Do you go to bed only to find yourself staring at the ceiling with what seems like a million things running through your head?  Sometimes it can feel like negative thoughts and worries are on repeat.

Rumination (repetitive thinking) is usually associated with anxiety and stress. You may find yourself worrying obsessively about something in particular during your waking hours to the point where it affects other aspects of your life and possibly your relationships. And when it occurs when you are settling in for sleep, it is also considered a symptom of insomnia.

Why does rumination occur?

  • Fluctuations in hormones has been linked to anxiety and mood disorders, and is associated with rumination. Women are more prone to increased symptoms of anxiety and mood disorders as estrogen and progesterone decline in menopause.
  • Medications may also impact your sleep, causing rumination and insomnia.
  • Caffeine can also make it difficult to fall asleep and in turn cause your mind to race more.
  • Stress is a major contributor to racing thoughts any time of day. Major life transitions and stress at home, work, financially and more can cause rumination as you try to fall asleep.

How to manage repetitive thoughts

Build your resiliency to counteract stress and its adverse effects. Start with learning what stress feels like in your body. Practicing a body scan can help you become more in touch with your body, noticing areas of tension, and then working on releasing them.

Practice Mindfulness. Mindfulness is defined as a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations. For busy, stressed people, this may seem impossible to achieve. But even just a few minutes during the day or before you go to bed, taking several deep, intentional breaths can have a very positive effect on helping you find your calm, control repetitive thoughts, and fall asleep. If you are unsure how to get started, there are many apps like InsightTimer and Headspace that can help you begin your mindfulness practice.

Try yoga nidra. Yoga nidra means "yogic sleep", and is a deep relaxation technique and a form of meditation. In this practice, the body is completely relaxed and your awareness is turned inward by listening to a set of instructions (much like a guided meditation).  

Start a bedtime journal. The practice of writing down your thoughts and feelings from the day can help to lower stress.  Research suggests that journaling can help us accept rather than judge our mental experiences, resulting in fewer negative emotions in response to stressors.

Set yourself up for a good night’s sleep. Get started by getting some exercise during the day, be consistent with the time you go to bed, avoid caffeine and alcohol in the hours leading up to going to sleep, turn off screens at bedtime, and keep your room cool and dark.

If your repetitive thoughts at bedtime just won’t quit, you may consider visiting with your doctor or therapist for support. Dr. Rebecca Dunsmoor Su, Gennev’s Chief Medical Officer shares, “We often recommend cognitive behavioral therapy for insomnia.” Cognitive behavioral therapy is a style of therapy that identifies negative behaviors, and works to manage them in amore effective way. Cognitive behavioral therapy for insomnia very specifically tracks behaviors around sleep, such as when you go to bed, what you do when you wake in the middle of the night, what things you include in your bedtime ritual, as well as what you do when you wake in the morning. Ultimately the therapy will work to adjust those habits to improve your sleep.”

You may also try working with a menopause specialist to learn about prescription and natural treatments, optimize your wellness (nutrition, movement, mindfulness) and identify lifestyle modifications (such as a new sleep ritual) that will support better sleep.


The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause”can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev's telemedicine doctors before beginning any new treatment or therapy.


Ann Marie MacDougall

October 28, 2022

Medically Reviewed By

Dr. Lisa Savage

Board-Certified Obstetrician & Gynecologist

Subscribe for our weekly newsletter for helpful articles sent straight to your inbox:

Recommended Products

Sleep Supplement

Sleep Supplement

Are racing thoughts keeping you awake at night? Gennev’s Sleep for Insomnia & Anxiety Relief in Menopause supplement is specially formulated to help women with falling asleep and staying asleep.

Podcast episode available on Spotify Podcasts

Have you taken the Menopause Assessment?

Join 200,000 women to learn more about your symptoms and where you are in the menopause journey.