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    Includes Expert Content
    Sleep trouble
    justmejust posted:
    Hi, I am in menopause and am having one major problem- I cannot fall asleep at night, and if I get to sleep I wake up after an hour or two and can't get back to sleep again.

    Please share your solutions, please, what works for you?
    Mary Jane Minkin, MD responded:
    Dear Justmejust,
    It is NOT just you! Lots of peri and menopausal women have significant sleep disturbances; some women wake up with hot flashes; some women just wake up. Some simple sleep measures do help. Keep your sleep area cool-the cooler the better. Get lots of good exercise early in the day. Avoid stimulants at night. And try to avoid wine at night; even though it may seem to help you get to sleep, the wine may well trigger hot flashes, and wake you.
    From a medical point of view, if you are a good candidate for estrogen therapy, most women do find estrogen therapy helpful, and you can discuss this with your health care provider. 
    From a non prescription medical perspective, some women find soy foods and products helpful. Another over the counter remedy, Remifemin, which is German black cohosh, can be very helpful. The Remi folks also have a product called Remifemin Good night, which also has some herbs which seem to help sleep. And there are some women who do find help with melatonin.
    There are also non hormonal prescription medications which may help. SSRI and SNRI antidepressants can be helpful with hot flashes. And believe it or not, the drug Neurontin also has been used with some success.
    Of course, plain sleep medications can be helpful. Although you don't want to get in the habit of daily use of sleep medications, if you've had several terrible nights in a row,  drugs like Ambien, Lunesta, and Sonata can help with sleep.
    So do talk with your health care provider. this will not be the first time (s)he has heard this problem, and should be able to give you further guidance.
    Good luck,
    Mary Jane
    justmejust replied to Mary Jane Minkin, MD's response:
    I don't have much complaint at all about hot flashes, just unable to fall asleep at night, and when I sleep it is not for very long. I wake up after a couple hours and just lay there awake, unable to sleep. The next day I am tired.
    I heard something about melatonin supplements. Are they safe and effective?
    SkittyCat; replied to justmejust's response:
    Oh, dear sweetheart! -- I was the same way! Please don't take anti-depressants, anti-anxiety, and sleeping pills. The side effects are under-rated, under-reported. Try bio-identical hormones. I just wrote a short post about it in this section (WedMD Menopause Community: Try Bio-Identical Hormones). After only a few days of use, I got my life back, my sanity back. Before that, I hadn't slept normally for almost a year. I tried Ambien to sleep -- which made me hallucinate and caused an overpowering sense of hopelessness and thoughts of suicide. I took anti-depressants, which dulled me out and made my mouth incredibly dry. My advice: Go natural. Drugs are over-rated and should only be used in emergencies and if nothing else is available. Do a search on Google for your area to find a doctor or pharmacy to help. Bless you!
    justmejust replied to SkittyCat;'s response:
    Thanks for your response. I am sleeping better now. Ocassionally I need to take tylenol pm.

    Featuring Experts

    Mary Jane Minkin, MD, is a nationally recognized obstetrician gynecologist, with a special interest in menopause. Dr. Minkin is clinical professor of ...More

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    For more information, visit the North American Menopause Society website