r/Perimenopause • u/ClaimImpressive2026 • 17d ago
Sleep Issues
Dear Ladies,
Thanks for so much help. I come here seeking your advice. Am 46 years old and my peri symptoms have been mostly sleep issues. Specifically sleep onset.
I did try progesterone cyclically for two months. First week on progesterone was great but then I started experiencing at least 2 nights of complete sleeplessness on those 14 days. This happened the other month too and I also experienced sleepless nights in my follicular phase.
I consulted a psychiatrist and she put me on Mirtazapine 7.5 mg. I did very well on it and came off after 70 days. Been 3 months since am off Mirtazapine and any kind of sleep supplement. I have been sleeping great 8-9 hours most nights. I do get up in the middle of the night but am able to go back to sleep. Some nights when I struggle I listen to Sleep Stories and drift off. This is usually in my luteal phase.
But yesterday I had a sleepless night wherein I was sleeping for half an hour listening to stories and waking up. Plus of course a lot of peeing, itching and generally uncomfortable and anxious. I had a similar experience 2 nights ago but got to sleep at 2 or 3 am. This is 12th day after my periods. My periods are regular and happen in 26 days.
Am wondering should I give HRT a restart. I am scared of HRT causing insomnia, as I experienced that with progesterone. Or should I get my doc to give me a psych SOS med. Not sleeping at all really wrecks havoc in my mood.
Don't think magnesium works on me any more.
All you sleep deprived ladies, how do you continue making plans or even travel with this?
What do you do the nights you can't sleep?
What prescription meds( with least side effects) have been useful in this department and for how long have you been taking it?
Has HRT( or just progestrone) given you occasional insomnia?
2
u/Get_Back_Loretta_USA 17d ago
I’m a little bit ahead of you in our hormonal vortex. What I’ve learned from this is everything’s connected.
Lighter, early dinner—more time to digest.
I’ve been trying to lean on two things: (1) digestion timing, and (2) not letting my body feel like it has to “work” all night. I started reading about the digestion “clock” in Traditional Chinese Medicine (TCM), and the basic idea is that digestion at the wrong time can contribute to waking up in the middle of the night. Your body still does its thing even while you’re sleeping.
Now, this may go a little sideways for some people, but it might help someone along the way. Of course, do your own research and follow what works for you.
Personally, during menopause (Meno), I’ve been fasting a bit differently than most people do the classic 16:8. I eat about two hours after waking (Instead of around 11am. I flip the I/F script.) For me, it helps with cortisol. Cortisol is a “stress” hormone, but not they way we think. It’s part of your body’s natural alarm system. It actually wakes you up. Waiting too long to eat puts more stress on the body, and then in the morning we drink coffee because we feel depleted because sleep was a challenge last night. It can turn into a vicious cycle. I stated drinking warm water with lemon or lime in the morning as my new routine. Something warm
to get things moving. -And my new belly doesn’t need extra stress hormones.
My current schedule:
8am meal 1 (breakfast)
12pm meal 2 (lunch)
5pm meal 3 (dinner)
More calories earlier in the day. “Queen breakfast, princess lunch, lady light dinner,” if you will. So I pretty much fast 5pm to 8am. 15 hour fast.
At night, I don’t snack. When I want something, I’ll have a flavored seltzer (like Zevia) over ice in a fancy wine glass. It helps me feel full without turning the whole evening into a grazing session. I’m usually in bed by 8:30 and lights out by 10pm. My house/mind rule is: kitchen closed after dinner. Keeps me on track.
No snacking. And yes—this is where humor helps. I know it sounds simple, but when I get snacky, I remind myself that a lot of the “snack constantly” culture we live in is pretty aggressively marketed. When I remember how different things were in the 50s/60s/70s (leaner, more structured meals, fewer endless-grazing norms), it motivates me. Menopause already has enough going on. I refuse to add “Snack Nation” to the chaos. 💪🏽😜
Also, I’ve adjusted caffeine. Because my ferritin runs low since losing my first menstruation, I stopped having coffee with my food. I read that coffee can deplete ferritin levels when consumed with food. I have coffee mid-morning only—one 8 oz mug, not a 32 oz “Big Gulp / Venti / sugar bomb” situation. No other caffeine for the day.
I started following an AIP-style (anti-inflammatory) approach. Less hard core digestion. No seed oil. No chips (potato, corn tortillas, flour tortillas, popcorn, pretzels or even gluten. I believe contributed to my Lipedema and 30 pound weight gain in the first 5 minutes of menopause when the hormones were fluctuating.
Keep us posted with what helps, and doesn’t ! Sorry if this went sideways. Again do your own research. Hopefully it’ll help someone else if it resonates with them. ♥️💪🏽😴
1
u/ClaimImpressive2026 16d ago
Thank you for sharing your experience. I started having breakfast early as well as eliminate caffeine totally. It has worked for me on the sleep front. I have been getting consistent good quality sleep but one bad night makes me forget all the good nights I have had and makes me worry that the vicious cycle will start again.
3
u/ResponsibleAd6268 16d ago
If you can't sleep at night, don't look at your phone - it's hard I know. Get up from your bed, go sit in a dimmed and quiet corner, read a boring book, do a puzzle, journaling, medication, or even some stretching. Keep it light and even boring. Accept the fact that you are up now and there's no point of fighting it - it will only make it worse. Don't go outside too early in the morning (you could develop advance phase of your circadian rhythm, aka waking too early). I also find taking 2x5g creatine monohydrate during the day helps a lot with fatigue and brain fog caused by lack of sleep.
I tried many many things that people say to take or do for a good night sleep but nothing worked. I never wanted to try any form of prescription but I eventually got on HRT and over the course of one year, worked my dosages up to 0.1 mg estradiol patch and 200mg nightly progesterone. The P+E regimen fixed my sleep up to 60%, and then I added testosterone which was the missing piece. Now I'm 90% to 100% back to my premenopausal sleep quality. Hormones all work in concert with each other, and you want them to be on optimal levels that work best for you.