Menopause and Sleep

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HRT to reduce menopausal symptoms, it is recommended that HRT be prescribed at the lowest effective dose and used only for brief periods, not long-term. It is recommended you talk to your physician about your symptoms, the risks and benefits of HRT and alternative approaches for managing menopausal symptoms, including sleep.

There are alternative approaches for managing menopausal symptoms which may work for you. These include nutritional products and medications such as calcium supplements, vitamin D, and bisphosphonates for the prevention or treatment of osteoporosis (thinning and weakening of the bones); estrogen creams and rings for vaginal dryness; and sleep-promoting drugs for insomnia. All forms of estrogen that enter the blood stream reduce hot flashes.

An alternative treatment for menopausal symptoms may come from soy products (tofu, soybeans, and soymilk). They contain phytoestrogen, a plant hormone similar to estrogen. Soy products may lessen hot flashes, but there are no consistent results for its ability to relieve them. Furthermore, they can have gastrointestinal side effects. Just because it is a natural product does not necessarily mean it is safer to use than other treatments.

Phytoestrogens are also available in over-the-counter nutritional supplements (ginseng, extract of red clover, black cohosh). These supplements are not regulated by the Food and Drug Administration (FDA); their proper doses, safety, long-terms effects and risks are not yet known.

Deciding what, if any, product to use and, if so, for how long, are questions a woman should discuss with her doctor. The answer will depend on personal and family medical history.


  • Eat healthy. Avoid large meals, especially before bedtime. Maintain a regular, normal weight. Some foods that are spicy or acidic may trigger hot flashes. Try foods rich in soy as they might minimize hot flashes.
  • Avoid nicotine, caffeine and alcohol, especially before bedtime.
  • Dress in lightweight clothes to improve sleep efficiency. Avoid heavy, insulating blankets and consider using a fan or air conditioning to cool the air and increase circulation.
  • Reduce stress and worry as much as possible. Try relaxation techniques, massage and exercise. Talk to a behavioral health professional if you are depressed, anxious
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