One possible natural solution is melatonin.
What is melatonin?
Melatonin is a molecule that wears several hats: it’s a hormone and an antioxidant; it helps set the body’s circadian rhythm (our internal clock) and it may have a role in gut health. Here we are interested in its role in sleep, and specifically in perimenopause, menopause, and postmenopause.
The pineal gland in the brain is the main place this hormone is produced, and it is released based on a daily (circadian) rhythm and the amount of light present: more is released when it’s dark and less when it’s light. In fact, levels of melatonin released at night are at least ten times higher than those during the day.
When melatonin is produced, it is released into the bloodstream and cerebrospinal fluid and circulated to all areas of the body. Melatonin receptors can detect when levels of the hormone are high at night and signal the body that it’s time for sleep. This system tends to work well unless it’s disrupted by factors such as doing shift work, being exposed to blue light (from electronic devices) near bedtime, or entering menopause. The production of melatonin also declines as we age.
Sleep problems and menopause
Sleep problems among women in perimenopause and beyond can be attributed to a number of factors. At the top of the list is night sweats, those hot flashes that occur once you get nicely settled under the covers in your dry nightclothes, and then wham! Or you wake up suddenly because you are soaking wet and you may experience chills as well. Now you’re awake, you need to get dry clothes, and you may have trouble getting back to sleep.
Going through hormonal changes can sometimes feel like a rollercoaster ride, with anxiety, stress, mood swings, irritability, and sadness as your passengers on the journey. Experiencing any one or more of these emotional challenges can make it difficult to get quality, especially when you take these issues with you to bed.
Another symptom of menopause, although not common, is restless legs syndrome. If this condition is preventing you from getting quality sleep, it’s time to talk to your healthcare provider about a remedy.
Melatonin for sleep problems in menopause
A number of studies have shown us that taking melatonin supplements can improve sleep quality and quantity as well as help with other symptoms that may be contributing to sleep problems. For example, a 2021 systemic review appearing in the Journal of Pineal Research evaluated 24 studies (1,173 participants) involving the use of melatonin in women was conducted. The reviewers concluded that “melatonin administration should be considered in menopausal women.” In particular, they noted that melatonin:
- Seemed to help with bone density and body mass index.
- Improved sleep quality in postmenopausal women who had sleep problems.
- Improved menopausal symptoms at a dose of 3 mg and higher.
In a few more examples:
- In a double-blind study, 199 menopausal (40-60 years) women were randomly assigned to take either 3 mg melatonin or a placebo each night for three months. The women were questioned about their sleep problems and other symptoms at the end of each month. Women who took melatonin had significant improvements in symptoms, including sleep, anxiety, pain, and sexual desire.
- In a study in which perimenopausal women were given melatonin, the women experienced relief from menopause-related depression.
- Postmenopausal women who had poor sleep also benefit from melatonin. In a double-blind, placebo-controlled study that lasted one year, women were given either 1 to 3 mg melatonin or a placebo. Those with poor sleep at the beginning of the trial who took melatonin experienced an improvement in sleep quality.
Using melatonin supplements
It’s essential to purchase melatonin supplements from a reputable source. A 2017 evaluation of 31 different melatonin supplements, for example, found that most of the products didn’t contain the amount of melatonin stated on the label and other compounds were also in the bottle. One-quarter of the supplements contained serotonin, a regulated drug that can be dangerous at low levels.
How much melatonin should you take? The amounts used in research vary, and experts offer a varying range of doses. Low doses are considered to be 0.3 to 1.0 mg and to be effective for some women while 0.5 to 5.0 mg or higher may be necessary for others. A 3 mg dose is typically considered average. A sustained-release form may be helpful for women who have trouble falling back asleep at night.
Melatonin supplements are considered to be safe when taken in appropriate amounts and have no disruptive effects on hormone levels. Minor side effects may include drowsiness, headache, dizziness, or nausea.
Women in the menopause years often experience sleep disturbances that can take a toll on their waking hours and daily activities. Melatonin supplements are a safe, effective way to promote restful sleep.