Can perimenopause disturb sleep?
Raise poor sleep with a clinician, and bring a two-week sleep log with your doses and cycle dates beside it. The pages linked below describe the menopause transition in general.
Sorting out what is going on
Note when the problem started and whether it lines up with changes to your cycle, your routine or your medicines. The FDA's menopause page and the Office on Women's Health menopause page describe menopause symptoms in general. The Menopause Society's sexual health pages are mainly about sexual health, so use them for that part of your questions.
Two weeks of sleep notes before your visit
Keep a sleep log for two weeks: bedtime, wake time, what woke you, and any doses taken or missed. Add cycle dates if you track them. At your visit, ask what could explain the pattern and whether your plan or its timing should change. If you take a medicine in the evening, ask whether the time of day matters.
Who adjusts the timing of a medicine
Logging sleep alongside a therapy plan gives your clinician something concrete, and any change to when or how you take a medicine is for your prescriber to make.