Melatonin can help against sleep problems during menopause

Many women suffer from severe sleep problems during their menopause and it often reduces their work capability and quality of life. Supplementation with the natural sleep hormone, melatonin, may improve their sleep, according to a study that is published in Clinical and Experimental Obstetrics & Gynecology. The authors also mention that melatonin helps regulate the sex hormone balance and other metabolic processes that are important for good sleep.

We humans synthesize our own melatonin but when menopause approaches, women may experience a significant drop in the body’s melatonin production which can affect their sleep. In the new study, the scientists wanted to see how melatonin supplementation affected sleep disturbances in women during this particular stage of their life. A total of 120 perimenopausal women took part in the trial. Perimenopause is the time that passes from you stop having your periods and have gone trough 12 consecutive months without a menstrual period. After that, a woman has officially reached her menopause. The women in this study were divided into the following three groups:

1. Women without sleep disturbances
2. Women with sleep disturbances who were treated with 3 mg of melatonin daily for three months
3. Women with sleep disturbances who were not treated with melatonin

During the period from March to December 2019, blood samples were taken and the following data was collected from the members of the three groups and analyzed afterwards:

• Pittsburgh Sleep Quality Index (PSQI)
• Levels of sex hormones
• Melatonin levels
• Levels of melatonin 1A receptor (MTNR1A)
• Levels of various kinases (KA, ERK1/2, p-ERK 1/2) that are enzymes with a number of different functions

It turned out that melatonin supplementation had the following effect on perimenopausal women with sleep disturbances:

• Significantly improved PSQI score that reflects better sleep quality
• Upregulation of melatonin levels and melatonin 1A receptor (MTNR1A)
• Improved activity of the kinase enzymes PKA and ERK1/2 in the blood
• Significant improved levels of hormones such as FSH (follicle-stimulating hormone), LH (luteinizing hormone), and estradiol
• No significant effect was seen with regard to levels of progesterone, testosterone, or prolactin

The scientists therefore concluded that melatonin supplementation of women during their perimenopause can help improve the quality of their sleep and improve their hormone balance.

Why good sleep and melatonin are important for our health

When we sleep, we digest our food and recharge physically and mentally. Also, toxic metabolic waste that has accumulated during the day is cleared from the brain. For that reason, a good and deep sleep is of utmost importance to our physical and mental well-being.
Melatonin plays a vital role in this connection. However, melatonin is also a very important antioxidant that protects our cells against oxidative stress and DNA damage.
On the other hand, lack of melatonin and the absence of sufficient high-quality sleep increases the risk of many diseases and poor well-being. Several studies have shown that perimenopausal women often have difficulty with falling asleep, they wake up during the night, or they lie awake because the produce too little melatonin.

Melatonin synthesis and why many women sleep worse than men

Melatonin is primarily synthesized by the pineal gland that has a direct nerve connection to the eyes. When daylight reaches the retina, information is passed on to the pineal gland. We start by producing serotonin, a melatonin precursor that affects our mood. When it gets dark outside, our melatonin synthesis begins.
Our natural melatonin synthesis depends on the interchange between daylight and darkness. The nervous system and hormone balance are also important for our melatonin synthesis. Moreover, women, as they are designed to give birth to babies, have a more sensitive hormone balance. Because of that, they sleep worse than men and that is a particular problem during perimenopause due to the hormone changes. Imbalances in the hypothalamic-pituitary-ovarian (HPO) axis are known to contribute to poor sleep, and the authors address melatonin’s role with regard to sex hormone production.

Other factors that inhibit the melatonin synthesis

The natural melatonin synthesis in men and women decreases with age because the pineal gland calcifies. A person who is 60 will only produce half as much melatonin as someone who is 20. It is also known that nightshift work and jet-lag are able to disrupt the body’s melatonin synthesis and the same is the case with lack of daylight and overexposure to artificial light at night. Blue light that is emitted from device screen and LED bulbs is especially bad. Coffee, alcohol, and other stimulants can also block the body’s melatonin synthesis.

Melatonin supplements during menopause and other stages of life

Melatonin is one of the most widely sold preparations in the world, especially in the countries where it is available in supplement form, unlike in Denmark where it requires a prescription. Taking melatonin can compensate for a reduced endogenous synthesis of the compound. In contrast to many types of sleep medication, melatonin is normally without side effects. Most tablets contain three milligrams of melatonin and the normal dose is one tablet to be taken half an hour or an hour before bedtime

References:

Puxiang Chen, Qinghua Zhang, Ting Zhang. Melatonin Alleviates Perimenopausal Sleep Disorder by Regulating the Expression of MTN1A and Hormone Level: A Retrospective Study. Clinical and Experimental Obstetrics & Gynecology. 2023

Samir Malhorta et al. The Therapeutic Potential of Melatonin: A Review of the Science. Medscape January 10, 2019