Trouble Sleeping & Fatigue

Exhausted from tossing and turning all night?

How long has it been since you woke up well-rested, refreshed and ready to tackle your day? If that feeling is just a distant memory, you may be one of the many women who suffer from sleep problems and fatigue.

While stress and anxiety contribute to many a sleepless night, if you suffer from overwhelming fatigue the problem may be your adrenal levels, particularly the hormone cortisol. If your cortisol levels are too high at night and too low in the morning you can feel completely exhausted and have trouble functioning.

To get back in balance, your health care provider may suggest hormone therapy. Remember there are natural options and bioidentical hormones available. Your provider should individualize your therapy to meet your unique needs.

For some women, taking over-the-counter melatonin may help you break the cycle and get back into a regular sleep pattern. Natural progesterone can be another helpful solution.

You’ll also need to take an honest look at your lifestyle and make the changes necessary to reduce stress, get enough exercise, eat a healthy diet and make time to find joy in your life.

Solutions: What you can do to ease your symptoms

Here are some tips to help you fall asleep, stay asleep through the night, and wake up feeling rested.

Practicing sleep hygiene

  • Set a routine bedtime and waking time so your body adjusts to the rhythm.
  • Schedule enough time for sleep, 7-9 hours is truly needed! Avoid napping during the day, but if you absolutely must, limit naps to 30-45 minutes.
  • Avoid alcohol 4-6 hours before bedtime. Falling blood alcohol levels act as a stimulant. Avoid caffeine 4-6 hours before bedtime as well.
  • Limit exercise right before bed as it can interrupt your ability to fall asleep.
  • Don’t eat heavy, spicy or sugary foods 4-6 hours before bedtime, as they can prevent you from staying asleep.
  • Eat a small, healthy bedtime snack such as whole wheat toast or a small bowl of cereal to keep your blood sugar levels stable during the night.
  • Establish a soothing sleeping environment with comfortable bedding. Block out all distracting noise and light.
  • Reserve your bed for sleep and sex, so your body associates the location with sleep.
  • Avoid watching TV in bed as the stimulation of light and noise can interrupt sleep. If part of pre-sleep ritual, try to shut off before falling asleep with it on. To help you set aside your worries, keep a pen and paper handy so you can jot down your thoughts if you wake during the night.
  • Keep your bedroom cool, which is usually the most comfortable temperature for restful sleep. Use a ceiling fan, even in winter. You may also want to keep a small fan on your bedside table, so you can easily adjust the air circulation as needed.
  • Avoid flannel sheets; increase the cotton count of your sheets if you’re having hot flashes or night sweats. Wear moisture-wicking fabric pajamas to stay cool.
  • Take a warm bath and/or read before bedtime.
  • Relaxing herbs like valerian, chamomile, and lemon balm can gently bring about the onset of sleep. Lavender aromatherapy produces a calming affect.
  • Get into your favorite sleep position and focus on relaxing thoughts. Practice relaxation techniques, such as deep breathing and consciously relaxing your fingers, toes, limbs and shoulders.
  • Over-the-counter products to aid sleep, such as Melatonin, may help. It’s been shown to be most effective for people who work the night shift or take overnight flights, but is a relatively safe option for many.
  • Your health care provider may prescribe a short term sleep aid to help you get break the insomnia cycle.
  • Ask your health care provider if an over-the-counter or bioidentical progesterone is right for you.

Choosing foods

  • Aim for a diet free of processed foods. Choose organic whenever possible to avoid preservatives, pesticides, hormones and other substances that disrupt hormone balance.
  • Whole foods are healthiest, so pick the orange instead of the orange juice. You’ll receive more hormone rebalancing nutrients and fiber to keep you healthy and well.
  • Shop the perimeter of the grocery store, where the most nutritious foods are found. Check labels: and avoid foods loaded with high fructose corn syrup (HFCS), refined carbohydrates and sodium (salt) as these can contribute to more imbalance symptoms.
  • Be aware of portion sizes. Honor your cravings with gratitude for yourself, but do so in moderation.
  • Aim to eat at least 5 servings of vegetables and 2 servings of fruit each day. The more colorful ones are packed with valuable nutrients to help your body achieve stellar function. Dark green and leafy vegetables such as spinach, kale and collards have been shown to help in memory recall and other mental functions.

Drinks to sip on

  • Drink more filtered water and green tea. General recommendations for water intake are half your body weight in ounces, every single day. You can work your way up to this amount, of course!
  • Limit your caffeine intake; drink less coffee and soda.

The importance of movement

  • Go for a walk, take the stairs and park farther away. Exercise gets your endorphins moving and helps alleviate symptoms associated with menopause.

Mental health

  • Your health care provider may choose to prescribe a short course of anti-anxiety medication while you establish a long term management plan.
  • They may also choose to assess your neurotransmitter balance. Neurotransmitters are hormones in the nervous system (such as serotonin, epinephrine, norepinephrine, GABA and dopamine) that regulate mood and sleep.

Stress reduction

  • Talk to your health care provider or pharmacist about adrenal support vitamins and herbs. Increasing your intake of B & C vitamins, particularly vitamins B5, B6 and B12 can be very helpful. Health food stores and compounding pharmacies are also good places to look for adrenal support vitamins specially formulated for your needs. Don’t be tempted to buy cheap products, invest in yourself.
  • Make time to do the things you love, whether it’s relaxing with a good book or pursuing a favorite hobby. These activities will help you tackle the stressors of life with more resiliency and perspective.
  • Get your life in order; getting rid of clutter can reduce your overall stress and help you manage midlife challenges.
  • Reduce your stress with massage therapy, join a yoga class or practice meditation.
  • Get more rest and a better night’s sleep. For tips, see theTrouble Sleeping symptom page

Vitamins, minerals, herbs


Addressing inflammation

  • Load up on berries that packed with anti-oxidants, like blueberries, blackberries, cranberries and strawberries. Fresh or frozen, they reduce oxidative stress which assaults the cells of the body. So, “berry up” to reduce inflammation and improve your brain cell signaling.
  • Avoid saturated and trans fats and choose olive oil and canola oil instead.
  • Choose foods high in Vitamin C, like red peppers, oranges, pine nuts, and roasted sunflower seeds. These foods are great for skin protection, leading to fewer wrinkles and less skin dryness overall.
  • Boost your omega-3s: a beneficial fatty acid found in fish oil, walnuts, canola and flaxseed oils.
  • Spice up your diet with herbs that have antioxidant and anti-inflammatory properties, like turmeric (also known as curcumin), garlic, rosemary and cayenne.

Banishing toxins

  • If you’re a smoker, seek the support you need to quit. On average, women who smoke experience menopause symptoms two years earlier than non-smokers, and smokers’ symptoms are often stronger and more troublesome. It’s never too late to quit smoking, so get started today.
  • Chemical disruptors can also throw off your balance, so avoid perfumes and go fragrance-free. Many natural alternatives to perfumes can be purchased or made, often lasting longer and delivering therapeutic effects as well as delicious fragrance!

Hormones, hormones, hormones

  • If hormone therapy is recommended, consider bioidentical therapy which matches your body’s hormone structure.
  • Discuss over-the-counter progesterone options with your health care provider.

Multidimensional healthcare

  • See a licensed health care provider for a comprehensive exam and full assessment of your overall physical, mental and emotional health. The type, timing and dosage of your therapy will be tailor-made so that you may attain the wellness you’ve been waiting for!
  • Talk to a Chinese medical practitioner about herbal therapy and acupuncture.
  • The naturopathic medical approach also has much to offer women struggling with hormonal transitions. By stimulating your body’s innate ability to heal- a force also known as the vis- naturopathic physicians can create a powerful individualized plan and adjust it whenever necessary.