From Your Mood to Your Menstrual Cycle: How Sleep Affects Women’s Health

by Jul 7, 2020

Ever noticed that you feel cranky, groggy, and generally “off” after a bad night’s sleep? We all know that good sleep hygiene is important to maintaining good health. For women, however, sleep is especially important, as sleep plays an essential role in governing your hormone health.

two women in a sleeping masks

Our hormones are linked to everything from the menstrual cycle (duh) to our mood (less obvious, but still true). Sleep helps keep sex hormones — such as estrogen, progesterone, and testosterone — as well as the stress hormone cortisol in check to maintain a healthy, balanced body.

Unfortunately, women also face a unique set of challenges when it comes to getting a good night’s sleep. We are more likely to report poor sleep quality and to suffer from insomnia than men. For this reason, it’s especially important to understand the effects of sleep on women’s health, and why good sleep hygiene is non-negotiable for women everywhere.

Your Hormones and Sleep

To understand hormones, we’ve got to learn a little bit of basic endocrinology — which is basically just a fancy term for “the science of hormones.”

The endocrine system refers to the collection of glands that produce hormones. The human body makes around 50 different hormones, each responsible for a different job. You’ve probably heard of many of these, including the sex hormones estrogen, progesterone, and testosterone; the fertility hormones luteinizing hormone and follicle-stimulating hormone, and the stress hormone cortisol.

Our sleep is governed by its own set of hormones. The hormone adrenaline helps us stay awake and alert, while the hormone melatonin tells us when it’s time to sleep. In turn, sleep influences the way our bodies produce and release certain hormones. For example….

  • Growth hormone is released during sleep, allowing our body to heal and repair itself
  • Sleep controls our appetite by regulating the levels of the hunger and fullness hormones, ghrelin and leptin
  • Lack of sleep can weaken our immune system by unbalancing the body’s levels of the hormone prolactin
  • Sleep deprivation also reduces sensitivity to insulin, potentially leading to diabetes and higher body weight
  • Elevated levels of the hormone cortisol — caused by lack of sleep or prolonged chronic stress — can cause disruptions in sleep, inflammation, and a compromised immune system

As you can see, your hormones play an important role in how much and how well you sleep. In turn, the amount and quality of the sleep you get influences the secretion of certain hormones in the body, affecting everything from your appetite to your immune system.

How Sleep Affects Your Health

As women, so much of our overall health is controlled by the health of our hormones. Sex hormones like estrogen and progesterone influence our weight, mood, menstrual cycles, and more. Meanwhile, maintaining optimum levels of cortisol by reducing stress ensures that our immune systems remain strong and our bodies are able to resist inflammation.

But just how do these hormonal processes work alongside the sleep cycle, and how do they result in the symptoms of hormonal imbalance we often see with poor sleep? In this section, we aim to answer just that, by exploring some of the many ways that sleep and our hormone health are interconnected.

Menstrual Cycle

Sex and fertility hormones like estrogen, progesterone, luteinizing hormone, and follicle-stimulating hormone control what stage of our menstrual cycle we are in and what symptoms we may experience as part of that stage. There are four main stages of the menstrual cycle:

  • In the follicular phase, estrogen levels rise as follicle-stimulating hormone triggers the release of an egg from a follicle on the dominant ovary. During this stage, hormones also tell the uterus to regrow its uterine lining, which was previously shed during menstruation
  • During ovulation, around day 14 of the menstrual cycle, the ovary releases the egg, which travels down the fallopian tube into the uterus. It remains there for only a day, but women are typically able to get pregnant within a seven-day window of ovulation
  • After ovulation, women enter the luteal phase, when levels of estrogen drop and levels of progesterone peak. During this phase, the corpus luteum — the remains of the follicle which released an egg during ovulation — dies off, hence the name “luteal phase.”
  • Assuming the egg is not fertilized (which would lead to pregnancy), estrogen and progesterone levels drop dramatically, triggering menstruation. This phase marks the first day of a new menstrual cycle and is characterized by the shedding of the uterine lining — what we call a period.

As many as seven in ten women say that hormonal changes throughout the menstrual cycle affect their sleep in some way, according to the Sleep Health Foundation. Most women report that these changes occur during premenstrual syndrome (PMS), which is commonly experienced three to six days before the start of a new period. During this time, estrogen and progesterone levels are low, which affects the body’s temperature control — and therefore the quality of our sleep. Some women may also experience low levels of melatonin during the premenstrual phase.

In most cases, sleep problems related to the menstrual cycle will resolve themselves after menstruation. However, experts suggest that cutting back on sugar, salt, and caffeine can improve sleep quality, as can adding more calcium to your diet during the menstrual phase.

Mood

Sleep disruptions are a common symptom of mood and anxiety disorders, such as major depressive disorder and generalized anxiety disorder. However, poor sleep can affect anyone’s mood, regardless of whether or not they suffer from a diagnosable mental health condition.

You’ve probably noticed that you or a loved one becomes grumpy and irritable after a night of restless sleep. Studies support this finding — a University of Pennsylvania research team found that participants limited to 4.5 hours of sleep per night reported feeling more stressed, sad, and angry than those who got a good night’s sleep. People with insomnia are also ten times more likely to have clinical depression and 17 times more likely to have an anxiety disorder than those who sleep through the night.

The relationship between sleep and mood is thought to have much to do with hormones and the brain. Certain hormones in the nervous system, known as neurotransmitters, play an important role in regulating both sleep and mood; these neurotransmitters include serotonin, GABA, and dopamine.

Serotonin, GABA, and dopamine all communicate feelings of calm and content by triggering nerve cells to send electrical impulses to the brain as a message. Low levels of these hormones can result in depression or anxiety. Antidepressant medications target these neurotransmitters, aiming to help the body produce greater levels of these “happy hormones” that reduce in a more positive mood. Doctors might prescribe a short-term course of this medication to people suffering from sleep disorders while a long-term care plan is established.

Stress

Whether positive or negative, a period of stress — such as planning a wedding or coping with unemployment — can affect both your hormones and your sleep quality. The body produces more of the stress hormone cortisol when it is sleep-deprived or under pressure, which leads to feelings of anxiety and alertness that can keep us awake at night. Abnormally excessive cortisol production is thought to be responsible for many clinical cases of insomnia.

The more stress a person experiences on a regular basis, the more their stress affects their sleep. 45 percent of adults who rate their stress as an eight, nine, or ten on a ten-point scale report feeling even more stressed when they do not get enough sleep, compared with 21 percent of adults with mild to moderate stress levels.

As you can imagine, chronic stress combined with chronic sleep deprivation has negative effects on people’s moods, friendships, relationships, and overall health. The consequences of poor sleep due to stress include irritability (half report losing patience with or yelling at their partner when sleep-deprived), overwhelm (reported by 40 percent), and skipping exercise (reported by 41 percent).

Practicing simple stress relief techniques can reduce stress and improve sleep. Experts recommend gentle breathing techniques and progressive muscle relaxation exercises, which calm down the body by slowing your breathing and heart rate.

The human endocrine system is complex, especially when you are a woman. Researchers don’t completely understand why we need sleep as a species yet, but we do know that sleep is linked to the production of important hormones that govern the menstrual cycle, mood, stress, and more. After reading this post, we hope you understand why it’s essential to get a good night’s sleep when you’re looking to optimize your health and your fertility!

✔️ Medically Reviewed by Banafsheh Kashani, MD, FACOG

Banafsheh Kashani, MD, FACOGBanafsheh Kashani, M.D., FACOG is a board-certified OB/GYN and specialist in reproductive endocrinology and infertility at Eden Fertility Centers, and has been treating couples and individuals with infertility since 2014. Prior to joining Eden Centers for Advanced Fertility, she was practicing as a top fertility specialist at Kaiser Permanente in Orange County and Reproductive Fertility Center. Dr. Kashani has received numerous awards throughout her years of study and medical training. 

Dr. Kashani has conducted extensive research in female reproduction, with a specific focus on the endometrium and implantation. Additionally, Dr. Kashani has authored papers in the areas of fertility preservation, and fertility in women with PCOS and Turners syndrome. She also was part of a large SART-CORS study evaluating the trend in frozen embryo transfers and success rates.

Dr. Kashani is a fellow of the American Congress of Obstetricians and Gynecologists. In addition, she is a diplomat of the American Board of Obstetrics and Gynecology and an active member of the American Society of Reproductive Medicine (ASRM) and Pacific Coast Reproductive Society (PCRS). She is also a member of the Society of Reproductive Endocrinology and Infertility (SREI).

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