Why Can’t I Sleep Anymore? Understanding Insomnia During Perimenopause
Many people expect hot flashes during perimenopause. Fewer expect to suddenly find themselves having a hard time sleeping, lying awake at 2 a.m., waking repeatedly throughout the night, and/or feeling exhausted and not quite like themselves.
If this sounds familiar, you're not alone.
Insomnia is one of the most common symptoms I treat in people experiencing perimenopause.
WHY is this happening all of a sudden?
During perimenopause, Estrogen and Progesterone fluctuate dramatically. These hormones don't only affect reproductive health, your hormones also influence the brain chemicals that regulate sleep and mood.
Estrogen interacts with neurotransmitters like serotonin, GABA, and melatonin, all of which play important roles in helping us fall asleep, stay asleep, and wake feeling rested.
As these hormones change, many people notice:
Difficulty falling asleep
Waking between 2–4 a.m.
Night sweats
Anxiety
Brain fog
Fatigue
Feeling "wired but tired"
Where Does Acupuncture Fit?
Acupuncture has been increasingly studied as a safe and effective treatment for Insomnia during Perimenopause.
A 2025 systematic review and meta-analysis examined 12 randomized clinical trials involving nearly 1,000 participants experiencing perimenopausal insomnia. These researchers found that Acupuncture was associated with improved sleep quality and concluded that it can help with perimenopausal insomnia.
And How Does Acupuncture Work with Insomnia?
Research suggests Acupuncture can affect the nervous system and the same neurotransmitter pathways involved in sleep—including GABA, serotonin, and melatonin.
GABA is the brain's primary calming neurotransmitter, helping quiet neural activity so you can relax and fall asleep. As estrogen levels fluctuate and eventually decline during perimenopause, GABA signaling may become less effective, contributing to insomnia, increased anxiety, and nighttime awakenings.
Researchers have found that Acupuncture, especially the combination of acupuncture points Heart 7 and Spleen 6 work on GABA pathways and can increase the amount of GABA in cerebrospinal fluid of the brain. An increase in GABA will quiet the central nervous system prior to sleep.
Awwwww sweet sleep relief.
Some Things I Want to Say Clearly:
Perimenopause is something I treat well regularly. Especially those struggling with Insomnia
Perimenopause affects much more than your reproductive health!
Hormonal Health is Everything
It’s Sleep, Energy Levels, Mental Health, Brain Function, Bone Health, Headache and Migraine Support, and More!
Of course, I love to help everyone sleep better- whether you are going through Perimenopause or not.
Nice thing about Acupuncture is we are treating things both specifically and holistically. We can focus on the symptom and the context, while also looking at how everything is connected. Which is especially important with Hormonal Health where so many different body systems are affected by your Hormones!
