Menopause, a difficult cap for sleep

At menopause, the woman's ovaries stop functioning. The production of two hormones is affected: that of estrogen falls and that of progesterone stops completely. This major development for women brings with it profound physiological upheavals, one of the most frequent of which is the degradation of sleep. Nocturnal awakenings, light sleep, less restorative: many women see their daily life disturbed, while they are still very active. "With hot flashes, bad sleep is the complaint that comes up most often," confirms P^r Florence Trémollières, at the head of the menopausal center at the Paule-de-Viguier Hospital (University Hospital of Toulouse).

The menopause can be accompanied by various symptoms that can alter the nights: hot flashes, of course, but also night sweats, anxiety, depression, urinary or badual disorders, joint pain … Age is also, in itself, a factor of insomnia.

Fortunately, there are solutions. In perimenopause, when menstrual cycles become irregular, the doctor can suggest natural progesterone. "Its structure is exactly the same as that produced by the ovary," says P^r Trémollières. It acts on receptors of the central nervous system, the receptors of Gaba, which put the brain at rest. The same as hypnotic sleeping pills. "There is a difference in size: while sleeping pills reduce the share of sleep slow deep, very restorative, at night, progesterone elongates. Result: we wake up in much better shape.

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Very useful extra therapies

Later, when menopause occurs (defined as a whole year without menstruation), the gynecologist may offer hormone therapy (THM), consisting of a gel or patch releasing estrogen through the skin, and oral progesterone. "The treatment works very well, especially at the beginning of menopause," says P^r Trémollières. The problem is her acceptance by patients since the publication of an American study in 2002 which, by attributing to her an increase in cardiovascular risk and bad cancer, has done her a lot of harm. "And even if Since then, the weak points of this work have been noted, the THM has kept bad reputation.

"Of the 30% of women who are very embarrbaded by their symptoms, less than 10% are treated," says the D^r Gabriel André, Gynecologist, Vice-Chair of the Study Group on Menopause and Hormonal Aging (Gemvi). It's not about prescribing the same thing to everyone, but at least relieving insomnia and hot flashes. But women are so frightened by hormones that they no longer think they have that choice. "

Women who do not wish to take hormonal treatment, or who can not because they have bad cancer or endometrial cancer, can try to improve their sleep by changing their lifestyle: increase their activity to stop smoking, reduce excitants, and even lose weight promote better sleep. Some adjunctive therapies such as acupuncture, yoga or sophrology can also be considered, their effectiveness varies from person to person. In any case, Florence Trémollières invites to take sleep disorders seriously. "They affect memory and degrade cognitive functions, which can increase the risk of dementia."