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Cited by 242Menopause: Health Impacts and TreatmentsSleep and related disordersSexual function and dysfunction studies

When does estrogen replacement therapy improve sleep quality?

Polo-Kantola, Päivi, Erkkola, Risto, Helenius, Hans, Irjala, Kerttu, Polo, Olli·1998·American Journal of Obstetrics and Gynecology
DOI 10.1016/s0002-9378(98)70539-3
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Abstract

Objective Our purpose was to evaluate the effect of estrogen replacement therapy on sleep complaints by postmenopausal women and to assess the predictive factors involved.Study design Sixty-three postmenopausal women entered a 7-month prospective, randomized, double-blind, crossover study consisting of two 3-month treatments with estrogen and placebo with a 1-month washout period between. Eight Visual Analogic Scale statements about different sleep complaints, the Basic Nordic Sleep Questionnaire, scoring of climacteric symptoms, The Beck Depression Inventory, and serum estradiol and follicle-stimulating hormone level controls were the main outcome measures.Results Estrogen replacement therapy improved sleep quality, facilitated falling asleep, and decreased nocturnal restlessness and awakenings (p < 0.001). The subjects were less tired in the mornings and in the daytime (p < 0.001) when taking estrogen replacement therapy. Estrogen-induced sleep improvement was associated with alleviation of vasomotor symptoms (r range 0.27 to 0.55), alleviation of somatic symptoms (palpitations and muscular pain, r range 0.26 to 0.36), and alleviation of mood symptoms (r range 0.28 to 0.37) on estrogen replacement therapy. The severity of initial insomnia predicted only one estrogen-induced sleep improvement effect: the more the subjects experienced insomnia, the better the estrogen replacement therapy facilitated falling asleep (r = 0.26, p = 0.040). Estrogen-induced sleep improvement was also reported by the 15 climacterically asymptomatic subjects. In these subjects initial insomnia scores strongly predicted estrogen-induced sleep improvement (r range 0.50 to 0.75).Conclusions Estrogen replacement therapy significantly diminished sleep complaints among postmenopausal women. Alleviation of climacteric symptoms was the most important predictive factor for the beneficial effect of estrogen replacement therapy on sleep complaints. The use of estrogen replacement therapy in women without self-reported climacteric symptoms could also be considered because women do not always recognize their climacteric symptoms or they ignore them.

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Crossref · 10.1016/s0002-9378(98)70539-3

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  • Numerous other factors affect the sleep quality of menopausal women, such as neurological diseases, metabolic changes, weight gain, low exercise, medications, lifestyle, and changes in hormone levels.

    “Numerous other factors affect the sleep quality of menopausal women such as neurological diseases, metabolic changes, weight gain and low levels of exercise, medications, lifestyle, and changes in hormone levels [60–62].”

    From Effect of acceptance and commitment therapy on mood, sleep quality and quality of life in menopausal women: a randomized controlled trial (2022) · cites this paper as [61]

  • Several studies comparing hormone therapy to placebo have found that hormone therapy improves perceived sleep quality and self-reported sleeping problems more than placebo.

    “Although several studies comparing HT to a placebo have found that HT improves perceived sleep quality and self-reported sleeping problems more than a placebo [112-123]”

    From Non-Pharmacological Treatment of Insomnia (2012) · cites this paper as [119]

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Authors
Polo-Kantola, P., Erkkola, R., Helenius, H., Irjala, K., & Polo, O.
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
1998-05
Volume
178
Issue
5
Pages
1002-1009
ISSN
0002-9378 (ISSN-L)
DOI
10.1016/s0002-9378(98)70539-3
OpenAlex
W1999431748
Cited by
242
References
27
Citations by year
2026: 3 · 2025: 3 · 2024: 4 · 2023: 7 · 2022: 4 · 2021: 3 · 2020: 6 · 2019: 5 · 2018: 4 · 2017: 3 · 2016: 5 · 2015: 2 · 2014: 11 · 2013: 6 · 2012: 9
FWCI
8.05
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Keywords
estrogen replacement therapy, sleep quality, postmenopausal women, menopausal symptoms, vasomotor symptoms, insomnia, nocturnal awakenings, somatic symptoms, mood symptoms, predictors of treatment response, estradiol, follicle-stimulating hormone
MeSH terms
Climacteric, Depression, Double-Blind Method, Estradiol, Female, Follicle Stimulating Hormone, Humans, Sleep Initiation and Maintenance Disorders, Middle Aged, Prospective Studies, Surveys and Questionnaires, Estrogen Replacement Therapy, Postmenopause, Cross-Over Studies

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