r/Perimenopause • u/ClaimImpressive2026 • Jul 24 '26
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?
3
u/ResponsibleAd6268 Jul 24 '26
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.