ArticleSexual medicine2025
Different temporal relationship between sex hormones and sleep status in midlife women: a longitudinal cohort study.
Article in Sexual medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Beyond Estrogen: Distribution and Hormonal Correlates of Serum Testosterone Among Postmenopausal U.S. Women, NHANES 2011-2016 and 2021-2023.Journal of clinical medicine · 2026Article
- Lifestyle factors affecting the pathogenesis of androgenetic alopecia: a literature review.Frontiers in public health · 2026Review
- Survey and analysis of sleep status among community-dwelling elderly diabetics: A cross-sectional study in Shanghai, China.Global health & medicine · 2025Article
- Association between sleep characteristics and physical functioning in middle-aged and elderly adults: findings from Chinese cohorts.Aging clinical and experimental research · 2025Article
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Authors and funding
2 authors.
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Abstract
Background: Fluctuation in sex hormones and the occurrence of sleep disturbance are 2 major health challenges among midlife women. However, the temporal relationship between them remains unclear. Methods: This study included 2488 females (mean ± SD age, 49.0 ± 2.70 years) with an average follow-up of 6.95 years. We constructed a composite score by summing items related to sleep problems to reflect the comprehensive sleep status of the participants in the Study of Women's Health Across the Nation. Cross-lagged path analysis was used to examine the temporal relationship between sex hormones and sleep status. Sensitivity analyses were conducted in nonoverweight and overweight groups and adjusted for vasomotor symptoms in the main model. Aim: In this study, we aimed to examine the temporal relationship between sex hormones and sleep status in midlife women using cross-lagged path analysis. Outcomes: The primary outcomes included results of the cross-lagged path analysis between sex hormones and sleep status. Results: After adjusting for age, race, income, menopausal status, body mass index, hormone therapy use, smoking, and drinking, the cross-lagged path coefficients from baseline follicle-stimulating hormone (FSH) and estradiol (E2) to follow-up sleep status were 0.054 ( Clinical Implications: Given the temporal relationship between sex hormones and sleep, our findings will provide scientific perspectives to benefit health management in the transition of menopause. Strengths and Limitations: This study used a longitudinal theoretical model to distinguish the temporal relationship between sex hormones and sleep status in midlife women. Limitations include limited causal evidence in observational studies, unknown confounders, and careful extrapolation. Conclusion: There were distinct patterns in the unidirectional temporal relationship between (1) FSH, E2, and DHAS and (2) sleep. Changes in FSH and E2 occurred earlier than the change of sleep, while the change of DHAS was later. In contrast, there was no temporal relationship between testosterone and sleep.
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