“Sleep touches on nearly every aspect of our physiology and psychology, of our interaction with the world and with others.”
William Dement (2000), Sleep Research Pioneer.
Do women need to focus on their melatonin production to reduce menopause symptoms as the seasons change?
It’s an interesting question isn’t it? And I’m asking it, based on relatively new research about our sleep hormone, called melatonin, and the pleotropic effect it has on women’s health in menopause.
The term ‘pleiotropic’ means ‘effects around the body’ and when it comes to melatonin and the menopause transition, the role of this hormone has a greater effect throughout the body than many of our clients may realise.
Melatonin is able to regulate several physiological functions from well-known sleep/wake cycles to nervous system protection as well as regulation of both the immune and hormonal systems. It also influences the energy organelles, known as mitochondria. The researchers called this effect, ‘cross-talk‘ between melatonin and reproductive hormones. [Cipolla-Neto et al, 2022]
Every week I get emails from women who are exhausted and exasperated from not sleeping. Is this your clients as well?
Sleep can be problematic for women in their midlife and older years, as many of you already realise. Many women also complain to me that they are still not sleeping, despite menopause-HRT and numerous supplements, which are costing them a small fortune.
Hence, after reading some of the work of William Dement as well as newer research on the health effects of seasonal change in melatonin production, I’m wondering if, because the seasons are changing, your clients may require renewed attention to their sleep routines and natural melatonin production.
Understanding Melatonin
Melatonin is the hormone released from a tiny gland in the brain, called the pineal gland. This gland sets and resets the circadian drive for sleep. As women move through menopause and age, it is well known that melatonin production naturally declines.
Melatonin levels decline gradually over the life-span. Researchers believe that this decline may be related to reduced sleep duration and lower sleep depth during and after the menopause.
Because of this decline, some deterioration of many functions and processes around the body that are controlled by circadian rhythms may arise.
The circadian rhythms are the natural day/ night rhythms that help the human body to function. These circadian rhythms are a 24 hr biological cycle, which are also present in peripheral tissues, including the heart and muscles. Changes to circadian function, including during seasonal variations or daylight saving changes affect body temperature, hormone secretion and locomotor activity. (Shukla et al, 2023).
When the seasons change, melatonin production changes too, hence, symptoms in menopause can also change on a seasonal pattern. Abnormal circadian rhythms have also been associated with obesity, diabetes, depression, bipolar disorder and seasonal affective disorder (SAD).
Insomnia associated with menopause is not only due to declining levels of the reproductive hormones. Reduced levels of melatonin have been shown to decrease with age, specifically as women approach menopause. Experts have proposed that the disturbance of the circadian system is of substantial relevance in menopausal women, because the direct impairment of sleep regulation impacts other symptoms. (Jehan et al, 2017)
Melatonin is the ‘go-to-sleep’ hormone. It is secreted from the pineal gland principally in the evening hours, researchers better understand the role of melatonin and it’s involvement in a number of other cyclical bodily functions.
Melatonin is an important hormone to focus on during the menopause transition. It is exclusively involved in signaling the ‘time of day’ and ‘time of year’. Hence, why women find that international travel may worsen their symptoms, or when the seasons change and daylight savings come into effect.
Melatonin is therefore, considered to be the body’s chronological pacemaker or ‘Zeitgeber’.
As sleep research has expanded over the last decade or so, melatonin supplements have been used as a therapeutic chemical in a large spectrum of diseases, mainly in sleep disturbances.
Whilst melatonin medications are not as ideal as training your brain to produce it’s own melatonin, because taking a synthetic melatonin will reduce your body’s ability to produce it’s own melatonin, sometimes it may be indicated during seasonal changes in sleep or when women are jet-lagged.
Melatonin Levels are Important to Regulate During Seasonal Changes
With the rapid expansion of sleep research over the past two decades, researchers better understand that this powerful and essential hormone may also play a role in the biologic regulation of mood, depression, cardiovascular system health, reproductive health, gut health and of course, the health of women as they age.
Inadequate sleep causes hot flushes and night sweats to become worse, and may contribute to depression and anxiety. Not enough sleep also affects the body’s ability to regulate stress hormones which can also lead to high blood pressure.
Getting enough quality sleep is also crucial for maintaining healthy levels of hormones that control appetite and blood glucose levels as well as energy. It’s why, if your clients aren’t sleeping, they may find it difficult to lose weight.
That’s why there’s a lot more to this powerful hormone than previously thought.
Researchers have discovered that melatonin is not only produced in the pineal gland (in the brain), it’s also produced locally in the bone marrow and the retina of the eye, in the gastrointestinal tract, the testes in males, and in human lymphocytes (white cells).
As such, when levels of melatonin decline as women age, there are effects around the body.
This matters to women in menopause.
The inter-connection between all of the hormones via the HPA-Thyroid Axis, means that the natural decline of reproductive hormones during menopause also impacts the production and action of melatonin around the body.
This is partly why, changing sleep patterns during menopause and during seasonal variations, impact hot flushes, night sweats, sore joints, depression, blood pressure, heart and gut health.
Should Women Have Melatonin Supplements?
Exploring the effect of melatonin supplements on women’s health and their symptoms during menopause, was the subject of a review article by Treister-Goltzman & Peleg (2021).
It made for interesting and curious reading, including the knowledge that disruptions in the circadian patterns of melatonin production, (including via seasonal changes), leads to numerous physiological changes in the body.
Many of these changes relate to symptoms during menopause.
Whilst the authors of the study mentioned that further studies needed to be undertaken and not all of the studies that they explored in their analysis showed a positive correlation of melatonin with menopause symptom reversal, their analysis of 24 studies on melatonin and women’s health, with a total of over 1300 participants, revealed that melatonin supplementation of 3-5mg over 6-12 months helped improve:
- Sleep quality in women with a pre-existing sleep impairment (which in turn improved immune function).
- Bone mineral density
- Weight loss in overweight women
- Mood state.
Whilst it is known that levels of melatonin oscillate throughout the menstrual cycle, the problem during menopause and post-menopause, is that ageing is also impacting melatonin levels.
These altered melatonin levels as women move into their post-menopause years, may then contribute to bone density concerns and osteoporosis (Shukla et al, 2023), immune health changes, gut health concerns and increased risk for heart disease.
Helping your clients get on top of sleep problems is an important role of your coaching. We all know that it’s difficult to function when we don’t have enough sleep. So, for those of you who haven’t undertaken the MyMT™ Practitioner Programme, whereby I go into more depth on sleep physiology during menopause, here are a couple of lifestyle changes to share with your clients.
- Avoid sugary foods and drinks at least 3 hours before bed. Sugar increases the production of insulin which is a hormone that carries glucose to specific tissues and organs around the body. One of these organs is the brain.
When insulin is carrying blood glucose to the brain, it crosses the blood-brain barrier and interferes with melatonin production and secretion. Hence, an important aspect for women struggling to get on top of their sleep is to look at their diet, especially in the evening.
2. Recommend foods which contain tryptophan. These foods include salmon, fish, lean beef, turkey, bananas and more! Tryptophan foods help to produce 5-HTP, which helps to produce serotonin which helps to produce melatonin, in the presence of B vitamins. But because Tryptophan is absorbed via the small intestine, if women have gut health concerns, then getting on top of this is a priority. Poor gut health and insomnia go hand-in-hand, and vice versa.
Millions of women around the world and their health advisors think that menopause is ‘just’ about hot flushes, but it’s not.
There are many more changes going on at this stage of life than we realise. Whether it’s sore joints, depression, insomnia, anxiety, brain fog or heart palpitations and hot flushes, it’s important for our health to turn these symptoms around as we age and to understand factors that influence these changes, including seasonal variation.
Your education about the influences on menopause symptoms and using evidenced lifestyle solutions to help your clients, is the purpose of the certified MyMT™ courses.
I hope you can join me on any of these when you can.
References:
Cipolla-Neto J, Amaral F, G, Soares, Jr J, M, Gallo C, C, Furtado A, Cavaco J, E, Gonçalves I, Santos C, R, A, Quintela T. (2022). The Crosstalk between Melatonin and Sex Steroid Hormones. Neuroendocrinology 2022;112:115-129. doi: 10.1159/000516148
Grivas T. & Savvidou O. (2007). Melatonin the “light of night” in human biology and adolescent idiopathic scoliosis. Scoliosis. 4(2)6. doi: 10.1186/1748-7161-2-6. PMID: 17408483; PMCID: PMC1855314.
Gursoy A., Kiseli M., & Caglar G. (2015). Melatonin in aging women. Climacteric. 18(6):790-6. doi: 10.3109/13697137.2015.1052393. Epub 2015 Sep 25. PMID: 26029988.
Jehan S, Jean-Louis G, Zizi F, et al. Sleep, melatonin, and the menopausal transition: What are the links? Sleep Sci. 2017; 10(1): 11-18. doi: 10.5935/1984-0063.20170003
Karasek M. (2004). Melatonin, human aging, and age-related diseases. Exp Gerontol. 39(11-12):1723-9. doi: 10.1016/j.exger.2004.04.012. PMID: 15582288.
Narita, K., Hoshide, S. & Kario, K. Seasonal variation in blood pressure: current evidence and recommendations for hypertension management. Hypertens Res 44, 1363–1372 (2021). https://doi.org/10.1038/s41440-021-00732-z
Treister-Goltzman, Y. & Peleg, R. (2021). Melatonin and the health of menopausal women: A systematic review. J. of Pineal Research, 71(2), 1-12
Wehr TA. (1997). Melatonin and seasonal rhythms. J Biol Rhythms. Dec;12(6):518-27.
West, C. & Egger G. (2017). Lifestyle Medicine, [Chapter 18], To Sleep, Perchance to …. Get everything else right. 3rd Ed. Elselvier Academic Press.
