Do you frequently find yourself tossing and turning in bed, unable to sleep at certain times of the month? Have you ever wondered what is affecting your sleep as you are approaching or on your period? You might be guessing a few things but the women have been there multiple times during their menstrual cycle. Premenstrual syndrome (PMS) involves one of the most aggravating symptoms, insomnia. Sleep difficulties are more common in women than men, and these obstacles are exacerbated by menstruation. This article will seek to prepare you for the repercussions.
The menstrual cycle is a natural, yet complicated cycle regulated by female hormones that result in frequent vaginal bleeding, or periods. The relationship between insomnia and the cycle is complicated since it varies by individual and hormonal fluctuations. However, hormones such as estrogen and progesterone generally make women feel more awake, less tired, and calmer.
There are four phases of the menstrual cycle:
Each phase’s duration is subject to fluctuation at any given time (Gudipally & Sharma, 2022).
The first phase is the menstrual phase. Depending on if an egg from the previous cycle is not fertilized, the menstrual phase begins. There is a decrease in estrogen and progesterone levels since pregnancy has not occurred.
The second phase is the follicular phase that starts when the brain first releases follicle-stimulating hormones (FSH). These hormones stimulate your ovaries to create around 5 to 20 follicles. Underdeveloped eggs are found inside each follicle and eventually, only the healthiest egg will mature. As your body reabsorbs the remaining immature follicles, a rise in estrogen caused by the mature follicle will thicken the lining of your uterus. If this produces a nutrient-rich environment, an embryo can develop.
Luteinizing hormones (LH) are released by your pituitary gland in response to rising estrogen levels during the second phase. This is what triggers the ovulation phase, the third phase. As previously mentioned, there is a chance that one of a woman’s ovaries can produce a mature egg during ovulation. The fallopian tube directs the egg towards the uterus, where if met with a sperm, will fertilize it and could potentially lead to pregnancy (“Better Health Channel,” n.d.). However, if the egg is not fertilized within a day, it will disintegrate or expire. You may be ovulating if you show any signs of a modest increase in body temperature or thicker, egg-white-like discharge. This process of ovulation may last about 16 to 32 hours depending on the individual. After the egg is released, the follicle transforms into a corpus luteum, or a cell which then releases progesterone and a faint amount of estrogen (“Better Health Channel,” n.d.).
This is when a woman’s body begins to transition into the luteal phase. The hormone increase keeps your uterine lining thick and prepared for the implantation of a fertilized egg. However if the egg is not fertilized, the corpus luteum will die, progesterone levels will decrease, and the lining will fade, resulting in a monthly period and bringing you back to the menstrual phase (“Better Health Channel,” n.d.). In which PMS and periods can result in several symptoms such as:
The luteal phase lasts about 14 days prior to one’s period and takes up the majority of the 28-day period that involves the menstrual cycle.
It is very common when undergoing PMS that insomnia is one of the prevalent side effects. However, more research needs to be done on how fatigue affects women with PMS or premenstrual dysphoric disorder (PMDD) throughout their menstrual cycles. According to studies, low levels of premenstrual fatigue are associated with steadily increased progesterone levels during the luteal phase (Gudipally & Sharma, 2022). Additionally, premenstrual symptoms were established in women with a fast fall in progesterone during the luteal phase but not in those with a gradual decline (“Better Health Channel,” n.d.).
Seven to ten percent of women report that their sleep patterns shift right before their period, which can commonly start three to six days prior to their cycle. Some women have a variety of premenstrual symptoms in addition to insomnia and potential sleep issues. While others only experience sleep issues as a result of PMS. Occasionally, women experience persistent sleep issues outside of their menstrual cycles.
In more detail, premenstrual syndrome (PMS) refers to the clinically taxing physical and psychological symptoms that occur during the luteal phase of the menstrual cycle, causing significant distress and functional impairment. These symptoms usually fade out during the last few days of menstruation. The combined prevalence of PMS in reproductive-age women globally is around 47.8%, in which approximately 20% of these women have symptoms severe enough to interfere with their daily activities (Gudipally & Sharma, 2022). Changes in hunger, weight gain, abdominal pain, upper and lower back pain, headaches, breast swelling, and other health concerns are all symptoms of PMS (Gudipally & Sharma, 2022).
The end of the premenstrual symptom spectrum, premenstrual dysphoric disorder (PMDD), also referred to as late luteal dysphoric disorder (LLDD), is the most severe form of premenstrual syndrome (PMS), having the greatest impact on women’s functioning and perceived quality of life. Women with PMDD react differently to typical hormonal changes that are present within a routine premenstrual cycle (Lanza di Scalea & Pearlstein, 2019).
Women tend to hate the few days of their cycle when they are in such pain that rescheduling plans or taking days off becomes a regular practice. Extreme cramping and heavy bleeding only serve to make the situation worse. PMS symptoms are other factors that contribute to terrible menstruation. However, what really causes these symptoms?
Progesterone and estrogen imbalances commonly cause PMS in patients. High estrogen and low progesterone levels cause critical sleep disturbances and symptoms. The proliferative hormone, estrogen, is in charge of the uterine lining’s expansion and thickness (Lovick et al., 2017).
Melatonin is produced from the pineal gland and serves as an internal synchronizer under the tight supervision of the central circadian timing system - your internalized clock - located in the hypothalamus part of your brain (Amaral & Cipolla-Neto, 2018). Sleep-wake rhythm shifts, subjective sleep disturbance, and variations in sleep electroencephalogram traits are frequently observed in PMS that include sleep issues. In a clinical case report, patients with PMS show a delayed sleep rhythm phase in the luteal phase of the menstrual cycle, whereas this rhythm is advanced in the follicular phase (Shinohara et al., 2000). In addition, PMS-related sleep performance can be dissuading and insufficient which leads to daytime sleepiness (Shinohara et al., 2000). Increased progesterone levels during the luteal phase may be crucial even though the precise mechanism underlying PMS and the sleep-wake cycle is still unknown since they might cause an increase in body temperature, which will ultimately result in more erratic sleep patterns (Sharkey et al., 2014).
Before deep diving into more hormonal tactics of PMS on the sleep cycle, every woman needs to understand their personal fundamentals of the menstrual cycle. This includes not only understanding how and when your menstrual cycle occurs, but also underlying issues with your health that could be affecting the cycle and vice versa. Women could examine their patterns and symptoms and pursue therapeutic procedures if they had a rudimentary comprehension of the game of hormones, PMS, and insomnia.
Sleep and deep sleep are there to help revitalize both our bodies and our thoughts. Insomnia and other stunts to getting a good night’s sleep is one of the most prevalent symptoms of PMS. However, you might be asking, “So what? It’s just a bit of turbulence in my normal routine.” Well, PMS-related sleeplessness might lead to higher contributors of degrading health.
First, a lack of sleep can drastically harm your mental health. Anxiety, melancholy, mood swings, and irritability can all result from sleep deprivation.
Second, rest is necessary for maintaining physical health. Your body renews and restores itself while you sleep, boosting your immune system and keeping you healthy. Lack of sleep can compromise your immune system, leaving you more susceptible to infections and illnesses.
Regardless, paying attention to PMS symptoms and insomnia - individually and collectively - can affect your daily life. Concentrating, being effective, or simply enjoying your day when you’re sleepy or foggy is challenging. Nonetheless, resolving these issues is critical for your overall health. So, if you’re having trouble sleeping throughout your menstrual cycle, don’t ignore it; seek advice from peers or a health practitioner. Or… there is another solution called Miracle Night.
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