Poor sleep: one of the first signs of menopause
Do you find yourself waking up in the middle of the night more frequently? Does it take ages to fall asleep? Or do you wake up far too early and struggle to drift off again? Poor sleep is one of the first signs that your body is entering menopause. And no, it doesn’t just begin “sometime around your fifties.” Hormonal changes can start as early as your thirties and typically become noticeable in your forties. However, many women don’t immediately associate these symptoms with menopause and end up enduring them for far too long.
It’s time to break this taboo.
What happens in your body?
Around the age of 40, the first hormonal changes may gradually begin. Typically, this starts with a decrease in progesterone, while oestrogen levels remain relatively stable for a while. This imbalance—commonly referred to as oestrogen dominance—can lead to symptoms such as poor sleep or mood swings. You might not notice changes in your menstrual cycle yet, but you may observe subtle signs like difficulty sleeping or mood fluctuations.
When your menstrual pattern begins to change, this is known as perimenopause. This phase usually starts around age 45 and can last for several years. As you progress through this stage, your hormone levels gradually decline, which can significantly affect your sleep quality.
The role of hormones in sleep
- Progesterone has a calming effect. It helps your body relax and supports falling asleep. When this hormone decreases, you may find it harder to unwind.
- Oestrogen (particularly oestradiol) influences your circadian rhythm, the natural sleep-wake cycle of your body. Fluctuations in oestrogen can disrupt this rhythm.
- A disrupted hormonal balance also makes you more sensitive to stress. This is because the stress hormone cortisol is less effectively broken down in the evening. Normally, cortisol levels drop at night, allowing your body to produce melatonin—the hormone that makes you feel sleepy.
- When it gets dark, your body converts serotonin into melatonin—the hormone that helps you fall asleep. Less serotonin = less melatonin = less (or poorer) sleep.
- And then there are the hot flushes, which can occur even in the early stages of menopause and interrupt your sleep multiple times a night.
I thought I just had a lot on my mind. It wasn’t until I also started experiencing hot flushes that it all clicked. - Anja (47)
What can you do?
You can’t control everything, but there’s a lot you can do to improve your sleep. Below are practical tips from a menopause specialist to help support your body during this hormonal transition.
Support your circadian rhythm
- Spend at least 15 minutes outside within an hour of sunrise. Repeat this a few times throughout the day. This gives your brain the right light signals to produce melatonin in the evening.
- Avoid blue light from screens after sunset or use blue light-blocking glasses.
- Stick to a consistent bedtime and wake-up time, even on weekends.
- Ensure your bedroom is dark, cool, and quiet.
Calm your stress system
- Practise a short breathing exercise 2 to 3 times a day: inhale for 4 counts, hold for 7 counts, exhale for 8 counts—for 2 minutes. This lowers your cortisol levels.
- Choose relaxing evening rituals like a warm shower, meditation, or reading.
Adjust your diet
- Avoid eating at least four hours before bedtime. This signals your body that it’s time to rest rather than digest.
- Avoid coffee and alcohol later in the day.
- Eat more fats and proteins, and fewer simple carbohydrates. Opt for complex carbohydrates like porridge oats, sweet potatoes, or brown rice. This helps stabilise your blood sugar levels, which benefits your sleep.
And if that’s not enough?
In some cases, medication can provide temporary relief. Consider:
- Sleep medication as a short-term solution to break the cycle of insomnia. Note: this is not a long-term solution.
- Melatonin tablets (e.g., 1 to 2 mg with extended release) for women whose natural production has been disrupted.
Considering medication? Always consult your doctor to determine the best option for your situation.
You’re not alone — and you don’t have to go through this alone
Poor sleep is not a “minor issue,” and it’s not something you just have to “put up with.” It’s your body signalling that something is changing—and you should take it seriously. At SeeMe-nopause, we believe it’s important that you feel heard. We’re here to support you with information, understanding, and real solutions.
Because you deserve rest. Especially during menopause.
Support for sleep problems during the menopause
Are you struggling to sleep due to hormonal changes? You are not alone — and there is support available. Supplements, herbal remedies or medication can help improve your sleep. Discover which options may ease your symptoms and request them with ease. Simply complete a medical questionnaire and a doctor will determine whether the treatment is appropriate for you.
Tips and advice
Thyrza (age 50): “My menopausal symptoms improved once I prioritised sleep”
Thyrza suffered from hot flashes, weight gain and other symptoms. Her health proved to be strongly connected to sleep quality. “Sleep is my number one priority now.”
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When it comes to diet, fats get a bad rap. This isn’t justified: certain types of fat help keep hormones balanced and reduce menopausal symptoms, while eating foods that are high in carbohydrates can make these symptoms worse. It's time to embrace fats and learn new ways to look at our diet.
Wies: “I used to joke that sleep was my hobby, until menopause arrived...”
Overnight, everything changed. It was like her sleep mechanism was broken. She got help. “You may find this hard to believe, but within weeks my insomnia was cured.”
