Especially since I went to bed at 2am. (laugh/cry)
I'm 42, so who knows if it's perimenopause or not. I have a sleep mask, I sleep in the guest room upstairs b/c my husband snores, and the fan hahaha, your description was 1000% correct, and I keep it as cold as the upstairs AC is willing to do when it's 90 degrees outside (Ah yes, North Carolina summers). The kicker is I can typically sleep quite well once I am asleep, it's just getting unconscious that is so damn difficult.
I try not to drink caffeine after 3pm, I too take Trazadone, occasionally Delta 9 gummies, and try to get some exercise every day, and drink tons of water. I take Magnesium, Zinc, and Iron every afternoon but that's more to heal my skin, b/c I had an all-over body rash for like 4 months due to an overactive immune system. Haven't noticed it doing anything for sleep. (I take a multi-vitamin and Pre/postbiotic in the mornings too.) I also sometimes take Hydroxozine b/c it helps with itchiness in particular, but it reminds me of Benadryl and can make me feel hungover, which I don't like. Ironically, I also drink bourbon most every night. Sure, bad habits, unhealthy, wtf-ever, but my cat who'd been with me for 20 years died at the end of March so - I'm dealing. I treat it a lot like wine though - I have sought out certain flavors and kinds and have some faves that have just the right amount of caramel. I occasionally read, but sometimes that just gets me more agitated, so I often watch tv I enjoy and color at the same time until I start yawning.
I am in a lucky position right now where I can sleep in, so I am giving myself grace about the sleep patterns and questionable habits right now. I have had a therapist forever, but she recently closed her practice, and my husband and I still do marriage counseling, so I actually plan to take a break from individual therapy for a bit. I'm tired of talking about my feelings! :S
Also - I truly truly appreciate this newsletter. I'm terrible at consistently participating in online communities but so far every one of these newsletters has helped me in some way, regardless of comments / chatting with other people. XO
YES to giving yourself grace around the sleep stuff right now, and to taking a break from talking about feelings-- ha, I've been there. (And I'm so sorry to hear about your cat.) Alcohol has murdered me since peri started; I basically quit drinking at 40 because I get hung over halfway through my first drink, and it messes with my sleep to the extent that the choice feels like "either drink or sleep tonight." Ugh!!!
Thank you so much for such kind words on the newsletter! It means a lot to hear that. xoxo
Ohhhh sure! Basil Hayden’s is a good one that’s pretty available everywhere. I love Rua, which is based in Charlotte I think, and Defiant, also NC based, so not sure if those can be found elsewhere. We went on a bourbon tour in Kentucky and went to Bardstown, they are pricey but delicious; we loved the Elijah Craig single barrel too.
I had to upgrade to paid to comment on this. I've always struggled with sleep (early waking mostly) and have tried everything under the sun. I've found relief in various drugs over the years Ambien (before we knew how bad it was), Trazodone, nortriptyline (another old timey antidepressant), Unisom, THC, PEMF infrared mat, continuously monitoring blood sugar, Oura ring, etc etc etc.
I sleep with white noise, an eye mask, ear plugs, blackout shades, and frigid temperatures (perimenopause yay!).
And still, I struggled.
I finally was convinced to try CBTI (cognitive behavioral therapy for insomnia) which is considered the "gold standard" treatment and has results that beat basically any and all drugs out there. You need a therapist to walk you through 6-8 sessions and it seriously has transformed my sleep more than anything else I've ever tried. I am drug-free and sleeping better than ever. I do still have off-nights and weeks where it's harder, but what's great is that I now have cognitive tools to deal with the stress of not sleeping well. I feel freedom from worrying about sleep. I know this sounds a little over the top but it's truly been amazing. It's not cheap, but sleep is priceless!
Dr. Matthew Walker and Donn Posner are two people who talk about this in interviews if you want to learn more -- Matt Walker's interviews with Peter Attia convinced me to finally try CBTI.
Also, hello from Portland! I too adore Bastion's bread and depend on it for my GF/DF sustenance.
Rebecca, fellow Bastion lover, you might have just changed my life?!?!? I didn't know this was a thing. Will definitely listen to those interviews, thank you so much. (And thank you for upgrading to share this!)
Are there any other GF/DF spots in town you love? Kate's ice cream and Tiny Moreso are two of my other go-tos. Bastion is a drive for me (I'm in Kenton) but I faithfully do it every other Sunday.
You must be devastated that Cultured Caveman closed! That used to be my #1 spot in town (weird ambiance, but such good food). Nothing's as good as Bastion, but Harlow, Fermenter (3 blocks away, RIP), and Feel Good are other solid spots for me. I hadn't heard of Tiny Moreso -- I'll pay them a visit!
I never got to Cultured Caveman before it closed! I moved here the week before lockdown hit, so my whole first 18 months in Portland were... you know. And right, I forgot about Harlow! Their biscuits are preeetty great. And they just opened one on Alberta!
Oh gosh, not the best introduction to Portland (or anywhere...). Yessss, Harlow! Their NW 23rd location is fun too if you feel like a little lunch 'n browse.
I'm not a great sleeper, and at almost 42 I'm nervous it's bound to get worse, but I do feel like I've been sleeping better than ever lately. Here's a few things that helped me. Can't wait to hear others' suggestions!
- I take a very low dose of gabapentin for unrelated nerve pain, but I think it's also helped my sleeping a lot as well.
- White noise machine always. I use this awesome one and what I love most about it is that it is tiny (fits in my palm) so I can easily take it when traveling. (https://www.amazon.com/gp/product/B07RWRJ4XW/)
- The best black out eye mask. Truly blacks everything out.
- CBD gummy with a small amount of THC when needed.
- I use mouth tape at night, which I think has helped reduce snoring and helped me to sleep better. I've been doing this for about 5 years. 3M Durapore tape is super gentle on the skin.
- Sleep in a separate bedroom from my spouse! I am a super light sleeper. He's the deepest sleeper known to man and also has to wake up extremely early for work. Let me tell you, sleeping in different rooms has been a game changer for my sleep and sleep quality. And for our marriage because I'm not crabby the next day from sleeping poorly!
- Magnesium does nothing for me.
- Knee pillow to keep me sleeping on my back because I learned that side sleeping just ruins my body.
- Reading before bed helps just calm everything down.
YESSS FOR LINKS! I love it. I forgot that I also occasionally use a very low THC gummy (known among my friends as “mom weed.”) The separate bedrooms thing is a big deal. My current partner is literally undetectable while sleeping - no noise, no movement, he’s basically unconscious- but my ex was a snorer and once we got over the idea that we were “supposed” to sleep in the same bed every night, I got way better sleep in the guest room. You’re right, total game changer.
Yes for normalizing separate bedrooms!!! 🙌 My husband sleeps in another room on weekdays because he gets up so early and it messes up my sleep, and I always feel like people will judge us for that. So I appreciate when others share they do the same. 💖
Red-tinted blue light blockers 2 hours before bed. Seeing sunrise, and seeing sunset. Getting as much natural light as possible and eliminating as much blue light as possible. Absolute game changer for me. (and I had already quit alcohol and coffee.) I'm 44, deep in peri-menopause, have no symptoms and sleep like a baby. Bonus since I've done this I've lost 15 pounds out of nowhere. Sarah Kleiner and Carrie Bennett have been the educators around this circadian rhythm stuff I've learned the most from.
Thank goodness my attentive psychiatrist has helped me tweak my bedtime rituals/aids over time. My peri/menopause journey has not been cute. Every clinical side effect all cranked to 11, plus a major depressive episode about 18 months ago (with no history of depression ever before). Much better now a year into menopause but temperature regulation is still a serious problem, mostly at night.
I’m 54 and this is my current sleep regimen:
1) Trazadone. I take 50mg a night. If I’m feeling particularly stressed or over-stimulated I take 75.
2) Rhapontic Rhubarb Root Extract. Estroven (gold box) over the counter. Might be woo woo but who cares.
3) CBD Fx brand THC Lemon Dream gummy. I cut them in half. Each one has 5mg THC, so I’m essentially taking a micro dose of Indica. I take it about 30 minutes before bed. I don’t drink or smoke so this is my calming “treat” - really helps my end of day “coming out of my skin” feeling.
4) Magnesium Glycinate. I take 1000mg at bedtime.
5) Hand held fan. Keep it on my bedside table. Easy to grab in the dark. A game changer.
5) Sound machine. We call her Gloria. The rhythm is gonna get cha😋
Gloria! Hahaha. And, oh man, similar peri/menopause story over here but with anxiety instead of depression. I'm so happy to hear you're feeling better a year into menopause! I take 25mg of Trazodone, 50 if I'm stressed/wired, and I'm so damn happy it exists. Off to Google rhapontic rhubarb root extract! (And thank you for your kind words - xoxo)
My sleep is excellent during the approximately 5 uninterrupted minutes I get. I have trouble falling asleep and lots of help waking up, from tiny people crawling into my bed to show off their whistling skills at 2 am.
I use a very heavy weighted blanket and several imagination-based games, which I play to help pass the time as I wait to finally fall asleep. Things like "if I could redecorate the local fancy hotel, how would I do it?" and "if could add unlimited luxury to one teeny tiny area of my life, what would it be?" (olive oil) Better than the endless to-do list of unfixable problems that otherwise runs in my head.
I am currently trying to find the fine line of "enough coffee to stay awake but not so much as to keep me awake". I've been switching to black tea more and more, as it encourages pausing rather than running.
Every time I learn something else about perimenopause and menopause I wonder why I never noticed hearing ANYTHING about it....and how shitty it is.... Still so many doctors acting like it's one more thing women are just supposed to "deal with" along with their young adult offspring, jobs, partners, chores, meal prepping, debt, and aging parents. I don't think there can be "too many" forums or CORRECT informational sites on this topic. Thanks 🙏
I’ve *never* been capable of just lying down and going to sleep thanks to the hard-working, nocturnal monkeys living in my brain, so I’ve read myself to sleep since I was a little kid. Post-menopause, even the act of putting my kindle down is enough to irrevocably wake me up. On a recent trip to California (where I always visit a dispensary) I discovered the magic that is CBN. It’s a “new” hemp derivative that is specifically sleep-focused. And when I tell you it works, I mean it’s like propofol — I fall asleep and the next thing I know, it’s morning. The ones I got in CA have THC also, but here in NC I’ve gotten some with D9 and also just CBD + CBN and I’m totally convinced now that CBN is magical.
I also have a partner who snores loudly enough to wake the neighbors. I found a mouth guard for him that shifts his lower jaw very slightly forward. He’s been using it now for two years and it is nearly 100% effective. The one I got is by PureSleep: https://www.amazon.com/dp/B07SD5W2KQ
Thanks Em for starting this conversation 🥰 and thanks everyone else for all the amazing recommendations.
My partner loves the Wyld line, but they make me loopy and stumbly if I get up to pee. Maybe try on a weekend or a day you can feel out the after effects?
OMFG sleep in menopause/perimenopause. I feel you! I am in my 5th year post menopause and sleep is STILL a thing. Not as bad as it has been but still. Things that have worked for me:
Gabapentin (Trazadone gave me seratonin syndrome, so I take gabapentin). It helps reduce hot flashes AND increases deep sleep. Low dose, non addictive as far as I know, and has been a godsend.
Getting up at night to pee was a big sleep disruptor for me. I recently started hormone therapy which has helped, but pelvic floor physical therapy ALSO helped.
Weighted blanket. Yep, I even bring it when I travel.
PLUS, I make space in my day for a nap. Just knowing it’s an option helps take the pressure off if/when a bad night’s sleep happens.
GOOD SLEEP VIBES to all of us doing that foundational sleep work!
Thank you for sharing all your strategies! The waking up to pee thing is the bane of my existence. I've tried two different pelvic floor therapists, but it hasn't really helped, and after like 8 visits to each one I just kinda gave up. I've noticed that my nocturia is way worse for a handful of days every 4-6 weeks, accompanied by cystic acne and sometimes a migraine, so I'm thinking it's an estrogen drop thing. Ugh!
I feel seen! Insomnia was my main perimenopause symptom and I had no idea 1) I was in perimenopause (early thanks to cancer/chemo 30 years before!) and 2) didn't realize sleep was such an issue for menopause.
I had to do a lot for my sleep that's already been mentioned but the big three were:
1. Balanced blood-sugar. My problem was waking up from 2-4, 2-5, 2-FOREVER and it got so much better once my blood sugar was balanced. This sometimes meant a protein rich snack and healthy carb right before bed (even though everyone tells you not to eat before bed. A small snack with protein + carbs can help for those whose blood sugar bottoms out at the middle of the night, causing the awakening).
2. Yes to the CBT for sleep anxiety (mentioned in this comment thread!). This helped me a lot as I became so anxious about my sleep that that was causing a lot of problems.
3. Taking walks during the day. While I am someone who is pretty emotional resilient at this point, I didn't realize my body didn't care about that.
Being more sympathetic dominant in peri/menopause meant I needed a lot of physical breaks to bring down my cortisol during the day. This also served to not make me go non-stop during the day which I can no longer do.
Having a gentle way to bring my cortisol down frequently during the day continues to help me so much.
I also did a podcast interview (w/transcript) with my sleep coach Kelly Murray who is a functionally-trained sleep coach if anyone is interested in a deep dive into insomnia root causes that are often missed. Because what I found with my own insomnia (for three years!!!) was it was a window into other health shifts I needed to make: https://alishapiro.com/sleepless-in-midlife-uncovering-hidden-root-causes-with-kelly-murray/
Hi Ali!!! You and me both, with the chemo inducing it early and also not knowing sleep was such an issue. Did your oncologists tell you to watch for it early? Mine mentioned it in passing when I was basically on my way out the door. These are such great tips, thank you so much for sharing, and I'll be listening to that interview on my flight Tuesday morning!
Your question made me unexpectedly cry, Emily! No, my oncologist didn't tell me. It's one of so many health cross-roads that remind me how much I've been on my own out here trying to navigate the fall-out from cancer treatments.
I was also 14 when I finished treatments, it was 1992 (a different cancer "era"), and I'm part of the first generation of childhood cancer survivors so there isn't a lot known about the long-term effects of treatments on children. I remember something vague about my fertility being in question but no one really knew.
I participate in research studies to help researchers better be able to help other cancer survivors; even in those bulletins, I don't recall early menopause being mentioned. It really needs to be and I wish they had providers who could help us navigate all the layers of menopause as cancer survivors given it's not a "one and done event" but a reverse puberty with critical health concerns for all women (women's overall health nosedives after menopause because of the hormonal drop-off).
And hope the tips help. I'm still astonished how much walking helps all the things. Not just with cortisol but when I want to scream into the void, etc. And it's so accessible from a time, money, and ease.
Aw, Ali -- what you went through was so incredibly difficult. There was just so much they didn't do and didn't know, and it's simultaneously shocking and not surprising (and, same feelings that most docs are probably STILL not really mentioning early menopause). My tx was in 2000, and I was 24, and I had the same experience with fertility info -- some vague conversation about it being potentially in question, but they didn't really know. Ugh!
You made me cry again, Emily. You are a healer in so many ways. Thank you for naming this. Not many people can understand. I had a friend who was diagnosed with breast cancer last year and she texted me, "I can't believe you went through this at 13." I cried then too!
And geesh - so we all got the vague fertility talk but nothing about hey, this matters way beyond your fertility. That's patriarchal medicine for you.
I am mold exposed which destroyed my sleep, probably forever. I take a nightly cocktail of OTCs such as magnesium, HTP5, GABA, l-theanine, Calms Forte from Amazon, melatonin 3mg time release. I also mouth-tape. I think the crones should form their own political party!
Beth, I'm so sorry to hear about your mold exposure -- that's a long healing process. Does the mouth-taping keep you from waking yourself up by snoring? AND AGREED ON THE CRONES.
Thanks Em. Can’t find a local doctor for treatment who doesn’t want $10k upfront so I’m living with it. And yes, if I take an unexpected nap and don’t tape, I snore like crazy. But *I* do not snore—it’s the mold, I swear!! 😂
I have a mold doctor rec if you want it. Sarah Holgen, she’s a naturopath out of bend, Oregon. I met with her virtually and she’s super affordable. She’s a wealth of knowledge.
Yes , lots of medical issues (high homocysteine unresponsive to folate/B12, Epstein Barr, mast cell issues are a few). Tested twice with Great Plains/Mosaic and second time was worse after two rounds of Cholestyramine.
Okay I bought one of those sleep mask/headphone combos several years ago! My ex used to call me Chad when I wore it because he thought I looked like a snowboard bro. Haha. Mine might have been a lemon (it was from Amazon, I don't remember the brand) because it didn't hold a charge for very long, so I would get awakened all the time by a shrill voice saying "Battery low, please charge now!" and it made me really mad at it. Does yours have that problem?
HA! Now I'm going to think of this as my ski bro headband 😆 Mine does the annoyingly loud low battery announcement, but the charge lasts for days. I try to plug it in every 3-4 days and it hasn't been an issue.
Thank you for writing this post!!! The comments are so helpful too! I miss our group and I'm so glad to see you fostering the community sharing here now too. :)
Ok here's my regimen, with a quick backstory: I used to be an awesome sleeper – a creative night owl with no issues really; I even managed to become an early riser over the years after getting married to a man who gets up stupid early for work, so that we could spend *some* time together in the mornings and at night – until I got pregnant. I was likely already dealing with depression before that, but during my third trimester 7 years ago, I developed diagnosed Psychophysiological insomnia, alongside PPD and general anxiety disorder and I've been medicated for each of them ever since. Fast-forward a couple years ago – when I had JUST started feeling like my sleep was getting back on track (fucking of course!!!) and the gnarly night sweats started, just like you described yours, and the insomnia creeped back. At 38 my PCP thinks I'm in perimenopause. I'm working with a naturopath to know for sure. Last week I sent in saliva tests and blood draws to know my hormone and micronutrient numbers. So TBD. In the meantime, here's where I'm at:
- I also take Trazodone every single night. Like you, I take half a dose though because the full dose prescribed will knock me out in a woozy way I don't like but the half is just right and required at this point to help me fall asleep every night.
- I use this ridiculously loud/deep white noise machine and think it's the absolute best - if/when I travel, it comes with: https://amzn.to/3Vz9eGm
- This sleep mask that I absolutely love: https://amzn.to/4eiYt2k I would never consider spending this much on a sleep mask until my SIL (a pediatric sleep consultant) bought it for me and now I don't know what life looked like before it
- Magnesium before bed; no idea though if it actually does anything. Same for the spray-on kind but I also use that sometimes when I feel sore for no reason?
- Ideally I go to bed by 9pm and wake up at 4am. I usually wake up multiple times a night but ATM am usually able to fall back asleep. Usually. Sometimes though I'm up for good at 3am and then will try to take a short nap around 1p.
- My BIGGEST RULE/TRICK: I leave my phone in the kitchen to charge from after dinner around 7ish, through until the morning, after I've had my quiet personal time from about 4ish - 6:30ish. This has been by far the biggest help for me!!! No checking the time in the middle of the night (I have an old school clock on my nightstand for this with a button for light if I want to check) and no picking it up first-thing in the morning to doom scroll mindless shit. I cannot emphasize how hugely important this has been for my sleep and overall health!!!
- No more than 1 glass of wine with dinner, and just a couple nights a week because same - at this point, *drinking* drinking equates to sleep or no sleep for me. I also try to chug water right after dinner so I'm hydrated but pee it out before I go to bed so I'm not waking up to pee!
- My husband snores sometimes and if/when he does, I no longer hope he stops or try to push him onto his side lol. I just get up and go into our guest bed. If I feel at all achy or sweaty or insomnia-y I just straight to the guest bed for the night because I don't want to have the stress of trying to be sneakily-restless and possibly wake him up if that makes sense. I can just move around allll I want in the guest bed. It sounds dumb but it's also another hugely helpful option.
Oh wow Sarah, your post-pregnancy sleep journey. And not for nothing: while also taking care of a new baby!?! That's... a lot.
As you know, I'm not a doctor (lol) but the one thing I'll say about saliva and blood draws in relation to hormone numbers is that menopause specialists don't generally rely on them, since our hormones are constantly going up and down in perimenopause, so you could have a "normal" result one day and a totally different result the next. For this reason, most of them go by your symptoms to determine whether you're in perimenopause. Not that blood tests aren't helpful, just that I've learned a "normal" result may be somewhat of a false positive.
Yes to leaving the phone in another room! Yes to guest bed!
This is good to know, thank you. Yeah, it's funny (but not) - right after I signed on with this naturopath and paid for and did the testing, I talked with a friend-of-a-friend who's a doctor and she basically said the exact same thing you just did. So I'm a little annoyed and hope I'm not getting taken advantage of. I think the naturopath's mentality is that we get as much data as we can at this point (he had me test on a very specific day in my cycle at least?), including knowing all my micronutrient levels, and see if there's anything extreme in my numbers to possibly follow-up on. He said he had a strong feeling that I have a progesterone deficiency, which apparently often presents itself with the exact same symptoms of perimenopause? like insomnia, low energy, night sweats, etc. I hadn't heard that before and thought that was interesting. So we'll see. Then again, maybe it's just a matter of figuring out what 124986 new things I suddenly need in my daily regimen and then I'll be totally good!
I just wish it didn't cost so damn much, that insurance covered at least SOME of it (especially for women and female bodies!), and that it wasn't such a privileged thing to figure out. It's fucking crazy to me that just getting to a BASIC level of "Hey, I feel okay and not totally shitty today!" -can be so difficult and have so many obstacles for so many people. It's nuts.
That was a total tangent but how I feel. lol.
Anyway. Happy travel day (I think) today!!!! Hope you have the BEST trip!!! xo
OMG same! I paid out of pocket for the Dutch test (a urine hormone test) and Inside Tracker (a blood test that measures 40+ biomarkers of health incl. metabolic health) and a continuous glucose monitor (insurance mostly covered this one) to try to figure out what the hell is going on inside my body. After reading 4 books by menopause experts and countless podcasts, I wish I would've reserved that $1,000 for the high-end sleep masks and chili pad LOL! (since really all you need with a "good doctor" should be a symptom checklist). As one of the physician authors wrote (Dr. Marie Claire Haver I think), "I listen to my patients, and I believe them." I was just feeling so helpless, I wanted to do SOMETHING. My naturopath put me on a testosterone pellet for fatigue and joint pain which helped slightly (but not the cognitive, emotional, and other issues) but I haven't been able to convince him I need estrogen which I find so weird. He said at 41 I am "too young for peri" and now I know better. I have an appt with a female menopause doc in one week. Fingers crossed relief is coming my way. Thanks for your share,
Oh man, what a whirlwind!!! And a frustrating one to say the least. Ugh, I'm sorry you're having to navigate all this. Wouldn't the world be such a better place to have all doctors who listen and believe their patients?! I'll be thinking of you as you meet with your female meno doc. Keep us posted if you think of it!
So I met with my new doc and there were some initial red flags for me when she suggested birth control or IUD to suppress my cycle to manage symptoms. But she was quick to pivot when I told her I was not interested in those routes and only wanted bio-identical HRT. Its been almost one week since I started a moderate dose transdermal estrogen patch and oral progesterone (Prometrium), so I can't say yet anything about benefits but I know I feel relieved that a professional is partnering with me to help me feel better. There was an additional barrier with a nation wide shortage of progesterone so I had to do extra leg work to find a pharmacy that had stock.
Ok, this is good! I appreciate you sharing your update. Good on you for being persistent about what you don't want and what you do, and for doing the extra leg work. I didn't know about the progesterone shortage. Eek. I'm about to start progesterone myself. Thinking of you and hoping you start to feel better with this new plan!!! xo
I found some relief in early peri with Magnesium Glycinate, then sleep seemed to get a little better and I was tiring of taking allll the supplements. I didn't realize how crappy sleep had gotten again until I started HRT and holy moly the progesterone!! It's glorious. Ceiling fan, always. I have learned that I prefer brown noise - it's lower/deeper? - and there's a spotify playlist that loops all night (this does a number on my spotify wrapped and recommended artists, as one might expect).
also! all my life (like - one of my earliest childhood memories!) I've dealt on/off with waking up to HOTHOTHOT feet. So weird. Lately it's helped to just do some foot cream right before tucking in - not the full slather with cotton socks deal because that makes me wake up with feet hot in socks. Aveda makes a really nice cooling foot lotion!
I keep a rice sock in my freezer and pull it out when my feet feel like they're literally on fire. It's aaaaaaaahhhhhh-mazing. Nice to know about the cooling lotion. I'll check it out.
My sleep in the one year I took HRT was SO much better -- the progesterone is a big deal! So glad to hear it works for you. When I'm traveling I use a sound app called Deep Sleep Pro, and its version of brown noise is my go-to. I wonder if someone with synesthesia named the noise colors! All I know is that pink noise makes me want to flee.
I upgraded to paid to join this chat too! Am feeling deeply alone in my perimenopause journey because I'm heterosexual, have a male therapist, and am older than most of my female friends. My mom always told me that no one would understand how hard graduate school is except my classmates. That's how I feel about "the pause" - I think it's one of those things you can't really understand unless you experience it firsthand. So I am thrilled to come across a meno-posse! Within the last year or so, I can fall asleep, but wake up at about 4am every day regardless of what time I go to bed. Like you Emily, I quit drinking because all of a sudden I couldn't tolerate even the smallest dose of wine. The irony is that right now even without it, I don't feel great. But I am hoping to get on HRT in the next few weeks and optimistic that it will be a game changer. In the meantime, my naturopath recently prescribed 1/4 to 1/8 teaspoon of nutmeg before bed. Sounds weird but in conjunction with a tiny melatonin dose (.5mg to 1mg) its been helping me sleep better! I make a Sleepy Time Chai (a recipe I found in Aviva Romm's book Hormone Intelligence) which has become a delightful ritual for me. I also take a hot bath and because I'm so desperate to sleep, I often get in bed between 8pm-9pm. It's not even dark out in the PNW where I live at that time but PRIORITIES! I am a psychologist, so I am pretty good at sleep hygiene (shout out to the person that recommended CBT-I!): no screens in bed, stop watching tv about an hour before I plan to go to sleep, etc. My husband snores and I feel so guilty sleeping when I sleep in a different bed, but ya'll are giving me permission. Again, I don't think he understands how fragile my sleep (and therefore my wellbeing) is right now. Thanks to Emily and all who commented! Cheers to better sleep for all!
Hi and welcome! So glad you’re here! I totally agree, it’s impossible to really get it until/unless you’re in it. I hit peri at 39 and didn’t have any older friends, so I experienced a lot of loneliness in it too. The 4am wakeups are the worst— hoping HRT does the trick for you! And nutmeg is a new one, thanks for sharing that.
OMG this newsletter made my day.
Especially since I went to bed at 2am. (laugh/cry)
I'm 42, so who knows if it's perimenopause or not. I have a sleep mask, I sleep in the guest room upstairs b/c my husband snores, and the fan hahaha, your description was 1000% correct, and I keep it as cold as the upstairs AC is willing to do when it's 90 degrees outside (Ah yes, North Carolina summers). The kicker is I can typically sleep quite well once I am asleep, it's just getting unconscious that is so damn difficult.
I try not to drink caffeine after 3pm, I too take Trazadone, occasionally Delta 9 gummies, and try to get some exercise every day, and drink tons of water. I take Magnesium, Zinc, and Iron every afternoon but that's more to heal my skin, b/c I had an all-over body rash for like 4 months due to an overactive immune system. Haven't noticed it doing anything for sleep. (I take a multi-vitamin and Pre/postbiotic in the mornings too.) I also sometimes take Hydroxozine b/c it helps with itchiness in particular, but it reminds me of Benadryl and can make me feel hungover, which I don't like. Ironically, I also drink bourbon most every night. Sure, bad habits, unhealthy, wtf-ever, but my cat who'd been with me for 20 years died at the end of March so - I'm dealing. I treat it a lot like wine though - I have sought out certain flavors and kinds and have some faves that have just the right amount of caramel. I occasionally read, but sometimes that just gets me more agitated, so I often watch tv I enjoy and color at the same time until I start yawning.
I am in a lucky position right now where I can sleep in, so I am giving myself grace about the sleep patterns and questionable habits right now. I have had a therapist forever, but she recently closed her practice, and my husband and I still do marriage counseling, so I actually plan to take a break from individual therapy for a bit. I'm tired of talking about my feelings! :S
Also - I truly truly appreciate this newsletter. I'm terrible at consistently participating in online communities but so far every one of these newsletters has helped me in some way, regardless of comments / chatting with other people. XO
YES to giving yourself grace around the sleep stuff right now, and to taking a break from talking about feelings-- ha, I've been there. (And I'm so sorry to hear about your cat.) Alcohol has murdered me since peri started; I basically quit drinking at 40 because I get hung over halfway through my first drink, and it messes with my sleep to the extent that the choice feels like "either drink or sleep tonight." Ugh!!!
Thank you so much for such kind words on the newsletter! It means a lot to hear that. xoxo
...could I get a few bourbon recs?
Ohhhh sure! Basil Hayden’s is a good one that’s pretty available everywhere. I love Rua, which is based in Charlotte I think, and Defiant, also NC based, so not sure if those can be found elsewhere. We went on a bourbon tour in Kentucky and went to Bardstown, they are pricey but delicious; we loved the Elijah Craig single barrel too.
Thank you! I just finished my bottle of Sazerac (it was lovely) so this is perfect timing.
I had to upgrade to paid to comment on this. I've always struggled with sleep (early waking mostly) and have tried everything under the sun. I've found relief in various drugs over the years Ambien (before we knew how bad it was), Trazodone, nortriptyline (another old timey antidepressant), Unisom, THC, PEMF infrared mat, continuously monitoring blood sugar, Oura ring, etc etc etc.
I sleep with white noise, an eye mask, ear plugs, blackout shades, and frigid temperatures (perimenopause yay!).
And still, I struggled.
I finally was convinced to try CBTI (cognitive behavioral therapy for insomnia) which is considered the "gold standard" treatment and has results that beat basically any and all drugs out there. You need a therapist to walk you through 6-8 sessions and it seriously has transformed my sleep more than anything else I've ever tried. I am drug-free and sleeping better than ever. I do still have off-nights and weeks where it's harder, but what's great is that I now have cognitive tools to deal with the stress of not sleeping well. I feel freedom from worrying about sleep. I know this sounds a little over the top but it's truly been amazing. It's not cheap, but sleep is priceless!
Dr. Matthew Walker and Donn Posner are two people who talk about this in interviews if you want to learn more -- Matt Walker's interviews with Peter Attia convinced me to finally try CBTI.
Also, hello from Portland! I too adore Bastion's bread and depend on it for my GF/DF sustenance.
Rebecca, fellow Bastion lover, you might have just changed my life?!?!? I didn't know this was a thing. Will definitely listen to those interviews, thank you so much. (And thank you for upgrading to share this!)
Are there any other GF/DF spots in town you love? Kate's ice cream and Tiny Moreso are two of my other go-tos. Bastion is a drive for me (I'm in Kenton) but I faithfully do it every other Sunday.
Hi Emily and Rebecca! Fellow Portlander here. I’m going to look into this therapy! Thanks for sharing.
I am GF, but still don’t do well with high carb things, but I have treated myself to Gem Bakery: https://maps.app.goo.gl/XiPcDVsXcbqyEVzQA?g_st=ic Also, Petunia’s as the most amazing GF and Vegan baked goods…soooo good! https://maps.app.goo.gl/YFxg6RZ5eUjSPGCU7?g_st=ic My local coffee shop stocks them and I can’t resist from time to time. (They might have more pastries than loaves.) Lastely, New Cascadia is pretty good: https://maps.app.goo.gl/9kv34wZY7ftZ2Nj6A?g_st=ic I haven’t been there in a while, but they used to make challah bread for Sundays…it was heavenly!
I love New Cascadia bagels!
They ARE so good!
This is the episode that started me down the path of CBTI: https://peterattiamd.com/understanding-sleep/
You must be devastated that Cultured Caveman closed! That used to be my #1 spot in town (weird ambiance, but such good food). Nothing's as good as Bastion, but Harlow, Fermenter (3 blocks away, RIP), and Feel Good are other solid spots for me. I hadn't heard of Tiny Moreso -- I'll pay them a visit!
I never got to Cultured Caveman before it closed! I moved here the week before lockdown hit, so my whole first 18 months in Portland were... you know. And right, I forgot about Harlow! Their biscuits are preeetty great. And they just opened one on Alberta!
Oh gosh, not the best introduction to Portland (or anywhere...). Yessss, Harlow! Their NW 23rd location is fun too if you feel like a little lunch 'n browse.
I'm not a great sleeper, and at almost 42 I'm nervous it's bound to get worse, but I do feel like I've been sleeping better than ever lately. Here's a few things that helped me. Can't wait to hear others' suggestions!
- I take a very low dose of gabapentin for unrelated nerve pain, but I think it's also helped my sleeping a lot as well.
- White noise machine always. I use this awesome one and what I love most about it is that it is tiny (fits in my palm) so I can easily take it when traveling. (https://www.amazon.com/gp/product/B07RWRJ4XW/)
- The best black out eye mask. Truly blacks everything out.
(https://www.amazon.com/gp/product/B07KC5DWCC/)
- CBD gummy with a small amount of THC when needed.
- I use mouth tape at night, which I think has helped reduce snoring and helped me to sleep better. I've been doing this for about 5 years. 3M Durapore tape is super gentle on the skin.
- Sleep in a separate bedroom from my spouse! I am a super light sleeper. He's the deepest sleeper known to man and also has to wake up extremely early for work. Let me tell you, sleeping in different rooms has been a game changer for my sleep and sleep quality. And for our marriage because I'm not crabby the next day from sleeping poorly!
- Magnesium does nothing for me.
- Knee pillow to keep me sleeping on my back because I learned that side sleeping just ruins my body.
- Reading before bed helps just calm everything down.
YESSS FOR LINKS! I love it. I forgot that I also occasionally use a very low THC gummy (known among my friends as “mom weed.”) The separate bedrooms thing is a big deal. My current partner is literally undetectable while sleeping - no noise, no movement, he’s basically unconscious- but my ex was a snorer and once we got over the idea that we were “supposed” to sleep in the same bed every night, I got way better sleep in the guest room. You’re right, total game changer.
Yes for normalizing separate bedrooms!!! 🙌 My husband sleeps in another room on weekdays because he gets up so early and it messes up my sleep, and I always feel like people will judge us for that. So I appreciate when others share they do the same. 💖
Red-tinted blue light blockers 2 hours before bed. Seeing sunrise, and seeing sunset. Getting as much natural light as possible and eliminating as much blue light as possible. Absolute game changer for me. (and I had already quit alcohol and coffee.) I'm 44, deep in peri-menopause, have no symptoms and sleep like a baby. Bonus since I've done this I've lost 15 pounds out of nowhere. Sarah Kleiner and Carrie Bennett have been the educators around this circadian rhythm stuff I've learned the most from.
Okay wow thank you— down the rabbit hole I go!
I love this idea! Easy to try out and basically zero side effects. Thank you!!!
Do you have links for the glasses
You would recommend?
Thank goodness my attentive psychiatrist has helped me tweak my bedtime rituals/aids over time. My peri/menopause journey has not been cute. Every clinical side effect all cranked to 11, plus a major depressive episode about 18 months ago (with no history of depression ever before). Much better now a year into menopause but temperature regulation is still a serious problem, mostly at night.
I’m 54 and this is my current sleep regimen:
1) Trazadone. I take 50mg a night. If I’m feeling particularly stressed or over-stimulated I take 75.
2) Rhapontic Rhubarb Root Extract. Estroven (gold box) over the counter. Might be woo woo but who cares.
3) CBD Fx brand THC Lemon Dream gummy. I cut them in half. Each one has 5mg THC, so I’m essentially taking a micro dose of Indica. I take it about 30 minutes before bed. I don’t drink or smoke so this is my calming “treat” - really helps my end of day “coming out of my skin” feeling.
4) Magnesium Glycinate. I take 1000mg at bedtime.
5) Hand held fan. Keep it on my bedside table. Easy to grab in the dark. A game changer.
5) Sound machine. We call her Gloria. The rhythm is gonna get cha😋
Thank you for all you do, Emily.
Keep up the good work and excellent content.
Gloria! Hahaha. And, oh man, similar peri/menopause story over here but with anxiety instead of depression. I'm so happy to hear you're feeling better a year into menopause! I take 25mg of Trazodone, 50 if I'm stressed/wired, and I'm so damn happy it exists. Off to Google rhapontic rhubarb root extract! (And thank you for your kind words - xoxo)
My sleep is excellent during the approximately 5 uninterrupted minutes I get. I have trouble falling asleep and lots of help waking up, from tiny people crawling into my bed to show off their whistling skills at 2 am.
I use a very heavy weighted blanket and several imagination-based games, which I play to help pass the time as I wait to finally fall asleep. Things like "if I could redecorate the local fancy hotel, how would I do it?" and "if could add unlimited luxury to one teeny tiny area of my life, what would it be?" (olive oil) Better than the endless to-do list of unfixable problems that otherwise runs in my head.
I am currently trying to find the fine line of "enough coffee to stay awake but not so much as to keep me awake". I've been switching to black tea more and more, as it encourages pausing rather than running.
Oooooh I love these imagination games with small parameters!
Every time I learn something else about perimenopause and menopause I wonder why I never noticed hearing ANYTHING about it....and how shitty it is.... Still so many doctors acting like it's one more thing women are just supposed to "deal with" along with their young adult offspring, jobs, partners, chores, meal prepping, debt, and aging parents. I don't think there can be "too many" forums or CORRECT informational sites on this topic. Thanks 🙏
Hear hear!
I’ve *never* been capable of just lying down and going to sleep thanks to the hard-working, nocturnal monkeys living in my brain, so I’ve read myself to sleep since I was a little kid. Post-menopause, even the act of putting my kindle down is enough to irrevocably wake me up. On a recent trip to California (where I always visit a dispensary) I discovered the magic that is CBN. It’s a “new” hemp derivative that is specifically sleep-focused. And when I tell you it works, I mean it’s like propofol — I fall asleep and the next thing I know, it’s morning. The ones I got in CA have THC also, but here in NC I’ve gotten some with D9 and also just CBD + CBN and I’m totally convinced now that CBN is magical.
For those of you who live in happy states, these are the ones I got in CA: https://wyldcanna.com/co/products/boysenberry-gummies. I take 1/4 or 1/2 depending on needs.
For those of us in the other states, these are the ones I’ve currently got at home: https://cltcbd.com/products/celestial-wellness-gummies-600mg-night-time-cbd-cbn/ and these: https://coastalhemp.co/products/modernherb-delta9-couchlock-gummies
I also have a partner who snores loudly enough to wake the neighbors. I found a mouth guard for him that shifts his lower jaw very slightly forward. He’s been using it now for two years and it is nearly 100% effective. The one I got is by PureSleep: https://www.amazon.com/dp/B07SD5W2KQ
Thanks Em for starting this conversation 🥰 and thanks everyone else for all the amazing recommendations.
THANK YOU LAURIE!!! I live in Oregon where you can basically buy weed at the grocery store, so I'm off to get some Wyld CBN!
My partner loves the Wyld line, but they make me loopy and stumbly if I get up to pee. Maybe try on a weekend or a day you can feel out the after effects?
I'm buying this mouth guard now. My partner woke our son DOWN THE FLIPPING HALL once. I so feel your pain.
OMFG sleep in menopause/perimenopause. I feel you! I am in my 5th year post menopause and sleep is STILL a thing. Not as bad as it has been but still. Things that have worked for me:
Gabapentin (Trazadone gave me seratonin syndrome, so I take gabapentin). It helps reduce hot flashes AND increases deep sleep. Low dose, non addictive as far as I know, and has been a godsend.
Getting up at night to pee was a big sleep disruptor for me. I recently started hormone therapy which has helped, but pelvic floor physical therapy ALSO helped.
Weighted blanket. Yep, I even bring it when I travel.
PLUS, I make space in my day for a nap. Just knowing it’s an option helps take the pressure off if/when a bad night’s sleep happens.
GOOD SLEEP VIBES to all of us doing that foundational sleep work!
Thank you for sharing all your strategies! The waking up to pee thing is the bane of my existence. I've tried two different pelvic floor therapists, but it hasn't really helped, and after like 8 visits to each one I just kinda gave up. I've noticed that my nocturia is way worse for a handful of days every 4-6 weeks, accompanied by cystic acne and sometimes a migraine, so I'm thinking it's an estrogen drop thing. Ugh!
I feel seen! Insomnia was my main perimenopause symptom and I had no idea 1) I was in perimenopause (early thanks to cancer/chemo 30 years before!) and 2) didn't realize sleep was such an issue for menopause.
I had to do a lot for my sleep that's already been mentioned but the big three were:
1. Balanced blood-sugar. My problem was waking up from 2-4, 2-5, 2-FOREVER and it got so much better once my blood sugar was balanced. This sometimes meant a protein rich snack and healthy carb right before bed (even though everyone tells you not to eat before bed. A small snack with protein + carbs can help for those whose blood sugar bottoms out at the middle of the night, causing the awakening).
2. Yes to the CBT for sleep anxiety (mentioned in this comment thread!). This helped me a lot as I became so anxious about my sleep that that was causing a lot of problems.
3. Taking walks during the day. While I am someone who is pretty emotional resilient at this point, I didn't realize my body didn't care about that.
Being more sympathetic dominant in peri/menopause meant I needed a lot of physical breaks to bring down my cortisol during the day. This also served to not make me go non-stop during the day which I can no longer do.
Having a gentle way to bring my cortisol down frequently during the day continues to help me so much.
I also did a podcast interview (w/transcript) with my sleep coach Kelly Murray who is a functionally-trained sleep coach if anyone is interested in a deep dive into insomnia root causes that are often missed. Because what I found with my own insomnia (for three years!!!) was it was a window into other health shifts I needed to make: https://alishapiro.com/sleepless-in-midlife-uncovering-hidden-root-causes-with-kelly-murray/
Hi Ali!!! You and me both, with the chemo inducing it early and also not knowing sleep was such an issue. Did your oncologists tell you to watch for it early? Mine mentioned it in passing when I was basically on my way out the door. These are such great tips, thank you so much for sharing, and I'll be listening to that interview on my flight Tuesday morning!
Your question made me unexpectedly cry, Emily! No, my oncologist didn't tell me. It's one of so many health cross-roads that remind me how much I've been on my own out here trying to navigate the fall-out from cancer treatments.
I was also 14 when I finished treatments, it was 1992 (a different cancer "era"), and I'm part of the first generation of childhood cancer survivors so there isn't a lot known about the long-term effects of treatments on children. I remember something vague about my fertility being in question but no one really knew.
I participate in research studies to help researchers better be able to help other cancer survivors; even in those bulletins, I don't recall early menopause being mentioned. It really needs to be and I wish they had providers who could help us navigate all the layers of menopause as cancer survivors given it's not a "one and done event" but a reverse puberty with critical health concerns for all women (women's overall health nosedives after menopause because of the hormonal drop-off).
And hope the tips help. I'm still astonished how much walking helps all the things. Not just with cortisol but when I want to scream into the void, etc. And it's so accessible from a time, money, and ease.
Aw, Ali -- what you went through was so incredibly difficult. There was just so much they didn't do and didn't know, and it's simultaneously shocking and not surprising (and, same feelings that most docs are probably STILL not really mentioning early menopause). My tx was in 2000, and I was 24, and I had the same experience with fertility info -- some vague conversation about it being potentially in question, but they didn't really know. Ugh!
You made me cry again, Emily. You are a healer in so many ways. Thank you for naming this. Not many people can understand. I had a friend who was diagnosed with breast cancer last year and she texted me, "I can't believe you went through this at 13." I cried then too!
And geesh - so we all got the vague fertility talk but nothing about hey, this matters way beyond your fertility. That's patriarchal medicine for you.
Thank you for this exchange. Truly grateful.
I am mold exposed which destroyed my sleep, probably forever. I take a nightly cocktail of OTCs such as magnesium, HTP5, GABA, l-theanine, Calms Forte from Amazon, melatonin 3mg time release. I also mouth-tape. I think the crones should form their own political party!
Beth, I'm so sorry to hear about your mold exposure -- that's a long healing process. Does the mouth-taping keep you from waking yourself up by snoring? AND AGREED ON THE CRONES.
Thanks Em. Can’t find a local doctor for treatment who doesn’t want $10k upfront so I’m living with it. And yes, if I take an unexpected nap and don’t tape, I snore like crazy. But *I* do not snore—it’s the mold, I swear!! 😂
It's definitely the mold. DEFINITELY. (And 10k up front makes me want to flip a table... fuckity fuckkkk.)
I have a mold doctor rec if you want it. Sarah Holgen, she’s a naturopath out of bend, Oregon. I met with her virtually and she’s super affordable. She’s a wealth of knowledge.
That is amazing, thank you so much!🙏🏻❤️
Beth, how did you know it was mold? Like were there any symptoms in addition to poor sleep? And did you get tested?
Yes , lots of medical issues (high homocysteine unresponsive to folate/B12, Epstein Barr, mast cell issues are a few). Tested twice with Great Plains/Mosaic and second time was worse after two rounds of Cholestyramine.
Gosh, what a mess. I'm sorry!!!
Ambien.
Vibrator.
Bahahahaha! A SOLID COMBO
First, THANK YOU for talking about this. This information needs to be as common place as two-bathtub ads for Viagra.
Ditto the refrigerator-like temperatures, white noise machine, and fan-in-the-face. What also helps:
Estroven Sleep Cool, which has lessened my night sweats have both in intensity and frequency. https://estroven.com/products/menoapuse-relief-sleep-cool?selling_plan=748355656
Also, I love, love, love this sleep mask/headphone combo. It really helps when my partner's snores start sounding more like heavy machinery and less like a living person. https://lullaleisure.com/products/lullaband-sleep-headphones
Okay I bought one of those sleep mask/headphone combos several years ago! My ex used to call me Chad when I wore it because he thought I looked like a snowboard bro. Haha. Mine might have been a lemon (it was from Amazon, I don't remember the brand) because it didn't hold a charge for very long, so I would get awakened all the time by a shrill voice saying "Battery low, please charge now!" and it made me really mad at it. Does yours have that problem?
HA! Now I'm going to think of this as my ski bro headband 😆 Mine does the annoyingly loud low battery announcement, but the charge lasts for days. I try to plug it in every 3-4 days and it hasn't been an issue.
Great to know!
Thank you for writing this post!!! The comments are so helpful too! I miss our group and I'm so glad to see you fostering the community sharing here now too. :)
Ok here's my regimen, with a quick backstory: I used to be an awesome sleeper – a creative night owl with no issues really; I even managed to become an early riser over the years after getting married to a man who gets up stupid early for work, so that we could spend *some* time together in the mornings and at night – until I got pregnant. I was likely already dealing with depression before that, but during my third trimester 7 years ago, I developed diagnosed Psychophysiological insomnia, alongside PPD and general anxiety disorder and I've been medicated for each of them ever since. Fast-forward a couple years ago – when I had JUST started feeling like my sleep was getting back on track (fucking of course!!!) and the gnarly night sweats started, just like you described yours, and the insomnia creeped back. At 38 my PCP thinks I'm in perimenopause. I'm working with a naturopath to know for sure. Last week I sent in saliva tests and blood draws to know my hormone and micronutrient numbers. So TBD. In the meantime, here's where I'm at:
- I also take Trazodone every single night. Like you, I take half a dose though because the full dose prescribed will knock me out in a woozy way I don't like but the half is just right and required at this point to help me fall asleep every night.
- I use this ridiculously loud/deep white noise machine and think it's the absolute best - if/when I travel, it comes with: https://amzn.to/3Vz9eGm
- This sleep mask that I absolutely love: https://amzn.to/4eiYt2k I would never consider spending this much on a sleep mask until my SIL (a pediatric sleep consultant) bought it for me and now I don't know what life looked like before it
- Magnesium before bed; no idea though if it actually does anything. Same for the spray-on kind but I also use that sometimes when I feel sore for no reason?
- Ideally I go to bed by 9pm and wake up at 4am. I usually wake up multiple times a night but ATM am usually able to fall back asleep. Usually. Sometimes though I'm up for good at 3am and then will try to take a short nap around 1p.
- My BIGGEST RULE/TRICK: I leave my phone in the kitchen to charge from after dinner around 7ish, through until the morning, after I've had my quiet personal time from about 4ish - 6:30ish. This has been by far the biggest help for me!!! No checking the time in the middle of the night (I have an old school clock on my nightstand for this with a button for light if I want to check) and no picking it up first-thing in the morning to doom scroll mindless shit. I cannot emphasize how hugely important this has been for my sleep and overall health!!!
- No more than 1 glass of wine with dinner, and just a couple nights a week because same - at this point, *drinking* drinking equates to sleep or no sleep for me. I also try to chug water right after dinner so I'm hydrated but pee it out before I go to bed so I'm not waking up to pee!
- My husband snores sometimes and if/when he does, I no longer hope he stops or try to push him onto his side lol. I just get up and go into our guest bed. If I feel at all achy or sweaty or insomnia-y I just straight to the guest bed for the night because I don't want to have the stress of trying to be sneakily-restless and possibly wake him up if that makes sense. I can just move around allll I want in the guest bed. It sounds dumb but it's also another hugely helpful option.
Oh wow Sarah, your post-pregnancy sleep journey. And not for nothing: while also taking care of a new baby!?! That's... a lot.
As you know, I'm not a doctor (lol) but the one thing I'll say about saliva and blood draws in relation to hormone numbers is that menopause specialists don't generally rely on them, since our hormones are constantly going up and down in perimenopause, so you could have a "normal" result one day and a totally different result the next. For this reason, most of them go by your symptoms to determine whether you're in perimenopause. Not that blood tests aren't helpful, just that I've learned a "normal" result may be somewhat of a false positive.
Yes to leaving the phone in another room! Yes to guest bed!
This is good to know, thank you. Yeah, it's funny (but not) - right after I signed on with this naturopath and paid for and did the testing, I talked with a friend-of-a-friend who's a doctor and she basically said the exact same thing you just did. So I'm a little annoyed and hope I'm not getting taken advantage of. I think the naturopath's mentality is that we get as much data as we can at this point (he had me test on a very specific day in my cycle at least?), including knowing all my micronutrient levels, and see if there's anything extreme in my numbers to possibly follow-up on. He said he had a strong feeling that I have a progesterone deficiency, which apparently often presents itself with the exact same symptoms of perimenopause? like insomnia, low energy, night sweats, etc. I hadn't heard that before and thought that was interesting. So we'll see. Then again, maybe it's just a matter of figuring out what 124986 new things I suddenly need in my daily regimen and then I'll be totally good!
I just wish it didn't cost so damn much, that insurance covered at least SOME of it (especially for women and female bodies!), and that it wasn't such a privileged thing to figure out. It's fucking crazy to me that just getting to a BASIC level of "Hey, I feel okay and not totally shitty today!" -can be so difficult and have so many obstacles for so many people. It's nuts.
That was a total tangent but how I feel. lol.
Anyway. Happy travel day (I think) today!!!! Hope you have the BEST trip!!! xo
OMG same! I paid out of pocket for the Dutch test (a urine hormone test) and Inside Tracker (a blood test that measures 40+ biomarkers of health incl. metabolic health) and a continuous glucose monitor (insurance mostly covered this one) to try to figure out what the hell is going on inside my body. After reading 4 books by menopause experts and countless podcasts, I wish I would've reserved that $1,000 for the high-end sleep masks and chili pad LOL! (since really all you need with a "good doctor" should be a symptom checklist). As one of the physician authors wrote (Dr. Marie Claire Haver I think), "I listen to my patients, and I believe them." I was just feeling so helpless, I wanted to do SOMETHING. My naturopath put me on a testosterone pellet for fatigue and joint pain which helped slightly (but not the cognitive, emotional, and other issues) but I haven't been able to convince him I need estrogen which I find so weird. He said at 41 I am "too young for peri" and now I know better. I have an appt with a female menopause doc in one week. Fingers crossed relief is coming my way. Thanks for your share,
Oh man, what a whirlwind!!! And a frustrating one to say the least. Ugh, I'm sorry you're having to navigate all this. Wouldn't the world be such a better place to have all doctors who listen and believe their patients?! I'll be thinking of you as you meet with your female meno doc. Keep us posted if you think of it!
So I met with my new doc and there were some initial red flags for me when she suggested birth control or IUD to suppress my cycle to manage symptoms. But she was quick to pivot when I told her I was not interested in those routes and only wanted bio-identical HRT. Its been almost one week since I started a moderate dose transdermal estrogen patch and oral progesterone (Prometrium), so I can't say yet anything about benefits but I know I feel relieved that a professional is partnering with me to help me feel better. There was an additional barrier with a nation wide shortage of progesterone so I had to do extra leg work to find a pharmacy that had stock.
Ok, this is good! I appreciate you sharing your update. Good on you for being persistent about what you don't want and what you do, and for doing the extra leg work. I didn't know about the progesterone shortage. Eek. I'm about to start progesterone myself. Thinking of you and hoping you start to feel better with this new plan!!! xo
Thanks Sarah, that means a lot! I will definitely report back,
I found some relief in early peri with Magnesium Glycinate, then sleep seemed to get a little better and I was tiring of taking allll the supplements. I didn't realize how crappy sleep had gotten again until I started HRT and holy moly the progesterone!! It's glorious. Ceiling fan, always. I have learned that I prefer brown noise - it's lower/deeper? - and there's a spotify playlist that loops all night (this does a number on my spotify wrapped and recommended artists, as one might expect).
also! all my life (like - one of my earliest childhood memories!) I've dealt on/off with waking up to HOTHOTHOT feet. So weird. Lately it's helped to just do some foot cream right before tucking in - not the full slather with cotton socks deal because that makes me wake up with feet hot in socks. Aveda makes a really nice cooling foot lotion!
I keep a rice sock in my freezer and pull it out when my feet feel like they're literally on fire. It's aaaaaaaahhhhhh-mazing. Nice to know about the cooling lotion. I'll check it out.
that is genius!
My sleep in the one year I took HRT was SO much better -- the progesterone is a big deal! So glad to hear it works for you. When I'm traveling I use a sound app called Deep Sleep Pro, and its version of brown noise is my go-to. I wonder if someone with synesthesia named the noise colors! All I know is that pink noise makes me want to flee.
Synesthesia is a concept that I ponder with remarkable frequency!
I upgraded to paid to join this chat too! Am feeling deeply alone in my perimenopause journey because I'm heterosexual, have a male therapist, and am older than most of my female friends. My mom always told me that no one would understand how hard graduate school is except my classmates. That's how I feel about "the pause" - I think it's one of those things you can't really understand unless you experience it firsthand. So I am thrilled to come across a meno-posse! Within the last year or so, I can fall asleep, but wake up at about 4am every day regardless of what time I go to bed. Like you Emily, I quit drinking because all of a sudden I couldn't tolerate even the smallest dose of wine. The irony is that right now even without it, I don't feel great. But I am hoping to get on HRT in the next few weeks and optimistic that it will be a game changer. In the meantime, my naturopath recently prescribed 1/4 to 1/8 teaspoon of nutmeg before bed. Sounds weird but in conjunction with a tiny melatonin dose (.5mg to 1mg) its been helping me sleep better! I make a Sleepy Time Chai (a recipe I found in Aviva Romm's book Hormone Intelligence) which has become a delightful ritual for me. I also take a hot bath and because I'm so desperate to sleep, I often get in bed between 8pm-9pm. It's not even dark out in the PNW where I live at that time but PRIORITIES! I am a psychologist, so I am pretty good at sleep hygiene (shout out to the person that recommended CBT-I!): no screens in bed, stop watching tv about an hour before I plan to go to sleep, etc. My husband snores and I feel so guilty sleeping when I sleep in a different bed, but ya'll are giving me permission. Again, I don't think he understands how fragile my sleep (and therefore my wellbeing) is right now. Thanks to Emily and all who commented! Cheers to better sleep for all!
Hi and welcome! So glad you’re here! I totally agree, it’s impossible to really get it until/unless you’re in it. I hit peri at 39 and didn’t have any older friends, so I experienced a lot of loneliness in it too. The 4am wakeups are the worst— hoping HRT does the trick for you! And nutmeg is a new one, thanks for sharing that.
Thanks Emily, I hope you are feeling better from the Vid! I'm so looking forward to "The End" workshop.