Why You’re Not Sleeping: The Hormone-Sleep Connection in Perimenopause and Menopause
If you're waking up at 2 a.m. staring at the ceiling, you're not alone—and you're not doing anything wrong. One of the most frustrating parts of perimenopause and menopause is disrupted sleep. But here's the good news: you're not imagining it, and it’s not just stress or aging. It’s your hormones—and once you understand what's going on, you can take back control.
Let’s break it down.
One of the most frustrating parts of perimenopause and menopause is disrupted sleep.
Estrogen: The Soothing Hormone That Starts to Slip
Estrogen does more than regulate your cycle. It plays a vital role in your sleep-wake cycle. As estrogen starts to drop in perimenopause, you may notice you’re more restless at night. Why?
Because estrogen helps regulate body temperature and supports the production of serotonin—your feel-good, sleep-supporting neurotransmitter. When estrogen declines, it throws off both of those systems. That’s why you might wake up drenched in sweat or feel anxious for no clear reason.
Progesterone: Your Natural Calmer Takes a Back Seat
Think of progesterone as your internal chill pill. It promotes relaxation and sleep. When levels drop—often one of the first changes in perimenopause—you might find yourself tossing and turning, unable to fully settle into deep sleep.
Lower progesterone also makes you more sensitive to stress, which can spike cortisol levels and create that dreaded wired-but-tired feeling.
Cortisol: The Stress Hormone That Doesn’t Know It’s Bedtime
Here’s the kicker. As your sex hormones fluctuate, your stress hormone, cortisol, can get out of sync. Cortisol is meant to be high in the morning and low at night—but in perimenopause, that rhythm can flip.
Instead of winding down in the evening, your brain might start buzzing. You feel wired. Alert. And even though your body is tired, your mind is racing.
This is hormonal dysregulation, not personal failure.
Melatonin: The Sleep Signal That Fades Over Time
Melatonin helps your brain recognize that it’s time to sleep. But as estrogen and progesterone decline, melatonin production often declines with them. This means your internal clock starts to malfunction. You might fall asleep later, wake up earlier, and have more frequent wakeups in between.
Hot Flashes and Night Sweats: The Temperature Hijack
Let’s not forget the heat. Hot flashes and night sweats are more than annoying—they’re sleep-disrupting events. These symptoms are a direct result of estrogen instability affecting your brain's temperature regulation center. They wake you up, make it harder to fall back asleep, and can lead to fragmented, non-restorative rest.
What You Can Do to Reclaim Rest
The first step is understanding that this isn’t all in your head—it’s in your hormones. Once we remove the shame or self-blame, we can look at real solutions.
Here’s what I recommend:
Track your symptoms. Know what’s changing and when. This helps you make informed decisions.
Consider hormone support. From lifestyle strategies to bioidentical hormone therapy, there are options.
Create a nighttime routine that supports hormone balance. That might include magnesium, gentle movement, and reducing blue light exposure before bed.
Stop powering through. Sleep isn’t optional. It’s essential to your health, your mood, your metabolism—everything.
Final Thought: You Deserve Rest
If you’re in perimenopause or menopause and struggling with sleep, know this—it’s not about willpower. It’s about biology. And once we start working with your body instead of against it, things can change.
You deserve to feel rested. You deserve to feel like yourself again.
Let’s make that your new normal.
Products We Swear By
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Defy Menopause - Own the Change
Many women tell me: "One day I feel amazing. The next, I can barely get out of bed. Is this normal?"
Yes, it is. And no, you don’t have to suffer through it alone.
Hormonal fluctuations during perimenopause can make you feel like you’ve lost control of your body. But knowledge is powerful. And there are clear, science-backed ways to support your hormones, ease symptoms, and reclaim your energy.
That’s exactly why I created Defy Menopause: Own the Change — a 30-day program designed to give you the tools, knowledge, and support you need to move through these changes with clarity and confidence.
Inside, you’ll find:
Weekly access to Dr. Tracy Verrico at live, group sessions
Clear action steps for managing symptoms naturally
Because you deserve more than just "putting up with it."
You deserve to thrive.
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