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Dr. Sarrel explains why women experience sleep disturbances during menopause, and shares how women can advocate for their menopausal symptoms.
Dr. Sarrel:
Well, the first is about sleep disturbance and we’ve talked about that already as, among the most common symptoms, hot flushes are right up there as the most, fatigue, sleep disturbance, so those are among the most common. When we talk about most common, we’re talking 70% or more women experiencing such symptoms.
The sleep disturbance is very specific. There’s no trouble falling asleep because you’re exhausted, but about two hours later you wake up. When you wake up, you feel wide-awake. You may feel hot, may feel cold, may feel just wide-awake, and then you go back to sleep. In about two hours later, you wake up again. What this is about is, that during sleep, estrogen normally controls the release of adrenaline, and in the sleep cycle about every 90 to 120 minutes there are surges of adrenaline being released in your body, normally modified, but if the estrogen isn’t there, the surge wakes you up and of course you can develop drenching sweats as you would with any kind of surge of adrenaline.
Well, the question of, “What can a woman do to advocate for herself?” is an extremely important, kind of a central issue in today’s healthcare. The reason is, every patient should be able to advocate for themselves. Sometimes, patients are in a situation where they are very vulnerable, especially very sick patients, but, you know, a menopause patient could feel extremely vulnerable, doesn’t trust her memory, she feels very anxious, she is having hot flushes, she is very confused about what’s going on.
What I often recommended in that kind of situation is, don’t go to the doctor or the other, whatever healthcare, but don’t go by yourself; bring a friend. Have someone else in the room with you so that when you try to present what you are presenting, if you need any kind of support, you know it’s there. You’re not alone. We do know, it doesn’t take very long to present your problem, but you should be prepared. You ought to make a list, what are the priority issues, and remember on that list it’s going to be sex. Don’t leave it out because we have found women often will talk about hot flushes and fatigue and sleep disturbances and so on, but the really most troublesome thing is dryness and pain with intercourse or a loss of desire, and they don’t bring it up at the interview.
The doctor should routinely ask about that, but very often doctors won’t do that because they don’t want to impose on the patients. Don’t be shy about that. If there’s a problem, keep in mind we’re talking about over 80% of women by the time they’re in their mid 50s have got some kind of problem around sex. So you’re in the great majority if you have such an issue. You’re not in the minority and most of the problems are very simple to treat.
Family practitioner, the gynecologist, whoever the primary care, they all could make very simple interventions that will stop your problem within just a few weeks. There is no reason for you to suffer with those.
About Dr. Sarrel, M.D.:
Philip M. Sarrel, M.D., completed his medical education at New York University School of Medicine, his internship at the Mount Sinai Hospital, and his residency at Yale New Haven Hospital. In addition to his many years on the faculty of the Departments of Obstetrics and Gynecology and Psychiatry at Yale University School of Medicine, Dr. Sarrel has also been a Faculty Scholar in the department of psychiatry at Oxford University, Visiting Senior Lecturer at King’s College Hospital Medical School at the University of London, Visiting Professor in Cardiac Medicine at the National Heart and Lung Institute in London, and Visiting Professor in the Department of Medicine at Columbia University College of Physicians and Surgeons in New York. He is currently Emeritus Professor of obstetrics, gynecology, and psychiatry at Yale University.