Hormonal Insomnia-from Puberty to Menopause
If sleep is hard to come by, there’s a good chance your hormones are involved. The most obvious time this shows up is during perimenopause and menopause. Night sweats or hot flashes can make uninterrupted sleep feel impossible.
But hormonal imbalances can affect sleep across many stages of life—not just menopause. So let me take you through some of the most common scenarios I’ve seen in my clinic over the (almost) past two decades.
Womb care in this day and age
In today’s world, we often ignore the womb in our younger years (think birth control in the teens and twenties), then demand it “perform” in our thirties and forties (to make and carry babies), and later find ourselves frustrated with it in our forties, fifties, and beyond—when symptoms bring it into sharp focus, demanding attention more than ever before.
Most of us are disconnected from our womb, from this powerful core space that, according to some traditions, holds our intuition.
In Chinese medicine, the womb is directly connected to the heart, which is considered the home of spiritual consciousness in women.
Honoring and tending to our womb (whether we’re menstruating or not) not only supports hormonal health, it also activates a kind of sixth sense we women can access more powerfully. It helps us drop from the busy mind into the body, which, when asked, can speak with clarity and power.
Hormonal awakening in the teens and twenties—how we shape what’s to come
I grew up in a religious culture where menstruation was considered “unclean.” I wasn’t allowed to go to church on my period. That message that something was wrong with my body was internalized early.
Perhaps your experience was different. At best, you might’ve had a family that honored your first cycle with some kind of ritual. Maybe it embarrassed you at the time, but this kind of recognition can ripple positively for years.
The opposite sends the message that something is wrong with us and our bodies. It encourages shame and secrecy around what is, in fact, a beautiful cycle of monthly preparation for life, whether or not conception occurs. That shame often manifests as pain and other symptoms.
In the US, it’s common to go on birth control during this stage, either for contraceptive reasons or to regulate irregular cycles. That’s understandable. But we also need to recognize that hormonal suppression during these years can lead to long-term imbalances.
Teens and young adults with insomnia often have stress at the root of their sleeplessness. But I also see hormones playing a subtle but important role. Birth control can affect mood, sleep, weight, and even bone density, years later.
This brings us to a big question: how mature is the person when it comes to preventing pregnancy without birth control? That’s a real responsibility. If someone chooses to stay on the pill, I always recommend supplementing with key nutrients that tend to be depleted, including folate, vitamins B2, B6, B12, C, and E; and minerals like magnesium, selenium, and zinc.
Insomnia and hormonal shifts in your 30s and 40s
So much happens in our 30s and 40s, from baby-rearing to (possibly) IVF, to perimenopause, and sometimes even menopause.
Giving birth is a wild adventure. And for some women, the sleep deprivation of early motherhood can turn into long-term insomnia. Even when the baby starts sleeping through the night, the mother’s nervous system often does not (they “sleep with one eye open”, in case the baby needs something).
Childbirth also brings big hormonal shifts, often leading to estrogen and progesterone imbalances. This is when the body truly needs support, it’s been through a lot.
One thing I observe often: the sheer amount of responsibility placed on women in our culture. It goes far beyond child-rearing and many mothers don’t have family systems nearby for daily support, on top of that many mothers are also working full-time jobs.
IVF adds another layer for some women. It’s a miracle of modern medicine, and I celebrate that we have it. But I also encourage women not to take it lightly. Support your body—acupuncture, herbs, massage, nourishing foods, and yes, sleep—can help the womb recover from the intensity of the process.
And then there’s perimenopause, which can last up to 12 years. For some, signs begin in their late 30s; for most, it starts in their 40s.
As ovarian reserve declines, the brain increases stimulation to the ovaries. This leads to higher estrogen levels, but ovulation becomes irregular, meaning less progesterone. As a result, cycles become shorter, heavier, more irregular.
Sleep often becomes difficult the week before menstruation. Hot flashes and night sweats may also begin.
Is it possible to transition into menopause more gracefully?
Yes—but it takes months or even a year of preparation, and very intentional care as symptoms emerge.
Acupuncture can help regulate the hormones you do have. Supporting your adrenals and nervous system also makes a big difference. And don’t underestimate the emotional dimension. Working with a therapist or spiritual guide can help you process the identity shift that often comes with this stage of life.
Stepping into Menopause: 40s, 50s, and Beyond
Many women are relieved to stop menstruating, but that doesn’t mean there’s no grief. There’s a reckoning: we are in a new phase now. And when symptoms are intense, life can feel overwhelming.
We need to consider the impacts of lower hormones:
How do we protect our bones?
How do we reduce the risk of heart disease?
How do we care for our skin so we can age slowly and still feel beautiful?
And then there’s the big question: to use hormone replacement therapy (HRT), or not?
It’s not a simple decision. You’ll want to consider your family history, symptoms, overall health and, most importantly, listen to your body.
Drop into your womb and ask what it needs. Let the answer come over days or weeks. You may want someone to walk that journey with you: a therapist, a healer, a shaman, a wise friend. Honor your body, and it will often respond with more ease.
How can natural medicine support you through perimenopause and postmenopause?
There are many supportive tools and therapies—herbs, supplements, acupuncture, breathwork, massage—that can help ease this transition. These can often be used alongside conventional treatment.
Acupuncture is one of the safest, most natural therapies that exists. It works by optimizing your body’s resources, using fine stainless steel needles to stimulate key pressure points that regulate hormonal, nervous, and metabolic functions.
Functional medicine offers tests like DUTCH (Dried Urine Test for Comprehensive Hormones), salivary cortisol testing, and other labs based on your individual needs. These tools can help inform decisions about nutrition, supplementation, and other strategies to support your wellbeing through this phase.
Breathwork, especially the Buteyko method, has been a core tool in my practice. Menopause can change the way women breathe—whether or not they have sleep apnea—which is why breath training can be profoundly helpful.
What matters most is that your decisions—whether HRT, natural therapies, or both—come from a place of trust, not fear. The body responds best when it feels listened to and honored.
Sleep support: insomnia, sleep apnea, and more
Most of my patients have some hormonal connection to their sleep challenges, sometimes as the main root cause, other times as part of a bigger picture.
Acupuncture has been my core modality for almost 20 years. I’ve worked with patients who can’t use herbs or supplements due to clotting disorders or cancer history—and we’ve made real progress using acupuncture and breathwork alone.
With others, I integrate functional medicine principles: nutrients, herbs, and personalized plans that gently guide the body toward balance.
💛 If you’d like to explore working with me, book a free consult here
📘 Curious to learn more? Check out my book The Deep Blue Sleep—there’s an entire chapter on Hormones and Sleep.
