The short answer
Yes, many women take melatonin during perimenopause. For women over 40, a low dose is the place to start: about 0.5 mg to 3 mg, taken before bed at the same time each night. Your body makes less melatonin as you age, so the goal is to support that signal, not flood it.
Melatonin is not hormone therapy. It will not stop hot flashes. But it can support your body clock while the rest of your body is changing.*
Key takeaways
- Sleep trouble is more common in the years around menopause.1
- Melatonin levels fall with age. In one study, women past menopause had lower night melatonin than women in perimenopause.2,3
- A small dose matched normal night levels in adults over 50. A larger dose pushed levels into the next day.4
- Melatonin does not treat hot flashes or night sweats. It works on timing, not hormones.
Why does sleep change in perimenopause?
I see this at home. My wife lies awake at night while her mind keeps running: the kids, her work, her deadlines, whether she remembered to sign up for her fitness class. When she does sleep, she often wakes up well before her alarm and just turns it off.
Then the day starts. She gets the kids ready and off to school, and she has to be fully present at work until evening. What she needs is sleep that actually restores her, so she can feel like herself again.
She is far from alone. In a large survey of women at midlife, sleep trouble rose in the years around menopause.1 Several things change at once:
Hormones
Shifting estrogen and progesterone can affect sleep and body temperature.
Night sweats
Hot flashes at night can wake you and make it hard to settle again.
Melatonin
Your body's night signal gets weaker with age.2,3
A busy mind
Work, family, and a long to do list follow you to bed. With age, sleep later in the night also gets lighter, so small things wake you.5
Melatonin speaks to only one of these: the night signal. That is why I think of it as one helpful piece, not the whole answer.
Why I started looking into low dose melatonin
I trained as a nurse. In the emergency room, poor sleep was not a one off. Many of my colleagues told me they were not sleeping, yet they had to be sharp for a 12 hour shift and ready for whatever came through the door.
Years later, friends who tried melatonin kept telling me the same thing. It left them feeling too drowsy in the morning, like they were walking around in a fog. That made me curious, so I started reading.
Here is what I found:
- Many melatonin products on pharmacy shelves hold 5 mg to 10 mg.
- Your body makes far less than that, and it makes less as you age.2,3
- In Europe, the official sleep claim for melatonin is based on just 1 mg.11
- Melatonin is a chronobiotic. It is a time signal that tells your body when night has started. When that signal fades, it gets harder for your body to know it is time to sleep.
That changed how I thought about it. If the signal is fading, a small, steady dose made more sense to me than a flood.
Can I take melatonin during perimenopause?
For most women, yes. Melatonin is a natural hormone your body already makes. A 2017 review of sleep and the menopausal transition noted that melatonin may improve sleep quality in women at this stage.6
Talk to your doctor or pharmacist first if you take prescription medicine, including hormone therapy, blood thinners, or medicines for blood pressure, blood sugar, or mood. Melatonin can interact with some medicines. Read can you take melatonin with HRT and melatonin and blood pressure.
How much melatonin should women over 40 take?
Start low. Sleep doctors point to a range of about 0.3 mg to 3 mg for sleep. That is far below the 5 mg and 10 mg doses that fill store shelves.
| Dose | What to know for women over 40 |
|---|---|
| 0.3 to 1 mg | A gentle place to start. 0.3 mg matched normal night levels in adults over 50.4 1 mg is the amount behind the EU sleep claim.11 |
| 1 to 3 mg | Still inside the range sleep doctors point to. |
| 5 to 10 mg | Common in stores, but well above what your body makes. More likely to leave you groggy.4,7 |
On a phone, swipe the table sideways to see every column.
I explain dose in more detail in my guide to melatonin dose for adults.
When should I take it?
Take melatonin before bed, at the same time every night. In the MIT study, adults over 50 took it 30 minutes before bed.4 If your main trouble is falling asleep, some sleep doctors suggest taking it earlier, up to two hours before bed. Follow your product's label and your doctor's advice.
Consistency matters more than the exact minute. Melatonin is a time signal, and a signal works best when it arrives at the same time each night.
What if you wake at 3am?
This is the most common thing I hear from women in perimenopause. Here is the honest answer.
For waking in the middle of the night, some sleep doctors use a slow release form of melatonin that keeps working for hours.8 Most melatonin, including strips, is not slow release. It supports the start of your night. A low dose at bedtime can support your body clock, but I cannot promise it will stop every 3am wake up.
If 3am waking is your main problem, start with the free changes in why you keep waking up at 3am, and talk to your doctor about what fits you. Do not take a second full dose in the night. It can leave you foggy in the morning. Read more in why you feel groggy after melatonin.
There is no magic pill
Friends who sleep badly often tell me they wish there were a magic pill. Something to help them fall asleep, stay asleep, and wake up ready for the day ahead.
I wish that too. But there is no magic pill, and melatonin is not one. What I suggest is simpler:
- Start low. Begin near 0.5 mg to 1 mg, not 5 mg or 10 mg.
- Same time every night. Take it before bed, on weekends too.
- Pair it with light. Get morning daylight and keep evenings dim. Light is the other half of your body clock.
- Give it a few weeks, then check in. Some sleep doctors suggest trying melatonin for 4 to 12 weeks, then reassessing with your doctor.
- Choose a tested product. Many melatonin products do not match their labels.9
My pick
Why I chose a 1 mg strip
When I looked for something for women like my wife, I wanted a low dose that would not leave them foggy the next morning. 1 mg is in the low range, much closer to what your body makes than 5 mg or 10 mg. That is why I chose Driffly Night Reset Strips.
- 1 mg of melatonin, inside the range sleep doctors point to.
- Valerian root, lavender, chamomile, and hibiscus to support a calm wind down.*
- Melts on your tongue. No water at bedtime, which helps if night bathroom trips wake you.
- Sugar free.
Every order comes with a 30 night money back guarantee.
Common questions about melatonin and perimenopause
Can I take melatonin during perimenopause?
For most women, yes. Start with a low dose before bed. Check with your doctor or pharmacist first if you take prescription medicine, including hormone therapy.
Does melatonin decrease with menopause?
Yes. Your body makes less melatonin as you age, and in one study, women past menopause had lower night melatonin levels than women in perimenopause.2,3
How much melatonin should I take for menopause?
Start low, at about 0.5 mg to 1 mg, and stay within the 0.3 mg to 3 mg range sleep doctors point to. In adults over 50, just 0.3 mg brought night levels back to normal.4 Read my melatonin dose guide for more.
Is melatonin good for perimenopause?
It can be one helpful piece. A 2017 review noted that melatonin may improve sleep quality during the menopausal transition.6 It supports your body clock, but it does not treat hot flashes, mood changes, or other hormone symptoms.
Does melatonin affect estrogen or other hormones?
Melatonin is a hormone itself, and research on whether supplements change estrogen levels in women is limited. A low dose is closest to what your body makes on its own. If you take hormone therapy, note that estrogen may raise melatonin levels, so ask your doctor or pharmacist before adding melatonin. Read can you take melatonin with HRT.
What is the best melatonin for menopausal women?
Look for a low dose, about 0.5 mg to 3 mg, from a brand that tests its product with an outside lab. Pick a format you will take every night. For many women over 40, I think a low dose strip fits best, since it needs no water at bedtime.
What is the downside of taking melatonin every night?
Higher doses can leave you groggy, with headache or dizziness.7 Information on long term safety is still limited.10 That is why some sleep doctors suggest a trial of a few weeks, then a check in, rather than taking it forever without a plan.
Why shouldn't you take melatonin if you are under 55?
There is no rule against it. The age 55 comes from Europe, where a prescription slow release melatonin is approved for adults 55 and older.8 That is because melatonin levels fall with age. Supplements sold in the US are for adults, and a low dose is a sensible place to start at any age.
Does melatonin help with hot flashes?
No. Melatonin is not hormone therapy, and it does not treat hot flashes or night sweats. If those keep waking you, talk to your doctor about options.
Is melatonin safe with hormone therapy?
Ask your doctor or pharmacist. They know your full medicine list and can tell you what fits. Read melatonin and HRT for what to ask.
Can I take melatonin if I am on a GLP-1 in menopause?
Ask your pharmacist first, since GLP-1 medicines can change how other pills are absorbed. Read GLP-1s in menopause: night sweats, HRT, and sleep.
When should I talk to my doctor?
Talk to your doctor if poor sleep lasts more than a few weeks, if night sweats keep waking you, or if you snore loudly or wake up gasping. Sleep apnea, restless legs, and thyroid problems can also disturb sleep at midlife, and no supplement will fix them. Check with your doctor or pharmacist before using melatonin if you are taking prescription medicine.
Sources
- Kravitz HM, Ganz PA, Bromberger J, Powell LH, Sutton-Tyrrell K, Meyer PM. Sleep difficulty in women at midlife: a community survey of sleep and the menopausal transition. Menopause. 2003;10(1):19-28.
- Karasek M. Melatonin, human aging, and age-related diseases. Experimental Gerontology. 2004.
- Toffol E, Kalleinen N, Haukka J, Vakkuri O, Partonen T, Polo-Kantola P. Melatonin in perimenopausal and postmenopausal women: associations with mood, sleep, climacteric symptoms, and quality of life. Menopause. 2014.
- Zhdanova IV, Wurtman RJ, Regan MM, et al. Melatonin treatment for age-related insomnia. The Journal of Clinical Endocrinology and Metabolism. 2001;86(10):4727-4730.
- Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals. Sleep. 2004;27(7):1255-1273.
- Jehan S, Jean-Louis G, Zizi F, et al. Sleep, melatonin, and the menopausal transition: what are the links? Sleep Science. 2017;10(1):11-18.
- Mayo Clinic. Melatonin side effects: What are the risks? Expert Answers, Adult Health.
- European Medicines Agency. Circadin (melatonin 2 mg prolonged-release tablets): product information.
- Cohen PA, Avula B, Wang YH, Katragunta K, Khan I. Quantity of melatonin and CBD in melatonin gummies sold in the US. JAMA. 2023.
- National Center for Complementary and Integrative Health. Melatonin: What You Need To Know.
- European Commission. Commission Regulation (EU) No 432/2012 establishing a list of permitted health claims made on foods (melatonin: reduction of time taken to fall asleep, at least 1 mg per portion). 2012.
Tyler Smith, RN, BSN, BA is a registered nurse and the founder of Driffly. He writes and reviews the articles in the sleep guide. About Tyler
The author is the founder of Driffly, which sells the product mentioned in this article. This article is for education and is not medical advice. *These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.