Experiencing fatigue during perimenopause and menopause is incredibly common, affecting 3 out of 4 women, and it’s often one of the first symptoms reported. This isn’t just ordinary tiredness—it’s an overwhelming exhaustion your feel in every bone of your body, leaving you constantly thinking about when you can take a nap or struggling to make it through to dinner.
Why Does It Happen?
Estrogen
Estrogen plays a key role in regulating norepinephrine and serotonin, two chemicals in your body that influence your mood and sleep-wake cycle. As estrogen levels decline during perimenopause, these chemicals can fluctuate, potentially increasing anxiety, depression, and sleep problems. Low estrogen is also responsible for symptoms like hot flushes, night sweats, and increased nighttime urination—all of which can disrupt your sleep and leave you feeling drained.
Progesterone
Progesterone is a hormone that helps promote restful sleep. As progesterone levels decrease during the menopause transition, it can become harder to fall asleep and stay asleep.
If fatigue is a new experience for you, it could be one of the early indicators that you’re entering perimenopause. Like many menopause-related symptoms, fatigue can have multiple causes, so it’s important to consider other potential factors and rule them out to optimise your care.
Management Strategies
- Menopausal Hormone Therapy (MHT): MHT can be highly effective in reducing fatigue and boosting energy levels during menopause.
- Vaginal Hormone Preparations: If urinary frequency is disrupting your sleep vaginal hormone treatments may help.
- Addressing Other Underlying Conditions: It’s important to investigate other possible causes of fatigue, such as thyroid imbalances, iron deficiencies, or anxiety, and recieve appropriate treatment.
- Prioritise Rest and Nutrition: Ensuring you get enough rest and eating a balanced diet can support your energy levels during this time.
- Stress Management: Incorporating stress reduction techniques can help you manage fatigue.
- Sleep Hygiene: Create a relaxing bedtime routine, reduce screen time in the evenings, and make your sleep environment as restful as possible.
