Perimenopause, the transitional phase leading up to menopause, often brings a variety of physical and emotional changes, with sleep disturbances being one of the most common, yet frustrating symptoms. As fluctuating hormone levels � especially estrogen and progesterone �begin to impact the body, many women find themselves tossing and turning at night, waking up frequently, or struggling to fall asleep altogether. Studies have noted that 33-51% of women experience sleep disturbance in the transition into menopause.
These sleep issues can affect energy levels, mood, and overall well-being, making it harder to navigate daily life. But the good news is that understanding the connection between perimenopause and sleep can help you take actionable steps to reclaim restful nights. Below is an in-depth look at why perimenopause disrupts sleep and, more importantly, what you can do about it. From lifestyle changes and nutrition to stress management techniques that promote better sleep, this is how to navigate this natural life stage.
Menopause is diagnosed after a woman has gone 12 months without a menstrual period. Due to decreases in ovarian function and reduced levels of hormones, such as estrogen, this time also marks the end of a woman�s fertile or reproductive years. Natural menopause (as opposed to medically, surgically induced menopause) generally occurs in a woman�s 40s or 50s, but the average age in the United States is 51.
In addition to sleep changes, common menopause symptoms include menstrual cycle changes (due largely to changes in hormones such as estrogen and progesterone), hot flashes, night sweats, abnormal uterine bleeding, mood changes, brain fog, vaginal dryness, discomfort during sex, and urinary symptoms like urgency and nocturia (urination during the night). Weight and body composition changes also commonly occur during this time.
Perimenopause is the transition phase leading up to menopause. It begins with the onset of changes to the menstrual cycle (many women find that their periods become less regular) and extends through the last menstrual period through the first year of menopause. Again, this can begin earlier or later, depending on the person � and it typically lasts between two to eight years � but the average duration of perimenopause is four years.
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The decrease in estrogen and progesterone impacts many systems and processes in the body beyond the menstrual cycle and fertility, including some that impact sleep. Hot flashes, mood disturbances, and changes in brain function may all contribute to sleep issues. Many women begin to find it harder to fall asleep, stay asleep, or both.
Sleep disturbances can be especially frustrating, given the toll that poor sleep can take on mental health, energy, fitness, and weight. Because chronic sleep deprivation also contributes to inflammation and impaired immune system function, consistently getting poor sleep has been linked to an increased risk of health conditions including heart disease, dementia, type 2 diabetes, and even certain cancers.
Simply telling women why it�s so important to get quality sleep, without addressing the underlying factors of their sleep issues, does them a huge disservice. It can also foster feelings of shame and make them feel like they�re losing control over their health.
If you struggle with the unknowns that perimenopause brings, educating yourself about which hormones are changing and how that can impact your health may help demystify the situation and help you put a plan into action. This can be especially helpful if you�re someone who�s prone to tossing, turning, and fuming.
Talk to your doctor and get the appropriate bloodwork done to help get an idea of where your hormones levels are. Additionally, tracking your cycle basal body temperature (which is not affected by hot flashes, but can be affected by poor sleep), and indicators such as cervical fluid texture and volume � and symptoms like breast tenderness, fatigue, pelvic pain, backaches, and headaches � can be useful for noticing patterns and anticipating when you may be most likely to struggle with sleep. This will help you put a plan in place.
Even just tracking your basal body temperature to help estimate when ovulation occurred can be a good starting place, as it typically rises by about half a degree once ovulation has happened. You can also take advantage of the wide range of cycle tracking apps, wearables, and home hormone testing kits available.
For example, during the luteal phase (the days after ovulation, before your period starts), sleep disturbance is more likely to occur, so being able to identify when you are in that phase allows you to implement some additional sleep-supporting techniques.
Read More: 10 Ways to Improve Your Sleep Health
There are a few sleep hygiene essentials that everyone should implement. If you�re not already, start with these:
If you�ve already mastered the basics, a few upgrades to your nighttime routine can make a significant difference.
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What you eat can also play a role in how you sleep. Here are a few things to keep in mind:
Sleep supplements have become very popular. A few that have been shown to be effective are magnesium glycinate, magnesium citrate or magnesium L-threonate, L-theanine and GABA, and tart cherry extract.
If you already take a calcium and/or vitamin D supplement, try taking it at night. Melatonin is best used in small doses for a short period of time when you want to re-establish your sleep cycle, such as when crossing time zones, during a daylight saving time change, or if you are adjusting to a new sleep schedule.
Always touch base with your healthcare provider before starting a supplement to avoid interactions and overdoses. Ideally, you want to introduce one at a time, unless otherwise directed, so you can get a sense of whether it�s helping. When shopping for sleep supplements, look for products that are third-party tested, are verified for efficacy and safety, and are distributed from reputable brands.
If you�re finding it hard to stay asleep, you are not alone. This is an incredibly common occurrence for women in perimenopause. Here are a few things to do when you can�t sleep: