What I hear from my patients so often is that sleep—which used to be easy—suddenly feels like a battle as they enter their 40s. What people don’t realize is that in early perimenopause, your body stops ovulating as regularly, which means you lose the calming, sedative effect of progesterone on the brain. When that natural “calmant” for your nervous system declines, it’s very common to experience new sleep disruption and anxiety.
While some women choose to use bioidentical progesterone to help them stay asleep, there are several wonderful botanical options and herbs that I use to support rest during this transition. Specifically, for sleep support, I often recommend Passionflower, Hops, Lemon balm, Valerian. All of these can improve sleep quality, relaxation, and sleep duration.
Beyond these direct sleep supports, we also look at herbs that support your body’s own hormone production. For example, Chasteberry (also known as Vitex) can be helpful in supporting your body’s ability to make its own progesterone. Since progesterone naturally engages the GABA receptors in the brain to help you feel relaxed, you might also consider a GABA supplement to mimic that calming effect directly.
I also suggest being mindful of the “why” behind your sleep issues. If your sleep is being interrupted by hot flashes or night sweats, we might also look at estrogen-supportive herbs like Black Cohosh, Siberian Rhubarb, or soy isoflavones to address those systemic symptoms. If someone has a racing mind or a component of anxiety that is disrupting sleep then we can add herbs like theanine, lavender, magnolia, ashwagandha.
Other important considerations are of course are what we put in our bodies during the day. I always advise not drinking caffeine after midday, finish eating 3 hours before going to bed, and avoid sugar and alcohol in the evening because they too can cause hot flashes and nighttime awakenings. Additionally, limiting evening liquid intake to decrease the need to urinate in the middle of the night. Check out my blog “Why Can’t I Sleep” for more tips.
So where does this leave us? The take-home point is that you don’t have to just “tough it out” when you can’t sleep. Herbs can be a fantastic way to support your sleep and build resilience as your hormones shift in perimenopause. If you find that botanical support isn’t quite enough, it may be time to discuss whether individualized hormone replacement therapy is a good next step for you.
Dr. Bronwyn Fitz is double board certified in Obstetrics and Gynecology and Integrative Medicine. If you would like to learn more about her practice or make an appointment, please visit her website and click on the “Get started” tab to set up a free 15-minute discovery call.
