Menopause
Matters

In 2022, AMWA endorsed and adopted the 2022 hormone therapy position statement of The North American Menopause Society

In 2023, AMWA endorsed and adopted the 2023 Nonhormone Therapy Position Statement of the North American Menopause Society Health and Wellness

Smart Again, Aging Well. A National Action Plant: Collaborative Effort Aims to Change How Women Perceive and Experience Aging

AMWA Joins HealthyWomen Coalition to Find Solutions for the Healthcare Needs of Women in Midlife

AMWA joined a working group convened by HealthyWomen, the nation’s leading independent nonprofit health resource for women, and contributed to their new report, “Aging Smart. Aging Well. A National Action Plan.” Based on data in this report, it is critical that we address the unique challenges and needs of women in midlife.

A formal Aging Smart, Aging Well coalition has been formed to ensure collaborative efforts in addressing key emerging themes, including improving access to care and reducing barriers to early intervention, accessible resources, diagnosis and treatment. The coalition will formulate a multiyear roadmap by which to bridge the gaps, build on existing initiatives and advocate for solutions that elevate women’s midlife health and drive a pro-aging message. For more information, read AMWA’s news story.

AMWA was a part of the National Association of Nurse Practitioner’s in Women’s Health BOlder Women’s Health Coalition, an alliance of innovative leaders in women’s health and in the aging community (representing the nonprofit, public, and private sector) who were committed to defining, creating, and promoting a cohesive health agenda for older US women.

• The complex interaction between menopausal changes and sleep disturbance account for a marked increase in sleep complaints in women approaching midlife. In fact, sleep disturbances are very common in older women, affecting >40-60% of peri- or post-menopausal women
• Data suggest that:
  • Women had a 41% greater risk for developing insomnia than men
  • 25% of women between 50 and 64 years of age report sleep problems, and 15% of those report severe sleep disturbance significantly affecting their quality of life
  • 31-42% of women may develop chronic insomnia by the end of their transition into menopause
• The factors that affect sleep at a woman’s perimenopausal transition include changing hormone levels–decreased estrogen and increased follicle-stimulating hormone (FSH), progesterone and testosterone– as well as physiological and mental health changes occurring as a consequence of the shifting hormonal milieu. Women are at increased risk for sleep disturbances–insomnia, poor sleep quality and sleep deprivation, obstructive sleep apnea, restless legs syndrome–during times of hormonal change. Both aging and hormonal changes independently influence sleep architecture.
• Nocturnal melatonin secretion decreases with age, but also specifically decreases with the onset of menopause
• Women may experience vasomotor symptoms such as skin and temperature changes, in addition to mood disorders, circadian rhythm abnormalities, and altered lifestyle and metabolic factors that play a role in disordered sleep.
• These changes and conditions that occur as a consequence of, or in concert with menopause may exacerbate age-related sleep architectural changes that may be due to the decline in melatonin that accompanies aging and menopause onset
• In addition, mood symptoms such as depression and anxiety occur more frequently in women than men, and often occur in concert with sleep problems in peri- and postmenopausal women.
• Finally, there are many medical disorders that may cause or exacerbate sleep difficulties.
• Chronic pain conditions and other chronic conditions, as well as physical disorders such as restless legs syndrome (RLS) or periodic limb movement disorder (PLMD) may coincide with menopause and can aggravate preexisting sleep problems associated with these conditions.
• Randomized controlled trials examining the impact of hormone therapy (HT) on sleep demonstrate improved sleep quality and quantity with improved total sleep time and REM sleep, as well as decreased wakefulness
• The National Institute on Aging suggests the following lifestyle changes to improve sleep in perimenopausal women:
  • Adopt a regular sleep schedule and regular bedtime routine
  • Avoid napping, especially in the late afternoon / evening
  • Maintain a comfortable bedroom temperature
  • Exercise regularly, but not close to bedtime
  • Avoid caffeine and large meals close to bedtime

Management of Menopausal Symptoms: A Review (JAMA)

Enduring CME: Individualized Menopause Care

Menopause Matters: A Discussion – Oct. 24, 2020