Throughout 2020, she tried to balance her cortisol levels by taking adaptogens, magnesium, and CBD, as well as managing her stress and reducing her workout intensity. “Some of it sort of helped, but nothing really made a huge dent all the time,” she says. Reisdorf’s doctor even prescribed her the antidepressant Trazadone, which she only took for a month. “I wasn’t comfortable taking a medication like that because I am not depressed,” she says.
A colleague eventually referred Reisdorf to a local physician who deals with women's hormones. “She immediately said, ‘It’s not your cortisol, it’s your progesterone because you are perimenopausal and your progesterone is the first hormone to start dropping,’” Reisdorf says. Along with being a key player during pregnancy, progesterone is a calming hormone that helps alleviate anxiety and promote balanced sleep, so it would make sense that low levels were at the root of Reisdorf’s issues.
She began taking prescription progesterone in July and has since noticed that her sleep is significantly better. Today, she says, “I very rarely wake up in the middle of the night, except when a child wakes me up, and I feel rested.”
Poor Sleep Can Have a Major Impact on Your Hormones
Many women struggle to get a good night’s sleep. While this is often written off as a symptom of our busy lives, the truth is that insufficient sleep causes problems that go far beyond exhaustion and not functioning at our best. Poor sleep can cause a myriad of health issues, many of which stem from its disruption to our hormones.
Sleep is not merely the absence of being awake. “It’s a very dynamic state in which melatonin rises, cortisol declines, growth hormone peaks, and many other physiological states are distinctly different from their daytime counterparts,” explains ob-gyn Dr. Felice Gersh. Sleep is the critical time when your body goes into cleaning and restoration mode. Without this rebuilding period, your ability to stave off illness, heal both internally and externally (think acne scars), and fight free radicals that can cause cancer and other diseases suffers. These ripple effects can extend through all areas of your hormones and health.
Melatonin, which is made from serotonin, is the hormone most commonly associated with sleep. But it’s role in the body goes far beyond regulating your sleep cycle. According to Gersh, this hormone is instrumental in about 700 reactions in the body, including being a catalyst in the production of protective antioxidants and playing a critical role in regulating glucose. “Melatonin is very key to the control of glucose transport and can help to prevent pre-diabetes,” Gersh says.
During a good night of sleep, cortisol production dramatically drops. This, however, may not be the case when stress is involved, as Reisdorf initially suspected. When your cortisol doesn’t settle down for the night, your body can’t produce enough melatonin, which in turn affects your ability to get both adequate quality and quantity of sleep.
In women, unbalanced melatonin and cortisol aren’t just a problem for your energy level. Gersh explains that these two hormones also have distinct effects on ovarian function. Melatonin, for instance, has receptors on your ovaries, and when sleep problems lead to a reduction in melatonin production, it can change your menstrual cycle.
While Gersh says irregular cycles are the most common caused by poor sleep in women, it’s by no means the only one. “Sleep deprivation leads to alterations of digestion, which then leads to leaky gut and the evolution of systemic inflammation due to the passage of toxic bacteria into the body proper,” she says. A 2015 study also found that people who got less than six hours of sleep a night were several times more likely to get sick. In addition to these problems, sleepless nights can also lead to weight gain, mood dysregulation, headaches, constipation, and gastroesophageal reflux disease.