Emily Bassett, 3rd year medical student at Virginia Commonwealth University School of Medicine
Emily Bassett, Period Pro
It’s March, which means it’s Daylight Savings this month! While we all lose an hour of sleep as our clocks spring forward in the early hours of March 9th, it brings up an important question: what’s the relationship between sleep and the menstrual cycle?
As a matter of fact, sleep and the menstrual cycle are closely intertwined! There is evidence that the amount and quality of sleep can affect the menstrual cycle and vice versa. Turns out menstrual cycles can affect sleep too!
Let’s start with how the menstrual cycle may be affecting sleep. Remember, the menstrual cycle is dictated by a few hormones and defined by different phases, but the main players for this discussion are the hormones estrogen and progesterone. Progesterone levels peak during the luteal phase of the menstrual cycle, also known as the premenstrual phase before the period starts. There is evidence that progesterone levels have effects on other hormones in our bodies that control sleep quality, such as serotonin and GABA, making it more difficult to achieve a restful and restorative night’s sleep. Progesterone is also associated with increased core body temperature, which may make it difficult to fall asleep. It is also thought that there is a link between fluctuating estrogen and progesterone levels and amounts of REM sleep (an essential part of sleep that consists of dreaming) throughout the menstrual cycle, which may explain why some people experience restless sleep during certain times of their cycle.
It’s also important to mention how symptoms associated with periods and the premenstrual phase of the menstrual cycle have effects on sleep quality. Pain and cramping associated with periods may affect sleep quality. Additionally, changes in hormone levels around the premenstrual phase can cause changes in emotions and stress, which also can affect the ability to fall asleep and stay asleep.
So what about how sleep affects the menstrual cycle? Shorter sleep duration (less than 5-6 hours) is associated with more severe PMS (Premenstrual Syndrome), as well as abnormal menstrual cycles and heavy bleeding during periods. Additionally, poor sleep quality is associated with an increased number of painful periods. Poor sleep quality also increases the risk for menstrual cycle irregularity, such as prolonged or shortened periods or skipped periods altogether. Insomnia (a conditional that makes it difficult to fall asleep or stay asleep) has also been proven to cause an increased risk for menstrual cycle irregularity.
Let’s also not forget that there is a known link between sleep duration and stress levels. Fewer hours of sleep per night can increase stress.3 Increased stress can cause an increase in a hormone called cortisol, which can interfere with the hormones that control ovulation and the menstrual cycle. This can lead to prolonged, shortened, or even skipped periods!
So what can we do about all this to optimize sleep and feel better during menstrual cycles? First, sleep hygiene is essential! Be sure to avoid screens and electronics before bedtime. Maintain a consistent sleep schedule and create a healthy sleep environment, such as a cool, dark room. Pain control may also help with sleep quality. Remember, period pain can be relieved by exercise, heating pads, and over-the-counter medications such as ibuprofen and naproxen. Cognitive-Behavioral Therapy (CBT) or talk therapy has been shown to be effective in both stress reduction AND treatment of chronic insomnia.1 If hormones are significantly disrupting someone’s sleep, it’s essential to explore possible solutions—from personalized care and hormone management to lifestyle adjustments—to help improve rest and overall well-being.
Finally, as a general reminder, always talk to a healthcare provider if there are concerns about the relationship between sleep and menstrual cycle, or uncontrollable pain or menstrual irregularity.
- Rugvedh P, Gundreddy P, Wandile B. The Menstrual Cycle’s Influence on Sleep Duration and Cardiovascular Health: A Comprehensive Review. Cureus. 2023;15(10):e47292. Published 2023 Oct 18. doi:10.7759/cureus.47292
- Jeon B, Baek J. Menstrual disturbances and its association with sleep disturbances: a systematic review. BMC Women’s Health. 2023; 23(1). doi: 10.1186/s12905-023-02629-0
- American Psychological Association. (2013, January 1). Stress and sleep. https://www.apa.org/news/press/releases/stress/2013/sleep
- Sonnier S. How stress can affect your menstrual cycle. UT Health Houston: UT Physicians. August 2, 2022. Accessed March 9, 2025. https://www.utphysicians.com/how-stress-can-affect-your-menstrual-cycle/
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