Why menopause steals your sleep and how to get it back

Our expert at London Gynaecology explains what’s happening, and how to reclaim your rest.

If you’ve hit peri-menopause and find yourself staring at the ceiling at 3am, you’re not alone. Over half of postmenopausal women (51.6%) experience sleep disorders which can include middle-of-the-night wake ups, difficulty falling asleep or just feeling permanently unrested.

We all know that sleep is like the glue holding us together so without it, everyday life can feel a lot tougher. 

“The hormonal changes that occur during peri-menopause specifically, the years leading up to menopause, can cause real problems with sleep. Poor sleep is one of the many symptoms a woman might experience so together they can make day-to-day life extremely uncomfortable,” says Dr Claire Phipps (@menopausegp), female-health GP and BMS Specialist at London Gynaecology. 

Menopause usually occurs between ages 45 and 55, with 51 being the average age in the UK, but every woman’s experience is different, meaning your sleep struggles, and how you manage them, will be unique too.

At London Gynaecology, we work with you on an individual basis to help restore healthy sleep patterns. 

“You can reclaim your rest and carry on living life as normal,” reassures Dr Phipps.

Why menopause is affecting your sleep 

The main culprit behind your poor perimenopausal sleep, is the huge drop in hormones, oestrogen and progesterone. In particular, oestrogen. 

“These changes can trigger night sweats and hot flushes that cause frequent awakenings and the need to change bedclothes,” says Dr Phipps.

“Joint pain and stiffness can also make it harder to find a comfortable sleeping position. In addition, genitourinary syndrome of menopause (GSM) can lead to bladder sensitivity, urgency and increased nighttime urination. All of these can further fragment sleep and reduce overall rest quality.”

Can’t stop waking up at 3am? This could be down to increased levels of the stress hormone cortisol, which can naturally elevate around this time, but can also be elevated even further during perimenopause in some women.
It’s somewhat of a catch 22 though as a lack of sleep also increases cortisol levels with research finding that just one night of total sleep deprivation increased cortisol levels,especially in the early evening and early morning hours. Stress ratings also increased during the day after one night of sleep deprivation.

“For some, the anticipation of bad sleep can make sleep even worse. If you’re worried about perimenopause affecting sleep, then it’s as though you’re almost waiting for it to happen,” adds Dr Phipps. 

The impact of sleepless nights

Even one or two nights of bad sleep can have a knock-on effect on how you feel and function. 

“It’s during your sleep hours that your body resets,” says Dr Phipps.

 “Without sleep, life just feels 10 times harder. You lose focus, your productivity can decline and your cortisol levels stay high, which can affect your mood, weight and even how your body regulates temperature. It’s only natural to want to reach for another coffee when you’re tired, but this can affect not only sleep, but can also be a trigger for some perimenopausal symptoms such as anxiety, hot flushes and night sweats.”

Chronic sleep loss has also been linked to higher inflammation, reduced immunity and even slower recovery after exercise. 

“These factors can understandably make this stage of life feel more tiring. Inflammation, in particular, may contribute to feelings of fatigue and, over time, can affect overall health and wellbeing,” explains Dr Phipps.

Improving your sleep during menopause 

Your menopausal sleep loss isn’t something you have to live with. After all, there’s a good reason why we spend around a third of our life asleep;  because sleep is essential for staying physically and mentally well. So putting steps in place to improve your rest really is important. 

Dr Phipps says that a few lifestyle tweaks might make a difference to your shuteye.

“Eliminate or reduce alcohol and caffeine as these won’t do your sleep any favours. Make sure your bedroom is cool and dark and use light, breathable bedding. 

“Try to stick to a consistent sleep-wake schedule too, making sure you allow for seven to nine hours of sleep. Your body likes routine and if it knows when it’s ‘due’ to go to sleep, it will naturally start winding down.”

Screens can also disrupt sleep due to the blue light they omit. 

“Use your bed for sex and sleep only is my mantra,” says Dr Phipps.

Managing stress can also help.

“During perimenopause, you may feel more stressed than usual due to fluctuating hormones, so it’s even more important to focus on relaxation. That could be in the form of meditation, gentle yoga or simply taking time to wind down with a book before bed. Breathwork can also be really helpful to calm the nervous system,” says Dr Phipps.

If sleep problems persist, it might be worth looking into medical options. 

How can London Gynaecology help? 

If your menopausal symptoms are disrupting your quality of life, sleep, relationships or emotional wellbeing, then it can help to seek support from a menopause specialist. 

At London Gynaecology, we offer GP and consultant-led menopause clinics with BMS and FRSH registered menopause specialists and nutritional therapists. 

“Because every woman is different, each consultation focuses on you, your lifestyle and your symptoms. We’ll offer your practical advice, treatment recommendations and also long-term support for managing your health, including your sleep, during perimenopause and beyond,” says Dr Phipps.

Our experts will also be able to discuss HRT in detail, including the benefits and risks, the best way to take it and whether it’s right for you. 

“HRT typically contains oestrogen only or oestrogen and progesterone and it can be taken as a tablet, applied to the skin as a patch, gel or spray, or it can come in cream or pessary form,” explains Dr Phipps.

There are many different options to treat menopause symptoms and HRT is just one. Testosterone treatment is also something that will be discussed and recommended if appropriate. At London Gynaecology we focus on a holistic approach, discussing different options that may work for you. 

“Sleep-related therapy and non-hormonal prescription medications may also help,”  says Dr Phipps.

“Sleepless nights are uncomfortable, disruptive and they can negatively impact your health. But with the right support, your sleep can be saved.”

View our Expertise