Hashimoto’s hypothyroidism sufferers: Why sleep is more difficult for women

female hormones sleep

Is there a torture worse than hitting the sack exhausted from a long day only to toss and turn for hours, unable to fall asleep? Or perhaps you fall asleep but later bolt awake and can’t fall back asleep?

By the time women hit their mid 30s or early 40s, many struggle with sleep. Either it’s difficult to fall asleep, difficult to stay asleep, or both. Although sleep difficulties can have many causes, fluctuations of female hormone prior to and during the transition to menopause can steal many hours of precious sleep.

Having Hashimoto’s hypothyroidism can add insult to injury. During an autoimmune thyroid flare-up, symptoms can include anxiety, jitteriness, heart palpitations, and insomnia. Unmanaged immune imbalances that contribute to Hashimoto’s hypothyroidism can also keep the body in a perpetually “wired” state that makes it difficult to sleep even when you’re physically exhausted.

Female hormone imbalances and sleep problems

When a woman enters perimenopause, her production of estrogen and progesterone begins to decline. Ideally the adrenal glands, which produce stress hormones, take over production of these hormones to ensure a smooth transition into menopause. Unfortunately, most women today enter perimenopause (pre-menopause) in a state of chronic stress and their adrenals glands are either producing too much or too little stress hormones. To take on the added job of producing sex hormones is simply more than they can handle. That’s when sleep issues can kick in, as balanced levels of estrogen and progesterone are necessary for healthy sleep. Other symptoms may include hot flashes, night sweats, depression, anxiety, fatigue, and more.

Women may also experience sleep issues during certain times of the menstrual cycle when hormone levels fluctuate.

Hormonal imbalances also raise the risk of triggering an autoimmune condition like Hashimoto’s hypothyroidism, or exacerbating an existing autoimmune disorder. In fact, many of the strategies used to help balance hormones also work to help balance an autoimmune disorder such Hashimoto’s hypothyroidism.

Low progesterone and problems sleeping

Low progesterone seems to have become increasingly common among women and can play a large role in sleep problems. Progesterone is referred to as the “calming hormone” whereas estrogen is more excitatory, and low progesterone is associated with sleeping difficulties.

Chronic stress can impact progesterone levels. Every time you experience stress your adrenal glands release cortisol, a stress hormone. When demand for cortisol is constantly high the body borrows pregnenolone, which is needed to make progesterone and other hormones, to make cortisol instead. This is called “pregnenolone steal” because the body steals pregnenolone from the hormone cascade in order to keep pace with the demands of stress.

Stopping pregnenolone steal may help improve hormone function and improve sleep. Strategies for stopping pregnenolone steal include an anti-inflammatory diet, which eases the body’s burden of stress. You may also need to work on restoring gut health, taming chronic inflammation, or managing an autoimmune disease such as Hashimoto’s hypothyroidism, approaches that benefit from the guidance of an experienced practitioner.

Estrogen and sleep problems

When estrogen is too high and progesterone too low, it can cause sleep problems for the obvious reason—there is too much of the excitatory estrogen compared to the calming progesterone and the brain can’t calm down enough to rest. A proper ratio between the two is important.

However, low estrogen can also contribute to sleep problems. Estrogen is intimately connected with serotonin, a brain chemical that is converted to melatonin, a sleep hormone. Low estrogen may lead to low serotonin activity and contribute not only to sleep problems but also depression and anxiety. The female brain is highly dependent on sufficient estrogen for normal function in general, and low estrogen can also cause symptoms that include brain fog and memory loss.

Strategies to support hormone balance and Hashimoto’s hypothyroidism

Tending to adrenal function and other health issues may help not only improve hormonal balance but also autoimmune Hashimoto’s hypothyroidism. Reducing lifestyle stress, eating a diet lower in carbohydrates to prevent blood sugar swings, avoiding foods that cause an immune reaction, not drinking too much alcohol, tending to bacterial gut infections and other aspects of digestive health, and supporting immune balance are all whole-body approaches that can foster proper hormone function and improve sleep.

Ask my office for help in supporting healthy hormonal balance and Hashimoto’s hypothyroidism, and improving sleep.

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