The Daily News Transcript

By: Red Hot Mamas

Published: February 28, 2007

Understand Your Body

By Jennifer Lord/Daily News Staff

Tuesday, October 11, 2005

Everyone knows about the hot flashes.

They’re the forerunner of menopause, moments when the body’s temperature control system goes haywire and causes a woman to break out in sudden drenching downpours of sweat.

There’s another symptom that is just as common, but few women ever bring it up to their doctors, not realizing it’s a simple fact of menopause:  insomnia.

“It’s worse than hot flashes, really,” said Karen Giblin, a menopause expert and CEO of the Red Hot Mamas, an advocacy group that provides menopause management programs to medical providers nationwide.  “There are millions of women out there who are wondering ‘why can’t I ever sleep?’

“And it really is a serious problem,” she added.  “Having no sleep leads to more injuries at work, more accidents on the road.  It just isn’t going to help with your functioning.”

Twenty million baby boomers will be reaching menopause within the next decade, and they’re approaching it at a time when the treatment hailed as its savior – hormone replacement therapy – has been questioned.  For decades, hormone replacement was believed to lower the risk of heart disease and stroke, but studies earlier this decade determined the exact opposite.

Yet hormone replacement – for short periods and in low doses – does help women get through some of the harsher side effects of menopause, Giblin says.

“Women need to be really provocative and become partners with their health care professional and become educated medical consumers,” she said.  “They need to now realize that there is no finality in hormone therapy – you don’t have to be on it for the rest of your life.  You might need it to get through some bad symptoms, but it’s not forever.”

Menopause is the time when the ovaries cease functioning and menstrual periods stop, with the average woman in the United States entering menopause at the age of 51.  The symptoms commonly attributed to menopause actually start in the years leading up to it, called perimenopause, which generally starts three to five years before the onset of menopause.

“The decrease in estrogen associated with menopause increases the risk of osteoporosis and cardiovascular disease.  Fortunately, many of the methods recommended to help fight off the side effects of menopause can also help women decrease their risk at the same time,” Giblin said.

“Exercise, number one, is key,” she said.  “Exercise wards off depression, it raises those endorphins, it gets your blood pumping.  And women who exercise have less hot flashes and it reduces the loss of bone mass from osteoporosis.  No one wants to hear it, but exercise is the best thing we can do.”

Diet also plays a part.  Eating healthy, as well as taking additional calcium and vitamin D supplements for osteoporosis, can reduce side effects.

Many women swear by over-the-counter herbal remedies, such as soy tablets and black cohosh.  Giblin suggests that women consult their doctors before starting any medication, including herbal treatments.

“Some of these remedies may interact with their current medications and some of them you shouldn’t be taking at all,” she said.  “Be cautious.  They might not be as safe as some of the other therapies out there.”

“Doctors have also been using progesterone, antidepressants and anti-seizure drugs to relieve menopausal symptoms,” Giblin said.

About 75 percent of women report hot flashes, night sweats and insomnia during menopause as well as mood swings and some sexual side effects.  With women typically needing six to nine hours of sleep a night, insomnia can be one of the most frustrating menopausal side effects.

“Sometimes counting sheep just isn’t going to do it.  There are nights when you really just run out of sheep,” Giblin said.

A recent study by Sepracor, Inc., presented at the North American Menopause Society’s annual meeting, found that Lunesta, the Marlborough company’s new sleep medication, was effective in treating menopause-related insomnia without causing rebound insomnia, a temporary worsening of sleep following the discontinuation of treatment.

“Many women also fall into insomnia pitfalls.  They might exercise before bedtime, believing that will tire them out more, without realizing that exercise actually wakes the body up.  Some may also turn to alcohol as a sleep aid, which doesn’t lead to restful sleep,” Giblin said.

“You need to create a restful environment,” she said.  “Keep the room as cool and dark as possible.  Make it comfortable.”