Sleep Problems In Perimenopause

November 4, 2023

If you are a woman in your late 30s, 40s, or 50s, did you feel like as soon as your hormones started shifting and changing that the quality or quantity of your sleep got worse? You are not alone! The National Sleep Foundation gave a poll in 2022 and 60% of women in America said they only get a good night’s sleep less than half of the time, especially if they were in the perimenopause or menopause age range. Today we’ll cover why this happens and what you can do about it to get your beauty sleep back on track.  

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LEAH: Welcome to Dishing Up Nutrition, brought to you by Nutritional Weight and Wellness. We are a company specializing in life-changing nutrition education and counseling. I'm Leah Kleinschrodt. I'm a Registered and Licensed Dietitian, and I see clients in person at our Woodbury office, and I also see many clients virtually. So this is either video call or phone. My cohost today is Teresa Wagner, who occasionally we cross paths over at the Woodbury office.

TERESA: Yes, we do, but not often enough.

LEAH: Not often enough. There's only one office, so it's, it's that rare occasion.

TERESA: Yes. Well, I live in Woodbury, so sometimes it's nice just to pop in and say hello.

LEAH: Yeah. Makes sense.

TERESA: Well, good morning. And it's great to see you live in studio, Leah. And together rather than virtually, like we often do.

LEAH: Yes.

TERESA: My name is Teresa Wagner and I am also a Registered and Licensed Dietitian. And I do love the option to be able to see people both in person; it's nice to have that one-on-one; but also virtually. It gives people a lot of flexibility with their schedules and with where they live. So you don't have to be in Minnesota if you want to meet with one of us.

LEAH: Mm-Hmm.

TERESA: It's fun meeting clients in different time zones and from across the country and also internationally. I don't know about you, Leah, but I've had a couple of clients most recently, one from the UK. I've had clients in Australia, so it's kind of fun. It's, it's just fun that we can do that virtually.

LEAH: Yeah, absolutely. Yeah, it's been a hot minute since I've seen somebody internationally, so I'm glad that you're getting some of those. But yeah, all across the U.S., I mean, all walks of life there, so yeah. It's always fun to, yeah, just meet different people, different places and just get a sense for what their lives are like.


LEAH: So, yeah, I totally agree. And kind of like what you said, this allows us to educate and counsel on a bigger population that's, it's just not limited to the Twin Cities area here in Minnesota. And I mean, the number of downloads that we get monthly kind of speaks to this saying, you know, people want this information. They want this science-based nutrition message. Especially, I mean, there's is a lot of misinformation floating around either on social media, news headlines, even, I mean, even within our family and friend circles.

And I would even argue to say like, yes, there's a lot of misinformation out there, but there is just a lot of information, period. And how do you sort through all of that? I mean, it, it, it, you could have a PhD three times over probably with the amount of information that's out there.

LEAH: Yes.

TERESA: There's so much information and, and honestly like it, there's a lot of really good information out there too. But it's how do you distinguish which is the good?

LEAH: And what's good for you too?

TERESA: Yeah. And what's good for you. That's a very good point.

LEAH: Mm-Hmm.

TERESA: Right. And so, well, with all that information out there, today we're going to narrow it down to a topic.

LEAH: Mm-Hmm.

TERESA: And I think this topic today is going to resonate with a lot of women, women who are around my age. Some of you may be younger and some older. I am literally middle aged. I'm…

LEAH: Well, you don't look it.

TERESA: But you know what the thing is, is I love it. I mean, I can't speak for anything older, of course, but the forties has been my favorite decade. I love this decade. I am not unhappy about my age, even though it's middle aged.

LEAH: Yeah.

TERESA: So, but today Leah and I are going to talk about sleep problems in perimenopause, which happens, you know, around this middle age time for women.

LEAH: Mm-Hmm.

TERESA: And we hear a lot about perimenopause from our clients. There's just, there's a lot going on. And there can be some negative things that are happening. So Leah, I'm sure you hear some of these complaints from women too that are around this age.

LEAH: Yep, absolutely. All the time. You know, sleep is definitely one big one that comes up. I would say it's one of the most common issues that comes up during a nutrition counseling session. But especially in those perimenopause or menopausal or postmenopausal years even. So just kind of tossing this out to the audience. Have any of you female listeners out there noticed that maybe it started in your thirties, but maybe it was more like forties, even fifties, and you feel like, you know, you start to notice some of those hormones shifting and changing, and then how did that impact your sleep? You know, for some women it impacts the quality of the sleep. For some it's the quantity of sleep, and for others it's both. It's, it's the whole shebang.

TERESA: Yeah. Sleep is a, is a tricky one, and it is one of the biggest complaints I hear from women. One of the things many women talk about is what we refer to as surface sleeping. So maybe you're actually lying down and you're not sleeping, or maybe you are sleeping, but you're not getting into that deep restorative sleep that we need for rest and repair, you know, to rejuvenate our bodies.

If you're surface sleeping most of the night, most likely you're tossing and turning, and even after being in bed for seven or eight hour hours, you will probably wake up groggy and feeling tired because you're really not getting into that restorative sleep like we were talking about.

Statistics on sleep among women in America

LEAH: Yeah, absolutely. Yeah. And the National Sleep Foundation gave a poll pretty recently, back in 2022, and they found that 60% of women in America say they only get a good night's sleep less than half of the time.


LEAH: So that's yeah.

TERESA: Less than half.

LEAH: Yeah. Less than half of the time. And that's the majority of women. And almost 70% say they frequently experience sleep problems. And those surprise in perimenopause and menopause were the ones who reported the most sleep problems.

Overviewing what issues may be interfering with sleep

TERESA: So surface sleeping or sleeping lightly is definitely an issue during perimenopause, but there can be other things keeping you awake, awake at night. What about night sweats? Is that happening to anybody out there? Sometimes hot flashes and night sweats are one of the first signs of people going into perimenopause, and these can really disrupt sleep. My clients have told me that they have to get up out of bed sometimes more than once to change their clothes, maybe even change their sheets.

LEAH: Yeah. Yeah.  I had a taste of this after I had my second kiddo. I had my daughter back in 2022. And this didn't happen so much with the birth of my son, but for a couple of weeks after I had my daughter, I had those night sweats. I wasn't, I didn't have hot flashes during the day, but I did have the night sweats, and I would wake up just drenched and I, I slept on towels for a couple of weeks just because it was uncomfortable and I was kind of disgusted by it. So I was like, wow, okay, now I get it. I get where women in those with, with those big hormone fluctuations, now I know where they're coming from. And now it's like, oh, okay. I get it. I get why this is so disruptive.

TERESA: Yes. You can really empathize with women and what they're feeling.

LEAH: Yeah, absolutely. So it's not the worst solution. Or like people say, okay, well that's why I sleep with the fan on me all the time.

TERESA: Or the windows open in the window.

LEAH: Yeah, the windows open in the winter. Yeah. Like you're kind of that polar bear type of sleeping situation. And then depending, depending on what you have to do to keep yourself comfortable, this might be disruptive. I mean, not only did it, does it disrupt your sleep, but it could be disrupting your partner's sleep also. So it's, it gets really unpleasant then when you both get up and you're groggy and you're irritable with each other.

TERESA: Yeah. Nobody wants that.


TERESA: No. In addition to light surface sleeping and night sweats, many women also complain about a racing mind. So we're hitting all parts of the body here. It is a level of anxiety that kicks in due to hormonal shifts and causes that brain chatter and ruminating. You may be lying awake thinking about what you said during a work meeting or with a group of people. Maybe you're planning out your kids' schedules in your head for the next day when your brain should be shutting off to allow for a good night's sleep. But you just can't, you just hop from topic to topic. And sometimes it's, people will say, it's almost like they're, it's like a, a tape that keeps rewinding for people who know what tapes are. Right? Rewinding and playing…

LEAH: Well for people in the perimenopausal years, yes, they know exactly what tapes are.

TERESA: Yeah. Rewinds and plays. Rewinds and plays. It's kind of the same thought over and over and over.

LEAH: Yep. Yep. I hear that a lot too. And so our goal with today's show is to provide as many nutritional tips as we can during this time; if you can relate to any of these examples that we've talked about, whether it's the night sweats and the hot flashes or the sleep issues, the, the ruminating or the, or the going over things in your head. We want to have you have some practical takeaways on how to get a better night's sleep in those years leading up to menopause. But I think we have to take our first break.

TERESA: We sure do. You are listening to Dishing Up Nutrition and today we are talking about how women can get a better night's sleep during perimenopause. The perimenopausal years are the years leading up to menopause. And this time of hormonal change can last anywhere from one to 10 years. Usually women are in their forties or fifties, but it can start as early as thirties as well. So we'll be back after a short break.


LEAH: Welcome back to Dishing Up Nutrition. I'm Leah Kleinschrodt, Licensed Dietitian, and I'm here today with Teresa, who is also a Licensed Dietitian. Our topic this morning is sleep problems in perimenopause, and throughout this hour we'll be giving some nutritional tips to help you sleep more soundly. And we'll also have a couple of supplements we'll be discussing. So we wanted to just let the listeners know, if you don't already know, we've been having a customer appreciation sale the past few days, and it goes on through tomorrow, which is Sunday, November 5th. So the details are, it's 15% off Nutrikey brand products when you spend $50 or more. And then it is also 10% off of all other products with no minimum required.

Shop Nutrikey Products

TERESA: Yeah, and that's a great deal, especially if you're out supplements, or you've been wanting to stock up on something before the holidays, it's a great time to take advantage if you, if you buy some things that tend to be a little bit more on the pricier side to stock up on those; get that extra discount there. So to do that, go to our website, and then click on the vitamins tab. The Nutrikey brand already has the discount showing on the website, so you can see the price right there. For all other brands, use the code, WW10. Those are capital W’s. To receive 10% off, there is free shipping with a purchase of $50. And just to repeat, the sale goes through November 5th, which is tomorrow.

LEAH: Yep. Yep. Yeah. Like you said, great time to stock up or maybe try, maybe try something new, something you've had your eye on for a while, or get a little early Christmas shopping done.

TERESA: Oh yeah. Yeah. Everybody loves to get supplements for Christmas, don't they? Just what you've always wanted.

LEAH: I mean, I wouldn't be mad about some magnesium or some little gift items in my stocking.

TERESA: No, I wouldn't either. I wouldn't either. Okay. So back to our topic for today. We are talking about sleep issues during the perimenopausal, menopausal years. For those who aren't familiar with the pre-menopausal years, we'll, to talk about that for a minute, the average woman will go through menopause at age 52, but it really can vary from person to person. On average menopause usually occurs when women are between the ages of 45 to 55.

And I think it's really interesting and timely. One of our colleagues, Monica, wrote an article on on that actually goes through the entire cycle, which is really educational. And I think things that maybe a lot of women just don't really know, which we should really know, as she says in the article. And the article is titled How to Prepare for Menopause in Your 30s and 40s. But she just goes through what does a typical cycle look like? What hormones are involved? When are they high, when are they low? What, you know, what are you feeling when things are high, when are you low? So it's a great article I recommend to any woman 'cause we really should educate ourselves about what's going on with our body and so many of us just don't know.

LEAH: Yeah. Yep. I a hundred percent agree. Yeah. And the sooner you have that info, the better you can be prepared for what's coming down the line.

TERESA: Right. And if you have daughters, then you can teach them that they know what's going on.

Defining menopause and perimenopause

LEAH: Yep. Yes. So, yeah, I mean, again, for most people were looking at, at that time, those menopausal years potentially being, you know, later forties, early fifties. And, and let's take a step back to menopause is defined as having as not, excuse me, not having a menstrual cycle for 12 consecutive months. I've talked to several clients before too, where they think they're done, but at the 11 month mark they get their period. I don't know if it's like a cruel joke or what's going on there, but I've talked to several women who have had that happen and it's like, ah, now I have to restart that clock for another 12 months before I can kind of officially say, okay, I am kind of hit menopause. So and everyone's story is just a little bit different there. So it's again, it, what we're looking for is 12 months without a period.

TERESA: And that's menopause.

LEAH: And now you're in menopause.

TERESA: Yeah. Yeah. And so up until that point, so when you're going through perimenopause, you will probably start to notice irregular periods, longer, shorter cycles and more or less bleeding than usual. Mood swings are really common, you know, it's hormones are fluctuating. So mood swings or moods fluctuate along with that.

LEAH: Yeah, absolutely. You might be experiencing either increased anxiety or maybe some depression. You may have both. We hear about low libido and vaginal dryness. Those are some other fairly common signs that your hormones are changing.

What might be causing light surface sleeping?

LEAH: Yep. So, so let's tie this back into sleep and talking a little bit more about what causes light surface sleeping. Or maybe it's more noticeable: have you woken up in the middle of the night and felt wide awake? Like you have this rush of adrenaline that wakes you up? Or do you wake up several times during the night? That's one of the most frustrating things in the world when you can't get back to sleep right away.

TERESA: Yes, it is. And there can be a pretty easy solution for this issue, and that's maybe having a small bedtime snack. For some women this works really well.

LEAH: Yeah.

TERESA: Now we don't want to just snack on anything. We're very specific about what we want you to have or to try for this. Some snacks will cause you to wake up even more during the night. So we don't want that. What we're talking about is having a snack with a serving of healthy fat paired with about a half a cup of carbohydrates. So this is a pretty low carbohydrate snack. We're not talking about high carbohydrate foods here, which are kind of typical of what we have before bed.

LEAH: Yep.

TERESA: Or traditionally I should say.

LEAH: Yep.

TERESA: So if you are someone who likes to measure in grams, you'll want to have about 15 grams of fat and about 15 grams of that healthy carbohydrate.

LEAH: Right. So the one that we talk a lot about in our classes and on Dishing Up Nutrition is a bedtime snack of two tablespoons of heavy whipping cream. So the kind that you get from a carton, you know, Organic Valley is one brand that's out there, but there's a lot of others. And you pour that over a half a cup to maybe three quarters of a cup or so of berries and that that could be fresh berries. Frozen berries, that part doesn't matter.

TERESA: I kind of like it when they're frozen, 'cause then it crystallizes.

LEAH: Mm-Hmm. I do too. Yep. And so yes, you could have that kind of crystallized creamy cap over them. You could also whip up that cream if you wanted to have something fluffy and light to go over the top. But that's not a requirement. I mean, it tastes great and you can easily just pour it over the berries and it's totally fine.


TERESA: Another quick standby snack: two tablespoons of a natural peanut butter. So the ingredients should just be peanuts and salt.

LEAH: Mm-Hmm.

TERESA: Or any type of nut butter. It could be almond butter, cashew butter, whatever you like.

LEAH: Yeah.

TERESA: And a small apple or a half a banana.

LEAH: Mm-Hmm. Yeah. I'd say the peanut butter apple combo in our household, just, it's easy. We love it. It doesn't take a lot of thought process. So like that's a go-to in our household for sure.

TERESA: Yeah. Kids love it.

LEAH: Yeah. And one of our nutritionists who's who is in perimenopause also, she says for her what works really well is a half of an avocado with a half a cup of berries before bed. And she really notices that hits the, the sweet spot for her sleep.

TERESA: Yep. And it is time to take another break here. Our topic today has been about how to get a better night's sleep even during perimenopause when many women are experiencing a lot of challenges falling and staying asleep. If you are listening to our show live, chances are you have just celebrated Halloween, especially if you have young kids living at home.

Wondering what to do with the leftover pumpkins? Well, we have some great recipes on our website that taste like a treat without all that sugar. Leah's going to give us some examples when we come back.


LEAH: Welcome back to Dishing Up Nutrition. The holidays have officially started with Halloween being last week, and it is so easy to get caught in the holiday sugar trap. So if you're looking for alternatives or just ways around some of the extra sugar, check out our website for some healthy, tasty recipes that really are decadent, but don't have a boatload of sugar that goes along with them. You know, most people love the pumpkin cheesecake bars. We have a pumpkin muffin recipe, which is delicious. The pumpkin custard is really divine.

TERESA: That's so good.

LEAH: I, you know, I meant to make it last year for Thanksgiving and that got put by the wayside. So it is back on, on the list for this year. I'm hoping to get around to it. But it's real whipping cream, it's vanilla, some maple syrup. You do get some of that sweetness in there; cinnamon, pumpkin pie, spice, and I mean, you could put whatever kind of nuts you want to go along with that: pecans, walnuts, I mean anything really. And when you're browsing our website, I mean, there's a pumpkin spiced coffee recipe. There's pumpkin chili even for those of us in the Midwest that love our chilis and casserole and all that good stuff.

TERESA: Lots of pumpkin ideas.

LEAH: Lots of pumpkin ideas. So yeah, go to There is a recipes tab at the top and you can also search in the, in the search bar with just pumpkin. And all of these should come up towards the top. So lots of options if you're just looking to upgrade, do something different or really just trying to focus a little bit more on real food this holiday season.

Check Out Some of Our Recipes!

Why can a proper bedtime snack help with sleep?

TERESA: So before the break, we were talking about some ideas for helping with getting into a deeper, having better quality sleep. And one of our first suggestions was well try or experiment with having maybe a bedtime snack that contains both a little bit of carbohydrate and a little bit of fat, about 15 grams of both. And one thing I wanted to say about that too, the reason why we say this is because there's actually some chemical reactions that happen here when we have this combination. First of all, carbohydrates are very good for creating serotonin, which is our, a neurotransmitter that helps to relax the brain and the body.

And the fat, we want to pair that with that carbohydrate so we don't have a blood sugar spike. So we put the fat and, and it, and it holds you. And part of the reason why you don't get that blood sugar spike is because it slows down digestion. So it stabilizes blood sugar and it'll stick with you through the night.

LEAH: Yep.

TERESA: So that's the reason for the combination of those and why it helps with sleep. The, before we as Leah was saying, one of the dietitians that works at Nutritional Weight and Wellness, she really says that berries and avocado, which is kind of a funny combination. I'm assuming she's eating these things separately.

LEAH: You never know. I mean, maybe she scoops some berries into that pit area. You just never know.

TERESA: You never know. You never know. But one of the reasons that makes so much sense that it's helping for sleep is that avocados check some of the boxes that we need for a good night's sleep. It's got that healthy fat to stabilize blood sugars, as I was mentioning. It's got fiber in it, which also stabilizes blood sugar and slows down digestion. And avocados are high in magnesium, which is a calming mineral.

LEAH: Mm-Hmm.

TERESA: So you may have noticed that all three of our examples have 15 grams of healthy fat and 15 grams of fruit carbohydrate. But you could mix it up and you could use raw veggies, you know, if you wanted instead of fruit and you could use guacamole in place of any of the other fats. But sticking, really sticking with a small snack. We're not going to go to bed stuffed. That's not a good idea either. And this helps to keep your blood sugar levels stable while you sleep.

LEAH: Yeah. Yep. And kind of what you alluded to earlier too, Teresa, of like, okay, here are the bedtime snacks that we want and you gave the reasons why, especially for that stable blood sugar. The things that people tend to gravitate towards in the evening tend to be higher sugar, higher carb, especially more refined carbohydrates. So think popcorn, chips, crackers, like those are very common things that people gravitate towards during those evening hours. But those could potentially be making the problem worse because again, that breaks down to, those things break down to a lot of sugar. They're not buffered with any kind of fat or protein.

So you get those blood sugar spikes and then it's actually the dip that gets you later. A couple hours into the night you get a dip or a low blood sugar and that wakes you up. So that's where you get that kind of little bit of rush of adrenaline, 'cause your body says, oh, this is an emergency. Where's all my energy? Where's my, where's my blood sugar at? And that wakes you up. So that's, again, we're trying to stay off the rollercoaster of the blood sugar. Just stay nice and even keel gives us a better fighting chance for having those, that good night's sleep.

Beverages that can affect sleep negatively

TERESA: And since we're talking about foods to avoid, especially before bed, I want to bring up beverages and drinks that can affect sleep negatively during menopause and actually probably any time of life.

LEAH: Yep.

TERESA: Ladies, have you noticed that the wine that you had before, during, or after dinner has caused your night sweats to be more frequent? Or that your surface sleeping is more pronounced? Have you made that connection? So many women have made that connection. They're like, oh, I have a glass of wine and I'm not sleeping.

LEAH: Yep.

TERESA: Sometimes they're like, it's worth it. I got to have it. Other times they're like, no way. I'm not having that wine, 'cause I know I won't sleep. Or I'll have those hot flashes.

LEAH: Yeah. It, that is definitely a biggie. We hear that all the time. For some women it is an instantaneous reaction. They have that glass of wine, the beer, the cocktail, whatever, and they can feel themselves starting to get hot, clammy, sweaty.

TERESA: Just like those processed carbohydrates you were talking about Leah, alcohol does the same thing. It causes blood sugar imbalances and your blood sugar can take a dive in the middle of the night and that creates that adrenaline. And then we have night wake ups and we might have those night sweats too.

LEAH: Mm-Hmm. Yep. Absolutely. So again, it's, it's something to pay attention to. And and like we said, the alcohol, for some women, they do feel it immediately. Sometimes it is more like a couple hours delayed effect, or you might not notice until you start to not sleep well and then start to make that connection. So wherever alcohol is playing a role, just pay attention. What is it doing to your body, to your mental state, to your sleep, all of that good stuff.

We won't linger too long on caffeine, but just throwing caffeine in here quick because we have a lot of other tips to get to. Caffeine can also produce some spikes in blood sugar, which means, again, and on the backside it's going to come crashing down. And if you're noticing more hot flashes during the day, it from coffee or other caffeinated beverages, there definitely could be this connection. So if sleep is an issue for you, we suggest cutting out the caffeine. I mean, I, for, I would think for sure by noon, for some people we might even need to go a little earlier like by 10:00 AM or something like that. And if you can, avoiding the caffeine in afternoons and evenings would be a really great idea if you want to sleep better.

TERESA: Yes. That is a great idea. Easy to say, harder to do.

LEAH: Always.

Explanation of hormone shifts between menstruation & menopause

TERESA: Well, I want to give a brief explanation of what's going on with hormones and how they shift during the years between regular menstruation and menopause. There's this sort of myth that goes around about how declining estrogen levels are the cause of all menopausal symptoms. In the years leading up to menopause, the ovaries slow production of both estrogen and progesterone.

Ovulation slows down and is sometimes skipped. Eventually, this is what causes the menstrual cycle to stop. When ovulation doesn't happen, the ovaries are not making progesterone. During these hormonal changes, the drop in progesterone tends to be the more dramatic drop compared to the drop in estrogen.

What roles does progesterone play?

LEAH: Mm-Hmm. Yes. So I see, I can kind of see where we're, we're going here with this. We, when we think about progesterone, that is our big calming, relaxing hormone. So it makes sense with the noticeable drop in progesterone that some of these uncomfortable symptoms start to come up. Especially thinking anxiety, sleep problems, just even trouble relaxing in general.

TERESA: Yeah, exactly. You know, and just like what you're saying, what we've been talking about so far for sleep problems, the annoying night sweats, the middle of the night wake up, increased anxiety, rumination and brain chatter. Many women report that by using a small amount of natural progesterone cream before bed, that they start to sleep more soundly. The brain chatter subsides, the night sweats go away and they're able to relax and get into a deeper sleep.

LEAH: Mm-Hmm. And, and just to clarify too, that this small dose of progesterone cream that we are talking about, it's not considered hormone replacement therapy or, or HRT. This is not a prescription. It's an over-the-counter cream called Emerita Pro-Gest. And you just, you take a small dab. I actually at least the first couple of times have people just measure it out, making sure we're getting enough. You measure out about a fourth of a teaspoon and that contains about 20 milligrams of progesterone, which is the amount your ovaries would normally make during your regular, kind of like back when you were menstruating on a regular basis. So this is, we're not giving super high doses or super physiological doses. This is just kind of the normal amount your body is used to expecting.

TERESA: So essentially a quarter teaspoon, or sometimes it's recommended to use a quarter teaspoon two times a day; once in the morning. And I would say even after showering. So if you exfoliate your skin and your skin's warm and your pores are open, that's a good time to put that on.

LEAH: Yep.

TERESA: And then once before bed, which I mean some women shower before bed too. And so that would be, you know, that would be a good time.

LEAH: Yeah.

TERESA: This is just replacing the progesterone the ovaries used to make. This progesterone cream is natural, which means it mimics the progesterone your ovaries would be making.

LEAH: Mm-Hmm. And there, there was a study published a number of years ago, it was in the Journal of Clinical Pharmacology. And they published this back in 2018. And this showed that when progesterone cream was applied for 12 days and in this study they used it twice per day using that same amount, the quarter to half a teaspoon per day, that hormone levels in the bloodstream were restored to their same level as if the ovaries were producing progesterone during the menstruating years. And again, like that's kind of what we're aiming for. We're not aiming to get super high doses or super high levels of progesterone. We are just kind of looking to get back to our regular baseline.

TERESA: Yeah. Get to that sweet spot. I think that's kind of amazing, that study. You know, that they could get it there just using a natural cream like that.

LEAH: Yeah.

TERESA: And just clarifying too, we don't recommend that all women in perimenopause need to be using progesterone cream. You need to think for a moment of what symptoms that you are struggling with the most. Because no two women will have the exact same symptoms. If you are someone struggling with hot flashes, night sweats, anxiety, brain chatter, low libido, and vaginal dryness, then progesterone cream may be something that you could safely experiment with to see if you could find improvement with some of those symptoms.

LEAH: Mm-Hmm.

TERESA: And we're ready for our next break. You are listening to Dishing Up Nutrition. Perimenopause and menopause will happen to all women at some point in their lives, usually between 35 and 55. Of course ages can vary, but how women experience these hormonal changes can also vary. Some say they don't have any symptoms and others have debilitating symptoms. If you feel like you would benefit from a doing a deeper dive, it's a great time for you to take advantage of our sale on the Menopause Survival class series. It's six one-hour classes that support you through the perimenopause and menopause journey. And Leah will share more about that when we come back.


LEAH: Welcome back. You're listening to Dishing Up Nutrition. The online Menopause Survival Series has six one-hour classes that you can watch from the comfort of your own home. Topics we address are nutritional solutions to hot flashes, night sweats, insomnia, menopausal weight gain, hair loss, vaginal dryness, mood swings, and more. There are no topics that are off limits and menopause should not be a topic anyone is afraid to talk about.

The class series is on sale through November 6th, and you can save $50. Everyone who signs up can access the material for a full year. And you can check out the details at or if you have additional questions, you can call our office at (651) 699-3438.

Sign Up for Menopause Solutions - Online

Alright, so Teresa, we were talking, I mean, the topic of today's show, the overarching topic is sleep and sleep troubles more specifically during those perimenopause and menopausal years. And we kind of had wrapped up with a great discussion on progesterone cream, how helpful it can be for some of these symptoms.

Not everybody needs progesterone cream, but it can be a great option if you're really struggling with some of these, some of these symptoms. And as licensed dietitians, we always have more tools in our toolbox to share. So again, maybe night sweats aren't bothering you. Maybe you don't have a low libido, but we still have some of these sleep problems.

Magnesium is supportive for sleep

Though there's a variety of natural supplements to support different symptoms in perimenopause, one common mineral deficiency that can lead to poor sleep is magnesium. Three out of four Americans do not get enough magnesium from the foods they eat.

More signs & symptoms of magnesium deficiency

TERESA: And if you're wondering, well, how do I know if I'm low in magnesium? There are a couple of symptoms that you could think about for magnesium deficiency. On topic: trouble sleeping.

LEAH: Yep.

TERESA: Trouble falling asleep, trouble staying asleep. Otherwise, you might have some muscle cramps. That's a sign of magnesium deficiency. Maybe you have Charlie horses or muscle twitches. Think about that little twitching eye. I don't know if you've ever experienced that, Leah, but I certainly have. That usually comes around when I'm extra stressed because when we're stressed we use up our magnesium. Right?

LEAH: Yeah, absolutely.  

TERESA: So we get those eye twitches or muscle twitches; general muscle tightness.

LEAH: Yep. Yeah. And all the signs of low magnesium usually end up with some sort of tightness or constriction. So even think high blood pressure, which is constriction of the blood vessels. Headaches and migraines are another one. And constipation as well. So anything again, tight twitchy, crampy like that could be low magnesium.

Where can we get magnesium?

TERESA: Yeah. And Leah, you probably know this, but it was surprising to me when I learned about this year, you know, years ago, That the mineral magnesium plays a role in 300 different processes in the body. So there's no wonder there's so many signs of low magnesium. And we do like the food first approach at Nutritional Weight and Wellness. And the foods that have the most magnesium are going to be the dark leafy greens, meats, especially grass fed or pasture raised meats, nuts, seeds, avocados. Those are all high in magnesium.

LEAH: Mm-Hmm. Yep. And all delicious. And so we, that's one thing we do here at Nutritional Weight and Wellness is help people find ways to fit those foods into that real food eating plan, as many of those foods as we can possibly fit in that day. Unfortunately, the soil that the crops are grown in today, as well as the crops that cattle are fed, they're not just, they're just not as rich in nutrients as they used to be. And this includes that mineral magnesium. So unfortunately, even though yes, our real foods are our best sources of magnesium, they're not as optimal as they used to be. Say even 50, 60, 80 years ago.

What might cause our bodies to lose magnesium?

TERESA: Yeah. And not to just be giving bad news, because of course our goal is to educate. But there are certain foods, beverages, and other factors that might cause our bodies to lose magnesium every day. Eating sugar and those processed carbohydrates will cause us to lose magnesium. We use magnesium to metabolize those foods. Drinking soda, alcohol and caffeine depletes magnesium. Even exercise lowers magnesium in our body. And I don't want to discourage anyone from exercise because movement is super important to our health, but sweating and exercise naturally deplete some of our minerals.

LEAH: Mm-Hmm. Yep. And exactly like you said too, stress is a big one that will deplete us. And another one I think about is digestive issues. Especially if we tend more on the looser side with bowel movements. We, we're losing a lot of nutrients when we just, when things are passing through too fast. And this includes magnesium.

Is it necessary to supplement with magnesium?

So because magnesium is a relaxing mineral you know, we eat real food, but even just to replete people of that magnesium, oftentimes we do turn to supplements, at least in the short term. And so doing a relaxing a nice a higher dose of supplemental magnesium before bed can be really helpful with sleep. 400 milligrams is not out of the picture. 600 milligrams even for others. Some people can get away with 200 milligrams, but I'd say 400 is usually a great place for people to start and let that work for a little while.

And the bonus is hopefully you should also be noticing some fewer leg cramps, more relaxed muscles, and fewer headaches. Magnesium Glycinate is the one I recommend for people if they, if we are really looking for a lot of those relaxation effects and for the best sleep support.

TERESA: Yes, I have same. I'm always recommending Magnesium Glycinate. I feel like we all can use, we can all use it. If a client came to me and said, Teresa, my periods are irregular, I can't fall asleep. And when I do, I wake up sweating every couple of hours. Can you help? I start by recommending a balanced eating plan. We always start with a balanced eating plan.

LEAH: Mm-Hmm.

TERESA: That's the foundation.

LEAH: Mm-Hmm.

TERESA: And we talk about this often on our shows: eating real animal protein, vegetable carbohydrates, and healthy fats every few hours. I usually say every three to four hours. And I'd suggest experimenting with a bedtime snack containing fat and carb to stabilize blood sugar overnight. Remember it's that 15 grams of both: 15 grams of carb and 15 grams of fat. And I would remind her to really decrease or even stop the alcohol, sugary foods and caffeine. I will not be her best friend at this point, but I'm hoping to be.

LEAH: Yes, you will be when she has some good sleep on board.

TERESA: I'd encourage her to eat more magnesium rich foods, but would also add in a Magnesium Glycinate supplement and that dab of progesterone cream that we were talking about. And maybe even doing that in the morning, just depending on how, how she's struggling.

LEAH: Yep. Yep. Yeah. It's a, it's a solid plan. And I'm guessing, I mean, if people are able to take the bull by the horns and even really implement this for just two weeks, two to three weeks, at least 50% or more of women would start sleeping more soundly pretty quickly. And you know, we, we do have just a few minutes left where let's give a couple more tools in our toolbox. Some women have sleep issues that are a little more complex and this is normal. Sometimes it really does just take trial and error, 'cause the root cause for each individual is the root cause can be different for everybody.

TERESA: Absolutely. And it's worth it not to give up in the first couple of steps if they are not working.

LEAH: Yeah.

More sleep solutions ideas

TERESA: And fixing it right away. Sometimes a little tweaking and adjusting is needed for each individual plan. And that's why we do that. We work with the individual. If it's anxiety and the brain that are keeping you from falling asleep, or maybe you wake up to go to the bathroom and your brain just won't shut off afterwards, then you probably would benefit from a 5-HTP supplement. 5-HTP is an amino acid and the HTP stands for hydroxytryptophan. Does that tryptophan term, does that ring a bell?

LEAH: I know it does for most people, 'cause we associate that with Thanksgiving and turkey. But I mean, in reality, all animal proteins give us that amino acid, tryptophan. It's not something that's just unique to turkey. Tryptophan does break down into that 5-HTP, which converts into serotonin, helps us make those feel good brain chemicals.

TERESA: Yep. And taking two to four capsules of 5-HTP before bed helps to shut off that worrying chattery brain. I read an article by Dr. Jennifer Payne, director of the Women's Mood Disorder Center at Johns Hopkins. She said that the same hormones that control your menstrual cycle also influence serotonin, a brain chemical that promotes feelings of wellbeing and happiness. When hormone levels drop like the progesterone and estrogen, serotonin levels also may fall off, which contributes to increased anxiety, irritability, and sadness.

LEAH: Yeah. So I think that paints a nice picture too, saying that it's not just estrogen and progesterone that are changing during these times. There are lots of other things that are happening. And so we need to have that multi-pronged approach for a lot of women. So our goal at Nutritional Weight and Wellness is to help each and every person experience better health through eating real food. It's a simple yet powerful message that eating real food is life changing. Thank you for listening and have a wonderful day.

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