11/17/2025
Sleep getting worse in perimenopause?
You’re not imagining it — and it’s not just “stress.”
As progesterone begins to drop (often in your late 30s–40s), the hormone that normally calms your brain, balances estrogen, and helps you stay asleep becomes inconsistent.
Low progesterone = your nervous system has less “brake pedal” at night.
When that calming buffer disappears, your body leans harder on cortisol to keep things regulated — especially around 2–4 AM.
And cortisol’s job is to wake you up.
So you get the classic pattern:
✔ falling asleep fine
✔ then the sudden 2 AM wake-up
✔ mind racing
✔ heart feeling “on”
It’s not just stress.
It’s physiology + hormone shifts.
Supporting progesterone (naturally or therapeutically), managing blood sugar, and lowering evening cortisol can dramatically improve midlife sleep. Hormone replacement therapy is a game changer for many people because of its effects on cortisol and improvements in sleep.
Your sleep isn’t broken — your hormones are shifting. And they’re giving you clues.