Sleep problems and sex hormone symptoms in women

Some cancer treatments can lower the levels of sex hormones in the body. The main female sex hormones are oestrogen and progesterone. 

Low levels of sex hormones can cause hot flushes or anxiety, making sleep difficult. Coping with other symptoms can feel worse if you are not sleeping well.

On average most adults need around 7 to 9 hours of sleep a day. But some people may need more while others manage with less.

Sleeplessness (insomnia)

Insomnia is when you have difficulty falling asleep or staying asleep at night.

An occasional night without sleep will make you tired the following day. It won't affect your health, but it can make concentrating and decision making more difficult. Coping with other symptoms may feel harder if you are not sleeping well. 

Understanding why you are finding it difficult to sleep will help you to find possible solutions. 

Sleeplessness can be:

  • difficulty falling asleep
  • difficulty staying asleep
  • waking up often or too early in the morning
  • feeling tired when you wake up (poor quality sleep)

Tips to help with sleep:

  • Go to bed and get up at the same time each day and reduce naps.
  • Do some light exercise each day to tire yourself.
  • Make sure the room is not too hot or too cold.
  • Relax before bedtime, by taking a bath or listening to music.
  • Avoid alcohol, caffeine and smoking for about 6 hours before going to bed.
  • Don't go to bed hungry. Sometimes a light snack before going to bed can help.
  • Turn off mobile phones, tablets and TV at least 2 hours before going to bed.
  • Meditate, practice mindfulness or try deep breathing at bedtime.
  • Minimise noise and light in the bedroom.
  • Try putting a few drops of lavender oil on your pillow or use a lavender cushion.

Talk to your doctor or nurse if you have tried these tips and they haven’t helped.

What can help?

There are treatments and therapies that might improve your sleep, these include:

  • relaxation techniques 
  • sleeping tablets
  • complementary therapies
  • counselling

Relaxation techniques 

Relaxation techniques such as mindfulness, meditation and breathing exercises can help. They can help you feel calmer and cope with worries and anxieties. This in turn could help you to relax and sleep. 

You can read about meditation and other mindfulness-based techniques in our complementary therapies section. 

There are a number of organisations that produce CDs and podcasts. There are lots of meditation apps available, such as Headspace. 

Tablets to help you sleep

Your doctor might suggest a short course of tablets if you’re finding it very difficult to sleep. You usually only take these for a short amount of time. This is because sleeping tablets can have side effects.

Speak with your doctor if you think you need sleeping tablets. They can talk it through with you. 

There are several types of sleeping tablets and they work in different ways. 

Medication to help with sleep include:

  • benzodiazepines (lorazepam, temazepam)
  • non benzodiazepine hypnotics (zopiclone, zaleplon)
  • melatonin (if you are over 55) 

Complementary therapies for sleeplessness

Some complementary therapies may help improve your sleep. Talk to your doctor, GP, or nurse if you're considering using any complementary or alternative therapies. Some treatments may interact with other treatments you are already taking.

Acupuncture and reflexology

Studies have looked at acupuncture and reflexology to see if they might help with insomnia in people with cancer. There are mixed results.

They did appear to help some people. But we need more studies to understand how beneficial they might be. 

Hormone replacement therapy (HRT)

One way to help control hormonal symptoms is to take hormones to replace the ones your body is no longer producing. Hormone replacement therapy (HRT) Open a glossary item is an effective treatment for many women. But some treatments for breast cancer aim to either stop the body producing sex hormones, or block their action. If you are having these treatments, you can’t unfortunately take HRT.

Doctors don’t routinely recommend that you take HRT if you have a hormone dependent Open a glossary item cancer, such as breast cancer. Even if you have finished treatment there is concern that HRT may increase the risk of cancer coming back. Talk to your specialist if you are finding it difficult to cope with your symptoms. They can explain the risks and benefits of HRT and if this is an option for you.

Talking to someone

It can help to talk to someone about how you feel. Do speak to your doctor or nurse for advice.

You can also call our nurse freephone helpline on 0808 800 4040. They are available from Monday to Friday, 9am to 5pm. Or you can send them a question online.

Counselling

Counselling can help if your thoughts and emotions are affecting your sleep. There are different types of counselling including cognitive behavioural therapy (CBT). This type of counselling helps you change how you respond to situations or emotions. 

  • Associations between sex hormones, sleep problems and depression: A systematic review

    M.W.L.Morssinkhof and others

    Neuroscience & Biobehavioral Reviews, 2020 Volume 118, Pages 669-680

  • British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders
    S Wilson and others
    Journal of Psychopharmacology, 2010. Vol 24, No11, 1577-1600

  • Chronic Insomnia
    C Morin
    The Lancet, 2010.  Vol 379, 1129-1141

  • Cognitive Behavioural Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis
    J Trauer and others
    Annals of Internal Medicine, 2015. Vol 163, No 3, 191-204

  • The British Menopause Society & Women’s Health Concern 2020 recommendations on hormone replacement therapy in menopausal women
    H Hamoda and others 
    Post reproductive health, 2020. Volume 26, Issue 4, Pages 181–208

Last reviewed: 
30 Sep 2022
Next review due: 
30 Sep 2025

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