Hi there, it's Matt here and welcome back to the podcast.

This is a very different kind of podcast, an AMAA and Ask Me Anything podcast. I am joined today by a fantastic

partner in crime my wonderful colleague from the Center for Human Sleep Science,

Dr Ettie Ben Simone.

Hi everyone, very happy to be here. Let's dive right in. All right, so the next question is actually a

topic we had a lot of interest in and it goes back to what we discussed in the beginning,

the difference between males and females in terms of sleep,

but this time zooming in on sleep and female hormonal changes.

Now can you tell us a bit about how sleep changes during the menstrual cycle and then the transition to

menopause, the merry menopause period and then the menopause period.

Okay, fantastic and I will also answer the question about hormone replacement therapy a little bit, but I know it can have some controversy.

So there are certainly very intricate of course and dynamic hormonal changes during a

woman's menstrual cycle and there are equally significant changes during menopause and both of those will influence sleep.

By understanding the interactions we can try to see if we can think about what people should expect during each of those phases

is. So let me start with sleep and menstruation and the menstrual cycle. The menstrual cycle just as background for anyone. On average, it's around about 28 days, but it varies from one individual to the next. It's characterized by fluctuations in hormone levels and

perhaps they're not the only two by any means but two of the primary hormones that

change are estrogen and progesterone. There are others of course as I said and I'll take these

sleep changes that happen during menstruation based on the different phases of menstruation.

So I'll start with the follicular phase of menstruation.

That happens between about 1 to 14 days of that 28 day cycle.

And this phase starts on the first day of menstruation

and continues until ovulation. At this time estrogen levels rise during the

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