Hormonal Fatigue: What's Going On?
- Michael Frey, MD
- 5 hours ago
- 3 min read
Fatigue during premenopause and menopause affects many women, disrupting daily life and well-being.
This overwhelming tiredness can be managed by understanding its causes, helping women regain energy, and improve quality of life.
Causes
Feeling exhausted all the time, even after sleeping? That’s perimenopause fatigue. Changes in your hormone levels, stress, poor sleep, and blood sugar swings can leave your body and brain drained.
Why it happens:
Estrogen dips lower mood, motivation, and energy.
Progesterone drops disrupt sleep and calm signals.
Cortisol swings daytime tiredness and restless nights.
Night sweats or hot flashes prevent deep, restorative sleep.
Blood sugar ups and downs trigger crashes, irritability, and brain fog.
Stress makes everything worse.
This fatigue isn’t just physical—it’s mental too. You may feel drained, unfocused, or foggy even after a full night’s rest. Understanding the causes is the first step to reclaiming your energy.
Ways Hormones Boost Your Energy!
Estrogen is the star when it comes to energizing your body! It works by balancing brain chemicals like serotonin and dopamine. But when estrogen levels dip, these neurotransmitters can go off-kilter, leading to mood swings and that dreaded fatigue.
And let's not forget about progesterone, the calming hero! As its levels drop, you might experience sleep disturbances. This thrilling hormonal rollercoaster can impact how your body recharges its energy overnight.
Ways to Manage Fatigue
Managing fatigue during perimenopause and menopause requires a multifaceted approach. Here are some effective strategies:
Improve Sleep Quality
Create a cool, dark, and quiet bedroom environment.
Avoid caffeine and heavy meals close to bedtime.
Practice relaxation techniques such as deep breathing or meditation.
Establish a consistent sleep schedule.
Balanced Nutrition
Eat a diet rich in whole foods, including fruits, vegetables, lean proteins, and whole grains.
Include foods high in iron and vitamin B12 to prevent anemia.
Stay hydrated throughout the day.
Regular Physical Activity
Engage in moderate exercise like walking, swimming, or yoga.
Exercise boosts energy, improves mood, and promotes better sleep.
Avoid intense workouts close to bedtime.
Stress Management
Practice mindfulness or gentle yoga.
Set realistic daily goals to avoid feeling overwhelmed.
Seek support from friends, family, or support groups.
Medical Treatments and When to Consider Them
If lifestyle changes are not enough, medical options may help reduce fatigue related to menopause.
Hormone Replacement Therapy (HRT)
HRT can balance declining hormones and relieve symptoms like hot flashes, night sweats, and fatigue. It is not suitable for everyone, so a healthcare provider will assess risks and benefits based on individual health.
Thyroid Testing and Treatment
Since thyroid issues can mimic or worsen fatigue, testing thyroid function is important. If needed, thyroid hormone replacement can restore energy levels.
Addressing Other Health Conditions
Conditions such as anemia, diabetes, or depression should be diagnosed and treated to improve overall energy.
Supplements
B Vitamins: Fuel your brain and body—especially B12 for mental clarity.
Magnesium: Helps you sleep better and relax, while supporting energy.
Vitamin D: Low levels = low energy. Keep bones strong and mood lifted.
Iron: Only if deficient, but crucial for preventing fatigue and brain fog.
Adaptogens (Ashwagandha, Rhodiola, Maca): Balance stress hormones and boost stamina.
Omega-3s: Sharpen focus and fight inflammation that drags you down.
Final Thoughts
Feeling tired during perimenopause and menopause is pretty common, but you don't have to deal with it on your own. Getting a handle on how hormones and other things play a part can really help you find ways to get your energy back. Mixing up some lifestyle tweaks with treatments like HRT, if it makes sense for you, can really help turn things around.