April Spencer, M.D., explains how postpartum hormonal changes can affect mood, sleep, hair, skin, sexual health, and overall well-being—and when symptoms deserve medical attention.

Waking up at 3 am wide awake and unable to fall back asleep is one of the most disruptive symptoms of perimenopause, and one of the most misunderstood. Estrogen and progesterone both play a direct role in regulating sleep hormones and body temperature. When they fluctuate, so does your ability to stay asleep. Dr. April Spencer, M.D., breaks down the hormonal science behind midlife sleep disruption and the habits that research supports.