Why do I have sleep problem during my menopausal syndrome?

Condition analysis: 

Insomnia occurs in 40-50% of women during the menopausal transition, and problems with sleep may or may not be connected to mood disorders. Women with insomnia are more likely than others to report problems such as anxiety, stress, tension, and depressive symptoms.

Sleep disturbances during Menopause have been associated with estrogen deficiency; exogenous estrogen has been shown to improve both subjective and objective sleep, attributed to a decrease in hot flashes. One study suggested that elevated LH levels during late menopause produce poor sleep quality through a thermoregulatory mechanism, resulting in high core body temperatures.

Whether the sleep problems are associated with age-related changes in sleep architecture, hormonal status, or other symptoms of menopause (eg, vasomotor symptoms) is unclear. However, women who were transitioning into menopause were more likely to report severe sleep difficulty than women who were premenopausal.

Instructions:

Hormone replacement therapy: For mild depression, hormone replacement therapy alone may be appropriate. Estrogen may be used when traditional antidepressants failed, when patients refuse psychotropic medications, or when patients experience other clinically significant vasomotor symptoms. Women who have surgically induced menopause have an increased risk of depression, and they may be especially likely to benefit from hormone replacement therapy.

Results from studies of hormone treatments for depression have been inconsistent. Data from several studies suggested that estrogen replacement therapy had antidepressant effects or that it enhanced the effects of antidepressant treatment in perimenopausal women. Other studies did not show that estrogen adds to the effects of SSRIs. In general, such treatments appear to be helpful for managing depressive symptoms in perimenopause but not in postmenopause.