Journal I Perimenopause

Perimenopause Fatigue and How to Boost Your Energy

Feeling exhausted during perimenopause? Discover why fatigue hits hard and how to regain your energy with expert-backed strategies.

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Perimenopause has a way of sneaking up on you, and one of its most frustrating side effects is fatigue. Not just any kind of tiredness—the sort that feels like you’ve run a marathon when all you did was wake up. Perimenopause fatigue is real, and for many women, it can tank productivity and make getting through the day feel impossible. But understanding why crashing fatigue happens and what you can do about it puts the power back in your hands.

Let’s explore why you’re feeling so drained and, more importantly, how you can get back to feeling energised and in control.

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01

Understanding Perimenopause Fatigue

Is Perimenopause Fatigue Normal?

If you’re feeling unusually tired during perimenopause, you’re not alone. Perimenopause fatigue isn’t just about needing a nap—it’s the kind of exhaustion that doesn’t go away after a good night’s sleep. This intense tiredness is a common symptom of perimenopause and affects your physical, mental, and emotional well-being. You may feel like you’re constantly running on empty, and yes, that’s a typical part of the menopause transition(1).

Common Symptoms of Fatigue During Perimenopause

Fatigue during perimenopause doesn’t always stop at just feeling sleepy. Many women experience brain fog, difficulty focusing, and a general lack of motivation. It’s not just physical tiredness; it’s a mental fog that can make everyday tasks feel monumental. That combination of extreme tiredness and mental exhaustion is all part of the package during this transition(2).

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Causes of Crashing Fatigue in Perimenopause

How Hormonal Changes Contribute to Fatigue

So what’s behind this sudden wave of exhaustion? The answer is in your hormones. As your estrogen and progesterone levels fluctuate wildly, your body struggles to keep up. Estrogen, in particular, helps regulate energy levels, and as it drops, you may find yourself feeling increasingly tired. This hormone doesn’t just affect your reproductive system; it impacts everything from your sleep to your mood and how you manage energy throughout the day(3). It’s no wonder that many women describe perimenopause fatigue as hitting a wall of exhaustion mid-day.

Poor Sleep Quality and Night Sweats

Another factor stealing your energy? Night sweats. These disruptive symptoms can leave you waking up multiple times a night, drenched in sweat and struggling to fall back asleep. Over time, the lack of deep, restorative sleep takes a toll, leading to daytime fatigue and that sense of being permanently drained(4).

Other Factors Impacting Fatigue in Midlife Women

Aging and Metabolism

With age comes a natural decline in metabolism. This means your body processes energy less efficiently, making fatigue more noticeable. Add to that the hormonal rollercoaster of perimenopause, and it’s no surprise that many women experience weight gain and reduced energy levels during this time.

Mental Health Conditions

Anxiety and depression are also common companions during perimenopause, thanks to hormonal fluctuations. These conditions can drain your mental energy and contribute to insomnia, further fuelling the cycle of fatigue(2).

Stress from Family Responsibilities

Midlife can also bring an increase in stress from outside factors. Whether it’s caring for aging parents or dealing with teenagers, these additional responsibilities can worsen feelings of exhaustion. The mental load becomes heavier, making it harder to manage energy throughout the day(5).

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03

Strategies to Overcome Crashing Fatigue

Improving Sleep Hygiene and Managing Night Sweats

A great way to tackle perimenopause fatigue is by improving your sleep. Prioritising sleep hygiene—things like sticking to a consistent sleep schedule, avoiding screens before bed, and keeping your bedroom cool—can help minimise disruptions like night sweats. Small changes in your nightly routine can lead to big improvements in how rested you feel(4).

The Role of Physical Activity: Strength Training, Yoga, and More

Physical activity is a game changer when it comes to boosting energy. While it might feel counterintuitive to work out when you’re exhausted, regular exercise can actually combat fatigue. Activities like strength training, yoga, or even a brisk walk can help improve mood and energy by releasing endorphins. Plus, exercise helps reduce menopause symptoms like mood swings and anxiety(3).

Nutrition Tips: Eating a Well-Balanced Diet

What you eat plays a significant role in managing your energy. A well-balanced diet rich in whole foods—like fruits, vegetables, lean proteins, and healthy fats—can help stabilise your blood sugar and provide lasting energy. Avoiding sugary snacks is key, as these can cause energy crashes later in the day(2).

Addressing Iron Deficiency Anaemia and Blood Sugar Imbalance

For many women, iron deficiency anaemia can be a hidden cause of fatigue. If you’ve experienced heavy periods, it’s worth checking your iron levels with your doctor. Adding iron-rich foods to your diet or taking supplements may alleviate some of the tiredness you’re feeling(5).

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04

Long-Term Management and Treatment Options

Hormone Replacement Therapy (HRT)

If lifestyle changes aren’t enough, hormone replacement therapy (HRT) can help balance your hormones and reduce symptoms like fatigue and night sweats. Many women find HRT improves their overall energy and helps manage other menopausal symptoms. However, it’s important to consult with your healthcare provider to see if this is the right option for you(1).

Hormone-Free Alternatives

If HRT isn’t your choice, don’t worry. There are hormone-free options like herbal supplements and lifestyle modifications that can still make a big difference. Supplements like magnesium, vitamin D, and certain herbal remedies may help relieve some symptoms of fatigue. Again, it’s important to discuss these options with your doctor(3).

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05

Final Thoughts on Managing Perimenopause Fatigue

Crashing fatigue during perimenopause is challenging, but with the right tools and support, you don’t have to let it take over your life. By improving sleep quality, staying active, focusing on nutrition, and working with healthcare professionals, you can regain your energy and thrive during this transitional phase. It’s all about taking control of your journey and prioritising your well-being.

References:

  1. National Institutes of Health. “Menopausal Hormone Therapy Information.” National Institute on Aging, https://www.ncbi.nlm.nih.gov/books/NBK493191/.
  2. Mayo Clinic. “Perimenopause: Symptoms and Causes.” Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397.
  3. Freeman, Ellen W., et al. “Symptoms in the Premenopausal and Perimenopausal Transition: A Prospective Study.” Journal of Women’s Health, vol. 18, no. 7, 2009, pp. 915-924.
  4. National Sleep Foundation. “The Impact of Night Sweats on Sleep Quality.” https://www.sleepfoundation.org
  5. Cleveland Clinic. “Iron Deficiency Anaemia and Fatigue in Perimenopausal Women.” https://my.clevelandclinic.org

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