"There is a particular kind of frustration that comes from being able to help someone almost all the way, and then watching them hit a wall when they meet the more traditional health system."
For Tine Hertz, Founder of One Thirty Labs and Copenhagen Health Week, that frustration became the starting point for her latest venture, NOMAE, a female health centre in Copenhagen built around a single conviction: that women's health deserves to be understood as a whole system, not a collection of symptoms. Here sleep is foundational, and as our conversation made clear, it is often the very first sign that a woman's hormonal transition has begun.
I sat down with Tine to talk about why she founded NOMAE, what the medical system keeps missing about women's bodies, and why sleep, of all things, turned out to be the thread running through it all.
The wall: where female health care stalls
The idea for NOMAE came out of years of work, and out of repetition. Tine had spent a long time working in health optimisation and longevity, with a lot of women among the people she was helping. The pattern kept surfacing.
"As much as we can do from a generalised perspective," she tells me, "really making a difference the way I wish to requires a lot of personalisation and precision." And when the target group is women, that precision runs into something specific. "It's really hard to push the needle without hormones, because they're part of the puzzle."
She describes the wall. She and her team could carry these women a certain distance, and then the women would be sent back to their own GP or gynaecologist, where the progress would stall. Dismissed. Left without help on the part of the journey that mattered most.
"That's something I've struggled with for the past years," she says, "really trying to get my head around: how do we solve this issue?"
A female health clinic built differently
Tine is quick to acknowledge that the landscape is shifting. There are good clinics opening, private gynaecologists turning real attention toward menopause. But she noticed something about who was building them.
"A lot of the places opening are still built by men, by male doctors," she says. So she set out to make something else. "A female health clinic for women, built by women, for women," where health is looked at from a fully integrated, 360-degree perspective.
The distinction she draws matters to her. Hormones are part of the picture, but NOMAE is not a hormone clinic and not a menopause clinic. "It's about all life phases in a woman's life."
She lists the factors that get flattened or ignored when care is narrowed too far. Metabolic health. Hormonal health. Imbalances and deficiencies. Iron deficiency, which she calls a huge issue for women, and most women at that. Vitamin D. Thyroid issues. Toxins. The transition she is reluctant to label neatly. "I hate the word menopause, perimenopause," she admits, settling instead on the plainer truth of going through mid-life.
The complexity is the point. "Our biology as women is a bit more complex," she says, and meeting it requires looking at the greater picture rather than one variable at a time. The goal she keeps returning to is to change how women feel through this transition, to empower them, and to make it smoother, both mentally and physically.
Why is sleep the first sign of perimenopause?
When I ask whether sleep belongs in this conversation, the answer is immediate. "Yes. A big, big thing."
For Tine this is not abstract. It is her own story. "Sleep was the first symptom that hit me," she says of her own entry into perimenopause. At the time she had no idea it was connected to her hormones. It was only later, having spoken with and helped so many women, and having talked to so many experts, that she understood it as one of the earliest signs.
Her experience is not an outlier, it is the rule. Between forty and sixty percent of women report disrupted sleep during the perimenopausal and postmenopausal years, and self-reported sleep problems increase by two to three and a half times across the menopausal transition compared with the perimenopausal years.¹ Sleep is, in other words, one of the most reliable signals that the transition has begun, and frequently one of the first to appear.
How falling estrogen and progesterone disrupt sleep
The mechanism is worth understanding, because it explains why this particular symptom arrives early and runs deep. Perimenopause is a period of progressive decline in ovarian function, which means estrogen and progesterone no longer move in their familiar monthly rhythm but instead fluctuate and gradually fall.² Both hormones are directly tied to the architecture of sleep. Progesterone has a calming, sleep-promoting action and supports the ability to stay asleep through the night, so as it drops, women tend to wake more often and rest more lightly.³ Estrogen plays its own role, and its decline drives the vasomotor symptoms, the hot flushes and night sweats, that fragment sleep from the outside in by waking the body with sudden surges of heat.⁴ Layered on top of this, the production of melatonin, the hormone that anchors the circadian rhythm to darkness, declines with age, and fluctuating estrogen disturbs it further, which is why the timing of sleep itself can begin to feel displaced.⁵
This is the cascade Tine describes, and science maps it almost exactly. Once sleep becomes disrupted, she says, it begins to touch everything else. "Our mental capacity, our energy levels, how we eat, how we move." It spills outward. And it arrives precisely when so many other parts of a woman's biology are already changing. The research bears this out: sustained sleep disturbance through the transition is associated with a markedly higher risk of depression, and over the longer term with cardiovascular, metabolic, cognitive, and immune consequences.⁶ Sleep is not one symptom among many. It is the variable that amplifies or steadies all the others.
That convergence is why she places sleep where she does. "Sleep is one of the most fundamental things to get right," she says, "if you want to build a smooth transition and empower yourself through all the changes happening in the body."
She is realistic about what can and cannot be controlled. Hormone replacement therapy has its place, and the evidence is clear that it improves sleep meaningfully for many women during the transition.⁷ But the work, as she frames it, is to make the transition as insightful and as smooth as possible, and to understand both the short-term and the long-term picture, the risk factors and the wins alike. "If you approach this right," she says, "there can be real wins."
We landed where the conversation had been heading the whole time. To make the transition as smooth as possible, sleep is one of the foundations.
It is a fitting note for a clinic built on the refusal to treat any one symptom in isolation. Sleep is not a separate concern from female health. It is often the first signal, and one of the surest footings, of everything that follows.
Female health notes and studies
- Sleep problems affect 40–60% of perimenopausal/postmenopausal women; risk rises 2–3.5× across the transition: Menopause journal review, 2022.
- Perimenopause as progressive ovarian decline with fluctuating, falling estrogen and progesterone: Sleep Disturbance and Perimenopause: A Narrative Review, MDPI, 2025.
- Hormone therapy improving sleep during the transition to perimenopause: MDPI narrative review.
Bio: Tine Hertz is the founder of One Thirty Labs, Copenhagen Health Week, and NOMAE, a female health centre in Copenhagen. Laura Kanadel is the founder of The Sleep Institute and MUUN.
