Zhang J, Jiang B. Influence of Melatonin Treatment on Emotion, Sleep, and Life Quality in Perimenopausal Women: A Clinical Study. J Healthc Eng. 2023;2023:2198804. Published 2023 Oct 10. doi:10.1155/2023/2198804
This clinical study included 100 perimenopausal Chinese women, ages 45-55, who experienced climacteric symptoms (hot flashes, sleep disorders, anxiety, and depression) for less than one year with at least one menstrual cycle in the past 6 months. Women were given 3 mg of oral melatonin for 12 weeks. Compared with the subjects given placebo, those taking the melatonin supplement experienced decreased Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) levels and significantly lower scores on the Kupperman Index, Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Menopausal Quality of Life (MENQOL).
SNHI’s Advisory Council comments/takeaway from the article
While melatonin may not be the first therapy considered for women experiencing menopausal symptoms, this study adds to the literature suggesting the use of 3 grams of melatonin in perimenopausal women for a wide array of climacteric symptoms and to reduce LH and FSH levels. Serum melatonin testing is not an ideal measurement since this only reflects the amount of melatonin circulating at the time of collection; however, the improvements in LH, FSH, and menopausal symptoms in 12 weeks were significant, suggesting melatonin could be used alone or in combination with other therapies for perimenopausal women.
This clinical study was completed with 100 perimenopausal Chinese women, ages 45-55, who experienced climacteric symptoms (hot flashes, sleep disorders, anxiety, and depression) for less than one year with at least one menstrual cycle in the past 6 months. Women were given either a placebo (N=50) or 3 mg of oral melatonin (N=50) before bedtime for 12 weeks. The study aimed to explore melatonin’s effect on sleep disorders, mood, and quality of life in perimenopausal women.
The following were measured:
Melatonin (serum) levels
Additionally, the following validated assessments were used: Kupperman Index (commonly referred to as the Kupperman Menopausal Index -KMI), PSQI, HAMA, HAMD, MENQOL.
In the melatonin-treated group, there was a significant reduction (p<0.01) in:
1. LH* levels (34.84 +/- 11.94 reduced to 21.01 +/- 7.21)
2. FSH* levels (56.23 +/- 11.89 reduced to 36.27 +/- 12.64)
3. KMI scores (28.11 +/- 4.45 reduced to 12.68 +/- 4.41)
4. MENQOL scores (54.30 +/- 13.58 reduced to 23.51 +/- 8.29)
5. HAMD scores (19.64 +/- 6.78 reduced to 11.00 +/- 3.45)
6. HAMA scores (16.47 +/- 6.78 reduced to 9.51 +/- 3.36)
7. PSQI scores (11.55 +/- 4.26 reduced to 5.98 +/- 2.53)
No noticeable difference between the placebo and treatment groups was found in uterine volume, endometrial thickness, E2, or melatonin levels. Some adverse reactions were noted to include breast pain, rash, nausea, and vomiting though there was no difference between the two groups.
*LH and FSH levels begin to increase in perimenopause as hormone fluctuations. As a general guide, LH > 25 is suggestive of perimenopause, and > 35 is suggestive of menopause; FSH 25-45 is suggestive of perimenopause with levels > 50 indicating menopause/postmenopause.
Limitations Noted by Author(s)
Relatively small sample size
Nocturnal melatonin levels were not measured
Other limitations noted in this review
It was not stated how the measure of uterine volume and endometrial thickness was measured.
The researchers were aware of who received placebo vs. melatonin.
The specifics of the melatonin source (brand, manufacturer, etc.) were not stated.
Women included in the study were in perimenopause, a stage of life when hormones fluctuate in preparation for the final menses/menopause, the findings of LH and FSH may be a result of this normal fluctuation.
Article review completed by Kim Ross, DCN
Content reviewed by Deanna Minich, PhD
November 14, 2023