Can’t sleep, won’t sleep? 7 tips for a better kip in surgical menopause
If you’ve found yourself staring at the ceiling at 3 am, drenched in sweat, heart racing, and wondering if you’ll ever sleep again — you’re not alone. Insomnia is one of the most common and distressing symptoms of surgical menopause, and for many women, it arrives suddenly and without warning.
When both ovaries are removed, oestrogen, progesterone and testosterone levels plummet overnight. In natural menopause, this decline happens slowly; in surgical menopause, it’s instant — more like falling off a hormonal cliff. The shock to your system can cause intense night sweats, anxiety, racing thoughts, and a body that simply can’t switch off.
Women who experience medical menopause (from chemotherapy or hormone-suppressing treatments) often describe the same crash. Whether temporary or permanent, the result can be sleepless nights that erode confidence, energy, and mental wellbeing.
Here’s 7 tips to overcome insomnia (and why it happens)
1. Rebalance your hormones (if you can take HRT)
For women who are able to take hormone replacement therapy (HRT), it’s usually the most effective way to improve sleep. Oestrogen replacement helps regulate body temperature and serotonin levels, while micronised progesterone (like Utrogestan) can support deeper, more restorative rest thanks to its natural calming effect on the brain’s GABA receptors.
If you can use it, transdermal oestrogen (patches, gels, or sprays) combined with progesterone and, in some cases, testosterone, can dramatically improve sleep and overall wellbeing within weeks. Always start under clinical guidance, as dosing and absorption vary — especially after surgical menopause.
2. Cool your body to calm your brain
When oestrogen levels drop, the body’s thermostat becomes unpredictable. Hot flushes and night sweats trigger adrenaline, keeping you alert when you most need to rest.
Keep your bedroom cool (ideally 18 °C or less), use breathable cotton bedding, and try moisture-wicking nightwear - we love cotton muslin pjs. Some women find chilled gel pillows or a cool shower before bed helps lower core temperature and reduce sudden awakenings if night sweats are keeping you awake.
3. Build daytime habits for night-time rest
Ironically, sleep starts with what you do when you’re awake and our day to day activities can impact our night-time rest. Movement – especially outdoors – helps regulate circadian rhythm and boosts the release of melatonin later on.
Aim for 30 minutes of natural light and gentle exercise daily, such as walking, yoga or swimming – no need for HIIT classes! Avoid long naps during the day as these can fragment nighttime sleep, and try to keep consistent waking and bed times, even at weekends.
Reducing caffeine such as tea, coffee and coca cola can help with any jittery feelings that are making you restless. And finally, stop doomscrolling yourself into sleep – leaving your phone in another room is a great way to unwind before you get into bed.
4. Add magnesium-rich foods into your day to day meals
When hormones crash, blood sugar swings can worsen insomnia and anxiety. Focus on slow-release carbohydrates, lean protein, and healthy fats (especially omega-3s).
Magnesium-rich foods such as leafy greens, almonds, pumpkin seeds, and dark chocolate can promote calm, while reducing caffeine, alcohol and ultra-processed foods can ease night-time restlessness. Whether you are taking HRT or not, good nutrition supports our hormone metabolism and bone health while nourishing us from the inside out.
5. Reduce and manage stress as much as you can
It’s easy to say “reduce stress”, but the reality is that for many of us, surgical menopause can be a source of stress in itself. Reducing stress that occurs both externally and internally is important for our body and mind – and especially our sleep.
Cortisol, the stress hormone, naturally rises in the morning — but chronic stress keeps it elevated into the night, leaving us unable to sleep, no matter how many sheep we count.
Gentle mindfulness, breathing exercises, or progressive muscle relaxation before bed can help your body transition into sleep mode. Try guided meditations, a warm bath, or writing thoughts down before you lie down — anything that signals safety and calm to the nervous system. Moving your body during the day, and trying mindful activities such as yoga, breathwork or meditation can support your body to regulate stress.
6. Alternatives to consider if you can’t take HRT
For women who can’t use hormone therapy due to breast cancer or other contraindications, small daily habits become your best medicine. Focus on consistency: a cool, dark bedroom, low evening light exposure, and winding down at least an hour before bed.
Avoid doom-scrolling or late-night emails, and consider cognitive behavioural therapy for insomnia (CBT-I), which has strong evidence for improving sleep even in menopausal women. Certain non-hormonal medications (like SSRIs or gabapentin) can help with hot flushes and anxiety — talk to your GP or menopause specialist about options.
Magnesium glycinate can also help improve sleep by increasing GABA levels, which calms the brain, and by potentially lowering core body temperature to aid sleep initiation and maintenance.
7. Be kind to yourself
Poor sleep can leave you emotional, foggy, and fragile. Remember that this isn’t your fault — it’s biology, not weakness, and you are in one of the most challenging hormonal states that we can be.
Finding moments to rest and prioritising self care (and we don’t just mean a hot bath here) can help when you are struggling at night. Find moments during your day for you – gentle stretches, meditation, or simply lying quietly can help restore your nervous system. Every small step counts toward recovery and healing of your body during surgical menopause.
