The Gut–Sleep Connection: How Digestive Health Affects Your Nights in Perimenopause

Perimenopause |
4 min read

Written By

Brittany Dick

Published

December 31, 2025

Medically reviewed by

Alyssa Dweck MS, MD, FACOG, MSCP, Chief Medical Officer

It’s no secret that a late-night latte or heavy meal may potentially sabotage your restful sleep.¹

But did you know that one of the secrets to the gut–sleep connection runs even deeper than “no caffeine before bedtime”? Here, Bonafide Chief Medical Officer, Dr. Alyssa Dweck, talks through the connection between gut health and menopause—and what women can do to maintain a healthy gut microbiome to support better sleep in midlife.

Gut Health and Sleep: Perimenopause Edition

More than half of all women in menopause report trouble sleeping.² While common sleep hygiene hacks include taking steps to reducing night sweats, tweaking your bedroom temperature and trying blackout curtains, another potential approach that gets less attention is fine-tuning your diet to improve sleep in midlife.

A healthy, diverse gut microbiome—an ecosystem of bacteria, viruses, and fungi living within the digestive tract—is essential to optimal digestive, metabolic, and immune system functioning during menopause and beyond.³ And, according to Dr. Dweck, the gut microbiome can also play an important role in how women experience sleep, too.

“The gut microbiome, including the estrobolome, is linked to production and regulation of sleep related hormones: melatonin and serotonin,” explains Dr. Dweck. “Gut health influences melatonin, which relates to the body’s circadian rhythm, and serotonin, associated with mood and sleep, through the metabolism of tryptophan, an amino acid found in diet.”

The “estrobolome” Dr. Dweck is referring to is a subset of the gut’s microbiome responsible for metabolizing estrogen, a hormone that becomes volatile during perimenopause and then plummets during menopause.⁴ Without intervention, research shows the relationship between hormones, sleep, and the gut microbiome may contribute to a vicious cycle: as estrogen levels drop, both sleep and gut health may be altered .^5,6,7

Further, Dr. Dweck, suggests women in perimenopause and beyond may have altered tryptophan metabolism, an amino acid only available through diet.^8,9 Tryptophan is a precursor to the hormone, melatonin, which helps to regulate sleep, as well as serotonin, a neurotransmitter that influences mood, sleep, and appetite.^10,11

For these reasons, gut health may influence sleep more directly—and more powerfully—than most people realize.

Restoring Gut Balance for Better Sleep: Tips for Improved Perimenopause Digestion

So, is there any way to improve gut health during menopause for better sleep?

According to Dr. Dweck, there is! Her main takeaway is for women to consider a diet rich in foods that have been shown to help improve digestion and sleep in midlife.

“A Mediterranean-style diet, with plant-based foods rich in fiber such as fruits, vegetables, nuts, seeds, and whole grains, can help maintain the gut microbiome,” she says.

The Mediterranean diet Dr. Dweck mentions is known to increase microbial diversity, increase gut health, and potentially even lower the risk for some chronic diseases – it’s often a favorite of menopausal women.^12,13

Those wishing to incorporate the basic principles of the Mediterranean diet for improved sleep may consider consuming:^{14, 15, 16}

Whole grains from whole-wheat breads, brown rice, oats, quinoa, barley, etc.
Heart-healthy fats from extra virgin olive oil, olives, nuts, and fish
Moderate amounts of cheese and yogurt
Minimal red meat
Poultry, fish, or beans as protein sources (these are rich in tryptophan)
Minimal sweets and butter
Moderate amounts of wine/alcohol (or none at all)

In addition to altering diet for improved gut health and better sleep, Dr. Dweck says women may also consider trying to incorporate supplements known to benefit sleep, while under the guidance of a healthcare provider.

“Probiotics might be beneficial for some,” she adds. “Foods and supplements containing magnesium and antioxidants might be beneficial as well.”

While they’re no cure-all, probiotics have been shown to promote balance of beneficial bacteria, improve digestion, and support the immune system—all factors that influence how women experience sleep.^17,18

Magnesium is a mineral essential for healthy nerves, muscles, bones, and immunity—and also plays a major role in sleep by relaxing the muscles.^19,20 Women can choose to either supplement with magnesium or consume foods rich in magnesium, which include:

Magnesium-Rich Foods²¹

Leafy greens
Legumes (beans, edamame, etc.)
Nuts and seeds
Lean proteins
Whole grains
Low-fat dairy
Avocados
Bananas
Dark chocolate

When to Talk to a Healthcare Provider

If lack of sleep interferes with your quality of life, relationships, and more, talking to a trusted healthcare provider may help. Chronic poor sleep—with or without optimal gut health—may impair mental and physical health. A healthcare provider may be able to help by troubleshooting your symptoms or addressing the root cause.²²

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