How Do You Dudley: Menopause Edition

What does menopause have to do with getting dressed? When you’re a by women, for women brand, the answer is…everything!

At Dudley Stephens, we believe looking good and feeling good go hand in hand. And feeling our best means keeping up our health—even (especially) experiences that are universal yet underdiscussed.

This week we hosted Dr. Alicia Robbins on our podcast, Two Sisters in Business. Dr. Robbins is a Greenwich, CT-based certified menopause practitioner, meaning she’s one of the heroines helping to move the topic of feeling good in & beyond your 40s into the mainstream. The conversation was so rich with “a-ha” tips and takeaways we wanted to share more of her insights with you here.

To hear our full conversation, tune into our latest podcast episode on Apple or Spotify.

Dudley Stephens: Dr. Robbins, one thing that can really make or break your sense of wellbeing in your 40s is sleep. Why do sleep challenges seem to come on so suddenly at this point in life?

Dr. Robbins: Sleep in your 40s can be really challenging and the cause is often multifactorial: kids, more stress and mental load with families and careers, and hormonal changes (estrogen and progesterone are both important for sleep). Furthermore, blue light from screens actually inhibits melatonin secretion.

Dudley Stephens: Long story short, women in our 40s have a lot going on!  What do you recommend to your patients?

Dr. Robbins: I find a multifaceted approach works best.

The "must do's:" 

1. Magnesium glycinate supplements, 200-600mg at bedtime. Many women are deficient, and this helps relax the brain and body and even makes you feel sleepy. 

2. A nighttime routine. It’s not so much the actual routine but training the brain to slow down, since most of us are in constant "flight or fight" mode. Having a routine is a practice to help turn that off. 

3. Room conditions. Keep your bedroom cool and dark, and avoid blue light several hours before bed. Charge your phone away from your nightstand, since blue light actually sends a signal to the brain to stay up and be alert (not to mention most of the content we are looking at is stimulating). 

4. Exercise. Any type of exercise during the day helps with sleep at night.

6. Limit alcohol. Try to avoid more than 1-2 glasses late in the evening, as the metabolites can be stimulating and cause you to wake up with heart palpitations, anxiety and night sweats. (Is that why they created the 5pm cocktail hour? LOL.)

Other considerations:

1. CBD. Some science shows CBD can help maintain sleep, but most women need more than the standard dose. For example, most gummies are dosed at 25mg, but studies show 50-100mg is needed to reduce sleep-disruptive anxiety and stress. 

2. Over-the-counter medications. Medications (like Unisom) are not a great long-term solution, but can sometimes break a bad cycle and "reset" a few nights of insomnia. 

3. Melatonin. A supplement can help, but you usually need to take it about 5-6 hours before your bedtime, at low doses like 0.5-2mg. Sleeping at the same time every night will make it more effective (of course social plans can sometimes get in the way).

4. Therapy. If you’re really struggling, don't hesitate to seek out a CBT (cognitive behavioral therapy) therapist who specializes in sleep. You can also try an app called Stellar Sleep to try to “retrain” your thoughts if the anxiety around sleep has taken on a life of its own.

Dudley Stephens: Talk to us about hormone replacement therapy (HRT). It seems like it’s back “in” and women find it truly game-changing. What do you recommend?

Dr. Robbins: We know that progesterone & estrogen hormones are important for sleep, so talking to someone who understands how to prescribe them can be helpful. And that brings me to my next point….

You may have to be your own advocate but it’s worth finding a provider who listens and takes your concerns seriously. The reality is, a lot of OBGYNs are not comfortable or don't have experience prescribing HRT in perimenopause/menopause, but thankfully there are several telehealth platforms you can use to supplement your regular GYN care: Midi Health (takes insurance), My Alloy and Elektra Health. All of this can be done via telehealth, which really makes it accessible.

Prioritizing your health is so important, because we as women do so much for those around us! You deserve to feel good—and that has a positive ripple effect on those around us.

For more, follow along with Dr. Alicia Robbins’ favorite women’s health digital resources.