Sleep & Hormones in Women: How Cycles, Perimenopause, and Hormonal Shifts Affect Your Sleep Quality

Sleep is essential to overall health, yet for many women, restful sleep can feel elusive. The connection between sleep and hormones in women is complex, influenced by the menstrual cycle, perimenopause, and the body’s natural hormonal rhythms. Understanding this relationship helps women uncover the root causes of sleep disturbances — and find natural ways to restore balance.

The Hormonal Cycle and Sleep: What Happens Each Month

Throughout a woman’s menstrual cycle, estrogen and progesterone rise and fall, influencing mood, temperature regulation, and sleep quality.

• Follicular phase (days 1–14): Rising estrogen often improves mood and sleep efficiency.

• Luteal phase (days 15–28): Progesterone increases, producing a calming effect. When it drops before menstruation, insomnia and anxiety can appear.

• Premenstrual days: Fluctuating estrogen and serotonin can disrupt sleep and cause restlessness.

Tracking your cycle with an app such as Natural Cycles, Clue or Flo Health can help identify sleep changes linked to hormonal shifts.

For more on how hormones affect sleep across the menstrual cycle, visit the Sleep Foundation’s guide on Women and Sleep.

Perimenopause and Menopause: When Sleep Becomes a Struggle

During perimenopause and menopause, estrogen and progesterone decline, disrupting sleep regulation. These hormones normally help stabilize temperature, mood, and circadian rhythm — but as they decrease, symptoms such as:

• Hot flashes and night sweats

• Elevated nighttime cortisol

• Frequent awakenings

• Early-morning insomnia

become common. Up to 60% of women in perimenopause report chronic sleep issues (NIH, 2019).

For evidence-based menopause resources, explore the North American Menopause Society.

The Stress Connection: Cortisol, Melatonin, and Sleep

Cortisol — our main stress hormone — should peak in the morning and drop at night. Chronic stress or adrenal imbalance can keep cortisol levels high, suppressing melatonin (our sleep hormone) and disrupting circadian rhythms.

To support cortisol balance, try:

• Evening meditation or mindfulness apps like Headspace

• Gentle evening yoga or breathing practices

• Magnesium-rich foods such as leafy greens, pumpkin seeds, and cacao

Learn more about the relationship between stress and sleep from the Sleep Foundation.

Naturopathic Strategies to Restore Hormonal Balance and Improve Sleep

Improving sleep and hormones in women requires a holistic approach addressing both hormonal and nervous system balance.

Evidence-based strategies include:

1. Balance blood sugar: Stable glucose helps prevent nighttime cortisol spikes.
2. Support estrogen metabolism: Eat cruciferous vegetables (broccoli, kale, cauliflower) and flaxseeds.
3. Boost magnesium and vitamin B6: These nutrients support progesterone and relaxation.
4. Practice sleep hygiene: Keep a consistent bedtime, reduce blue light, and cool your sleep environment.
5. Use adaptogenic herbs: Ashwagandha, rhodiola, and holy basil can moderate stress response (NIH Review on Adaptogens).

At Aya Naturopathic Medicine, we guide women in understanding how hormones influence every aspect of wellbeing, from mood and metabolism to sleep quality.

When to Seek Professional Support

If insomnia persists for more than a few weeks or is accompanied by anxiety, hot flashes, or mood swings, it’s time to seek naturopathic care. Comprehensive hormone testing, including cortisol, estrogen, progesterone, and thyroid function, can reveal underlying causes and guide personalized treatment.

References

• Baker, F. C., & Lee, K. A. (2018). Menstrual cycle effects on sleep. Sleep Medicine Clinics, 13(3), 283–294.

• Freedman, R. R. (2019). Menopausal hot flashes: Mechanisms, endocrinology, treatment. Journal of Steroid Biochemistry and Molecular Biology, 190, 89–95.

• Pien, G. W., & Kravitz, H. M. (2021). Sleep disturbances during the menopausal transition: Physiology and interventions. Sleep Medicine Reviews, 56, 101407.

• Vgontzas, A. N., et al. (2020). Insomnia and hormonal imbalance: The role of cortisol and estrogen. Endocrine Reviews, 41(4), 543–563.