Does melatonin help with weight gain during perimenopause?

The honest answer is that melatonin does not directly cause weight loss, but there is a meaningful indirect pathway worth understanding. During perimenopause, weight gain is rarely a single-cause problem. It involves shifting estrogen levels, slower metabolism, gradual muscle loss, increasing insulin resistance, and, critically, disrupted sleep. Melatonin's most plausible contribution to managing perimenopausal weight gain runs through that last factor.

The sleep-weight connection is well supported by research. A study by Spiegel et al. (2004) demonstrated that even short-term sleep restriction significantly disrupted the balance of ghrelin and leptin, the hormones that regulate hunger and fullness. Sleep-deprived participants had higher ghrelin (which drives appetite) and lower leptin (which signals satiety), and they consumed noticeably more calories when given access to food. During perimenopause, night sweats, anxiety, and general sleep fragmentation compound what is already a biologically vulnerable period for weight regulation. If melatonin helps restore more consolidated and restorative sleep, it may indirectly reduce the appetite dysregulation that contributes to gradual weight creep.

Melatonin levels decline during the perimenopausal transition. Toffol et al. (2014) found that lower melatonin correlated with more sleep complaints in perimenopausal women. Bellipanni et al. (2001) studied melatonin in perimenopausal women and reported improvements in mood, wellbeing, and sleep, though the study was not designed to measure weight as a primary outcome. Some animal research has suggested melatonin may influence metabolism and fat distribution directly, including effects on brown adipose tissue activity, but human evidence for a direct fat-loss effect remains limited and should not be the basis for using melatonin as a weight management strategy.

Studies have used doses ranging from 0.3 mg to 5 mg. Research by Zhdanova et al. (2001) found that a low dose of 0.3 mg was effective for improving sleep onset and quality in middle-aged adults, making it as effective as higher doses with fewer side effects. Talk to your healthcare provider about the right dose and timing for your situation. Melatonin can interact with insulin sensitivity in some individuals, so if you are managing blood sugar alongside weight, that is worth discussing with your provider.

If perimenopausal weight gain is your concern, the most effective combination remains the fundamentals. Strength training preserves and builds muscle mass, which is the primary driver of resting metabolic rate and tends to decline after 40 unless actively maintained. Adequate protein intake spread across meals supports muscle protein synthesis and reduces appetite. Managing refined carbohydrate and alcohol intake reduces the insulin spikes that encourage fat storage. And protecting sleep quality ties all of these efforts together, because sleep deprivation undermines motivation, increases cravings for high-calorie foods, and disrupts the hormonal signals that normally communicate fullness.

Melatonin fits best as a sleep support tool that may indirectly support this broader effort, not as a weight loss supplement on its own.

It is also worth noting how cortisol interacts with weight during perimenopause. When sleep is consistently poor, cortisol levels tend to be chronically elevated. Cortisol promotes fat storage, particularly in the abdominal area, and it increases glucose production in the liver, which contributes to insulin resistance over time. This creates a cycle where poor sleep drives higher cortisol, which promotes abdominal fat gain, which further disrupts metabolic function. By helping stabilize the sleep-wake cycle and potentially reducing the overnight cortisol burden that comes with fragmented sleep, melatonin may have a modest role in interrupting that cycle. This remains a plausible mechanism rather than a proven one, but it adds another layer to why improving sleep matters so much for weight management during perimenopause.

Using PeriPlan to track both sleep quality and weight-related patterns together, such as appetite, energy for exercise, and food choices, helps you see whether better sleep correlates with more manageable cravings or more stable weight over time. This kind of longitudinal self-tracking often surfaces connections that individual days obscure.

When to see a doctor. If you are experiencing rapid or unexplained weight gain, especially alongside fatigue, cold intolerance, constipation, dry skin, or hair changes, ask your provider to check thyroid function. Hypothyroidism becomes more common in midlife and can present in ways that closely resemble perimenopausal weight gain. Also speak with your provider before starting melatonin if you have diabetes, take blood thinners, immunosuppressants, or any sedative or sleep medications, as interactions are possible. For persistent or significant weight gain that does not respond to lifestyle adjustments, a comprehensive evaluation is the right next step.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.