Menstruation

Tossing And Turning With PMS

by Staff

Do you find yourself tossing and turning at night? Most people think that insomnia results from stress, anxiety, caffeine, and alcohol use. But there may be other factors that play a part in insomnia. Premenstrual syndrome (PMS) and an imbalance of the female hormones progesterone and estrogen for instance, may sometimes play a part in a stubborn case of insomnia.

Women tend to have sleep disturbances twice as often as men and the menstrual cycle can affect sleep cycles. Insomnia in women is most common during the luteal phase of a woman’s cycle, or during the 1-2 weeks prior to menstruation. Women who are postpartum or postmenopausal, or those who suffer from PMS or  premenstrual dysphoric disorder (PMDD) may have trouble with insomnia because of the fluctuating levels of female hormones which affect sleep regulation at those points in a woman’s reproductive cycle.

In addition to sleep disturbances during the luteal phase of her cycle, a woman with PMS is found to have reduced dream sleep during this time. It has been documented that there are lower levels of progesterone in women with PMS when they are symptomatic. They also have lowered levels of allopregnenolone (a by-product of progesterone), and GABA receptor activity. The latter is responsible for calming nervousness and reducing anxiety.

Linked Cycles

In addition, women with PMS may have timing issues for the secretion of melatonin. This may be due to the fact that serotonin is less available to PMS sufferers during the luteal phase. Less serotonin may mean less melatonin is produced. All of this signifies that the body is fighting off an inflammation, since inflammation is known to stop the brain from producing serotonin. In essence, many of the body systems that are involved in the reproductive cycle also play a part in the sleep cycle.

If you think your insomnia may be linked to PMS, it pays to have your doctor evaluate your situation, since this is a treatable condition. Your physician will want you to chart your menstrual cycles and your accompanying mood for three months. The doctor may want to measure your levels of female and pituitary (FSH and LH) hormones at several junctures during both the first and second halves of your cycle, either through blood or saliva samples.

Inflammatory Symptoms

Saliva samples can also be used to measure your levels of melatonin during the second half of your cycle. During this time of your cycle, you should also record what you eat. If you notice more achiness or pain during the two weeks before your period, this should be noted as well, since this is a sign of inflammatory activity which suggests lowered levels of serotonin.

All of this is to help your physician pinpoint whether or not you have PMS and may also suggest what might be done for you in terms of treatment. Light therapy may help your body release more melatonin. A form of sleep deprivation can also sometimes be used to reset your circadian rhythms which may lead to normalized REM sleep and mood improvement. Selective serotonin re-uptake inhibitors (SSRI’s) can also be used to good effect in treating PMS. Other therapies include progesterone supplements, melatonin supplements, and changes in diet to reduce inflammation.

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