Waking at 2am – 4am During Peri-Menopause or Menopause? Understanding Hormones, Insomnia & Poor Sleep
Minal Patel - Naturopath & Food Scientist | Bhimble Wellness
If you’re waking between 2am and 4am in the morning, staring at the ceiling, feeling exhausted and completely wired,
I want you to know, you’re not broken and you’re not alone.
Around 40–60% of women going through peri-menopause and menopause struggle with sleep in some way. Once you’re awake, your mind can start racing, anxiety creeps in and falling back to sleep feels impossible.
In addition to that you might be dealing with - hot flushes, night sweats, mood swings, brain fog, heavy periods, fatigue, weight gain - that’s a lot for one woman to carry.
There is help and there is support available. I can help you.
What Does Insomnia or Poor Sleep Feel Like in Peri-Menopause & Menopause?
Sleep issues can look very different for each woman, you might recognise some of these:
- Feeling exhausted but unable to fall asleep because your mind just won’t switch off.
- Waking between 2am–4am and struggling to get back to sleep.
- Waking up drenched in sweat, overheating or tossing the covers on and off due to hot flushes or night sweats.
- Racing thoughts, worry or anxiety at night.
- Light, restless, unrefreshing sleep and you wake up feeling tired and not rested.
- Becoming extra sensitive to noise (the cat, the fridge, your partner’s snoring).
- Feeling flat and fatigued during the day but wired at night.
- Feeling more irritable, overwhelmed, less patient and less able to cope with stress.
If your sleep feels completely broken, it’s not because you’re “coping badly.” It could be your hormones.
What do my Hormones Have to do With Insomnia or Poor Sleep?
During peri-menopause and menopause, your key hormones, estrogen and progesterone start to fluctuate and eventually decline. Here’s how that can affect your sleep:
Estrogen (Estradiol) Changes - Lower estradiol levels can disrupt your circadian rhythm which is your internal body clock. Your circadian rhythm controls your sleep–wake cycles, melatonin production, body temperature, mood, digestion and energy levels.
Progesterone Decline - Progesterone has a calming, soothing effect on the nervous system. As your progesterone drops, your sleep can become lighter while anxiety and your nervous system sensitivity may increase.
High Estrogen Phases in Peri‑Menopause - In early peri-menopause, estrogen can spike high before it declines. High estrogen can raise your histamine levels, which may cause wakefulness and those classic 2am-4am wake-ups.
Cortisol & Blood Sugar - Cortisol is your stress hormone, when your blood sugar drops and estrogen fluctuations can all trigger early-morning waking.
Your body isn’t failing you, it’s speaking to you.
Other Things Worth Ruling Out
Sometimes sleep issues aren’t just hormonal and they may be due to other reasons.
It’s always worth checking in with your GP or health practitioner to rule out and investigate some of the things below:
- Iron Deficiency – low iron can cause restlessness, anxiety, fatigue and poor sleep.
- Vitamin B12 Deficiency – can contribute to night waking, nerve sensitivity and fatigue.
- Magnesium Deficiency – often linked with muscle tension, restless sleep and anxiety.
- Sleep apnoea – especially if you snore, wake unrefreshed, or feel very tired during the day.
- Restless leg syndrome – uncomfortable leg sensations that worsen at night.
- Thyroid imbalances – an overactive thyroid or under-active thyroid can disrupt your sleep.
- Fibromyalgia or chronic pain conditions – pain and nervous system sensitivity can disrupt your sleep.
Sometimes insomnia is simply your body waving a little flag saying: “I need some support.”
Simple and Gentle Ways to Support Better Sleep
These are small, realistic steps you can take to get a better nights sleep. Some of these include:
Having a Balanced Evening Meal – this should include protein, healthy fats and complex carbohydrates at dinner. This will help stabilise your blood sugar overnight and prevent cortisol spikes that may wake you up.
Support Your Sleep Hormone (Melatonin) - Reduce screen time 30–60 minutes before bed. Dim lights in the evening to help your body recognise it’s time to wind down and get ready to sleep.
Keep Your Sleep Space Cool - Light bedding, breathable fabrics and a slightly cooler room can reduce night waking from overheating.
Adequate Iron Intake - Iron deficiency can contribute to insomnia. Make sure you’re eating enough iron-rich foods and testing your iron levels if needed.
Be Mindful With Caffeine - Try having your coffee earlier in the day and avoid caffeine too late in the afternoon.
Calm Your Nervous System - Gentle breathing, stretching, journalling, prayer or a simple wind-down routine signals safety to your body and that it’s time for bed.
Remember to be kind to yourself. Poor sleep is a symptom, it’s not a personal failure
If insomnia has slowly become your “normal” I see you. You’re not alone.
Are You Ready For Support?
If insomnia or poor sleep is affecting your energy, mood, relationships or daily life, you don’t have to figure this out on your own.
With the right support, it is possible to sleep better. feel calmer, more energised and like yourself again.
Book a complimentary Hormonal Wellness Discovery Call.
Together, we’ll explore your hormones, stress levels, metabolism, gut health and lifestyle. I will create a personalised plan to help you feel calm, in control and sleeping well again.
With love & understanding,
Minal xx