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.

Tell your GP or specialist nurse if you have tried these tips and they haven’t helped.

Treatment for insomnia

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

• cognitive behavioural therapy for insomnia (CBT-I)
• tablets to help you sleep
• complementary therapy

Cognitive behavioural therapy for insomnia (CBT-I)

CBT-I looks at your thoughts, feelings and behaviours that may contribute to your sleep problems. Therapy involves:

• habits that promote quality sleep - this is also called your sleep hygiene

• relaxation techniques such as meditation

• sleep restriction – limiting the amount of time you spend in bed

• stimulus control – linking your bed and bedroom with sleep only and not with being awake

You can read about meditation in our complementary therapies section. 

You can also read about meditation on the Headspace website.

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, zolpidem, eszopiclone)
• melatonin (if you are over 55) 

Complementary therapies for sleeplessness

Some complementary therapies may help improve your sleep.

Acupuncture and reflexology

Studies have looked at acupuncture and reflexology to see if they might help with insomnia in women with menopause. They showed that acupuncture and reflexology may be effective.

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) 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 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

Struggling with sleeping problems can be difficult. It can help to talk to someone about how you feel. Speak to your GP or specialist 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.