NATUROPATHIC DOCTOR IN ONTARIO
The Connection Between Sleep, Hormones, and Perimenopause in Women
The Healing Power of Sleep During Hormonal Transition
Sleep and Perimenopause
Many women in their late 30s and 40s begin to notice something frustrating: falling asleep or staying asleep becomes harder than it used to be. Tossing and turning, waking at 3 a.m., or lying awake with racing thoughts becomes a regular pattern. These aren’t just signs of stress or aging—they’re often hormonal.
At our clinic, we hear this concern daily: “I used to sleep like a rock. Now I can’t get through the night.” Sleep disruption is one of the most common—and least talked about—symptoms of perimenopause. In this post, we explore why your sleep changes during midlife, how your hormones are involved, and what you can do to support deep, restorative rest again.
Why Sleep Becomes Harder During Perimenopause
Sleep issues during perimenopause are primarily driven by fluctuating levels of estrogen and progesterone, the two key reproductive hormones that start to shift in the years leading up to menopause.
Progesterone: Your Natural Sedative
Progesterone is a calming, soothing hormone that interacts with GABA receptors in the brain. It promotes:
- Relaxation and reduced anxiety
- Better sleep onset and sleep maintenance
- Regulation of body temperature during sleep
During perimenopause, ovulation becomes less consistent, which means progesterone is produced less regularly. Lower progesterone can lead to difficulty falling asleep, more nighttime awakenings, and feeling anxious or restless at bedtime.
Estrogen: Your Temperature Regulator
Estrogen plays a role in regulating body temperature, serotonin levels, and sleep architecture. Fluctuations—or sudden drops—can lead to:
- Night sweats or hot flashes that wake you up
- Mood disturbances
- Increased inflammation or joint discomfort that disrupts sleep
Together, these hormonal changes set the stage for broken sleep and the feeling that you’re no longer waking up rested—even if you technically spent eight hours in bed.
The Vicious Cycle: How Poor Sleep Worsens Hormone Balance
Not only do hormones affect sleep—sleep affects hormones. Sleep deprivation has downstream effects on:
- Cortisol (your stress hormone), which rises in response to poor sleep
- Blood sugar and insulin sensitivity, which can worsen weight gain or cravings
- Estrogen and progesterone metabolism, slowing their detoxification and creating further imbalance
- Mood and cognitive function, amplifying brain fog, irritability, or sadness
If you’re not sleeping well, it becomes harder for your body to self-regulate—which means your perimenopausal symptoms may get worse.
How to Restore Better Sleep: Our Approach
At Sequence Wellness, we help women rebuild a sleep foundation using a root-cause approach. This includes targeted lifestyle strategies, nutrient support, and natural therapies that consider both your hormones and your sleep patterns.
1. Identify and Address Hormonal Imbalances
We start with a thorough intake and may suggest testing for:
- Progesterone (typically on Day 21 of the cycle)
- Estradiol (E2)
- Cortisol (especially morning levels or via DUTCH testing)
- Melatonin (in select cases)
- Serial at-home hormone testing with Mira
From there, we build a tailored plan to support your hormonal balance, which often improves sleep as a downstream effect.
2. Implement Evidence-Based Sleep Hygiene
While it may sound simple, consistent habits make a big difference in midlife:
- Go to bed and wake up at the same time each day
- Avoid screens at least an hour before bed
- Keep your bedroom cool, dark, and quiet
- Use your bed only for sleep and intimacy
- Avoid caffeine after noon and alcohol in the evening
- Create a bedtime routine ritual that cues your brain and body that it can now shift into parasympathetic mode. This may include a calming face care routine, lavender essential oils, an indulgent warm epsom salt bath to relax your muscles, and a bedtime guided meditation to activate your vagus nerve (such as a yoga nidra meditation).
Even small adjustments to your sleep environment and routine can make a noticeable impact.
3. Support the Nervous System
A dysregulated nervous system—often caused by chronic stress—makes restful sleep nearly impossible. We often recommend:
- Magnesium glycinate for its calming effect on the brain
- L-theanine or GABA supplements when needed for acute stress
- Mindfulness, breathwork, or meditation to lower nighttime arousal
- Cognitive Behavioural Therapy for Insomnia (CBT-I), which has been shown to outperform sleep medications in the long term
We don’t believe in band-aid fixes. Our goal is to help your body re-learn how to rest.
4. Reduce Night Sweats and Hot Flashes
If you’re waking drenched in sweat, estrogen fluctuations may be to blame. We may use:
- Phytoestrogens like red clover or soy isoflavones to gently support estrogen receptor activity
- Black cohosh, sage, or vitamin E for symptom relief
- DIM or calcium D-glucarate to support estrogen detox
- Cooling sleepwear and temperature-regulating bedding to reduce discomfort
The key is to identify whether your symptoms are driven by high estrogen, low estrogen, or poor detoxification pathways—and treat accordingly.
A Note on Sleep Medications
Pharmaceutical sleep aids can provide short-term relief, but they often don’t address the root cause. Many women find they feel groggy or disconnected after using them, and long-term use may create dependency.
That’s why we prioritize non-pharmaceutical solutions first—and only consider medications when appropriate and supervised. Our goal is to help you sleep well naturally, for the long term.
You Deserve Rest
If sleep has become a nightly battle, you’re not alone—and you don’t have to just “push through.” Poor sleep affects everything from mood to metabolism to quality of life. Addressing it isn’t indulgent; it’s foundational to your health.
At Sequence Wellness, we help women in perimenopause uncover the root of their sleep challenges and build sustainable routines that restore rest. You don’t have to accept chronic exhaustion as your new normal.
Ready to sleep better and feel like yourself again?
Book a consultation with our team today and let’s create a plan that works for your unique needs.
Your Doctor: Meet Dr. Sarah
Dr. Sarah Goulding is a licensed naturopathic doctor in Ontario and has a BSc in neuroscience and biology from Dalhousie University (2004), and did her 4-year naturopathic training at the Canadian College of Naturopathic Medicine (2010). She’s since accumulated over a decade of clinical experience, and refined her practice to focus on women’s health and digestion. She is licensed and registered as a Naturopathic Doctor in Ontario by The College of Naturopaths of Ontario (CONO) and is a member of the Canadian Association of Naturopathic Doctors (CAND) and the Ontario Association of Naturopathic Doctors (OAND).
Dr. Sarah Goulding blends science and compassion, and acts as a personal health researcher to help you navigate your health. Tools that she uses include nutrition, supplements and botanicals, bioidentical hormones, and lifestyle modifications. The closer you get to the root cause, the gentler the therapies needed to resolve the issue.
