Menopause and fatigue

Everyone has days where they feel a little bit drained, especially when juggling work, home responsibilities and other life events. However, if you’re in perimenopause or menopause and feeling tired all the time, regardless of how much rest you get, you aren’t alone. Fatigue is one of the most common symptoms of menopause, with one study finding 67% of women reported suffering from it.

Fatigue during menopause is a result of not only fluctuating hormones but also the side effects that this can cause. It can affect your physical and mental well-being and leave you feeling overwhelmed.

Understanding what is happening in your body and the steps you can take to manage fatigue and menopause symptoms is invaluable when navigating this transitional life stage.

What we mean by fatigue

Fatigue is more than just occasionally feeling tired during menopause. Tiredness usually occurs after a long day, strenuous activity or a bad night’s sleep and is remedied by having a nap or some extra rest.

In contrast, fatigue is a feeling of severe mental and physical exhaustion in menopause that doesn’t improve with sleep or rest and interferes with your ability to do your usual activities.

Is fatigue a sign of menopause?

Fatigue is a common symptom of menopause and can range from mild to severe. Sometimes, it can be hard to attribute fatigue directly to menopause as many women in perimenopause and menopause are dealing with other life circumstances that can leave them feeling drained. For example, one in four women over 45 are carers and many women work full-time while also providing unpaid childcare for their grandchildren.

It can be helpful to track any and all symptoms you might be experiencing, including fatigue, as this can help you get the right treatment and support.

What does menopause fatigue feel like?

Everyone’s experience of menopause fatigue is likely to be different, but many describe it as a constant feeling of being drained, having no energy or motivation, and finding it hard to get through each day.

Symptoms of menopause fatigue can include:

Consistent drowsiness
Needing more breaks during tasks
Taking longer to recover from activities or exercise
Day-to-day physical movements, like walking up the stairs or getting up from a chair, feeling more difficult
Falling asleep after work
Weaker grip strength
Brain fog
Difficulty concentrating
Forgetfulness
Leaving tasks unfinished
Feeling less alert
Emotional numbness -finding it hard to care about anything

What causes fatigue during menopause?

Fatigue during menopause is largely driven by hormonal changes. As you transition through menopause, levels of oestrogen and progesterone, the primary reproductive hormones, start to fluctuate and decline. Oestrogen, in particular, plays a crucial role in regulating mood, sleep, and energy levels. When oestrogen levels drop, it can lead to disrupted sleep patterns, increased stress, and fatigue.

Progesterone, which stimulates the brain to produce a calming neurotransmitter called GABA (gamma-aminobutyric acid) also declines, which can make it harder to relax and get restful sleep. This hormonal imbalance can leave you feeling more tired than usual, even if you’re sleeping through the night.

In addition to these hormonal shifts, other symptoms, such as hot flushes and night sweats in menopause, can significantly interfere with your ability to rest. Waking up drenched in sweat or overheating throughout the night can disrupt your sleep cycle, preventing deep, restorative sleep. When you don’t get enough quality sleep, your energy levels drop, leading to daytime fatigue.

Fatigue can also be compounded by emotional symptoms like mood swings and anxiety, both of which are linked to hormonal changes. These emotional stressors can make it harder to wind down at night and can drain energy during the day.

Things that can help with fatigue during menopause

Managing menopause fatigue involves addressing both the root cause (i.e. hormonal changes) and the lifestyle factors that may be making it worse. There are a variety of steps you can take to help:

Hormone replacement therapy (HRT)

HRT can be highly effective in combating menopause fatigue by addressing the hormonal imbalances that contribute to tiredness. By supplementing declining levels of oestrogen and progesterone, HRT can help stabilise mood, improve sleep quality, and reduce other symptoms like hot flushes and night sweats that can disrupt rest. As a result, many women find that their energy levels improve, and they feel more refreshed after sleep.

However, HRT isn't for everyone, and it's important to discuss HRT risks and benefits based on your medical history, menopause symptoms and personal preferences.

Sleep hygiene

Menopause and sleep problems are closely linked but there are some simple actions you can take to promote better sleep. Good sleep hygiene involves creating an environment and routine that promotes restful sleep. Establishing a regular bedtime, avoiding screens an hour before bed, and keeping your room cool and dark can make it easier to fall asleep and stay asleep. Managing night sweats and hot flushes by wearing breathable fabrics or using cooling devices can also improve sleep quality, reducing the fatigue that comes from broken sleep. Practising relaxation techniques, like deep breathing or meditation, can help you unwind before bed, making it easier to get the rest you need.

A healthy, varied diet

A balanced menopause diet rich in fruits, vegetables, whole grains, and lean proteins can play a crucial role in managing menopause fatigue. Certain nutrients, such as magnesium, vitamin B12, and iron, support energy production and can help reduce feelings of tiredness.

Foods rich in phytoestrogens, like soy and flaxseed, may also help balance hormone levels naturally and improve hot flushes and night sweats.

Staying hydrated is equally important, as dehydration can lead to fatigue. Additionally, eating regularly throughout the day helps maintain steady blood sugar levels, preventing energy crashes. Aim to eat regular meals and healthy snacks every 3-4 hours.

Avoiding stimulants

Caffeine, alcohol, and sugary foods can have a negative impact on both energy levels and sleep quality. While caffeine can give you a temporary energy boost, it can also lead to restlessness and trouble falling asleep, especially if consumed in the afternoon or evening.

Alcohol may help you fall asleep initially, but it can disrupt the quality of your sleep, leading to fatigue the next day. Reducing or avoiding these stimulants can help improve both your energy levels and your ability to get restorative sleep.

Exercise

Regular physical activity is one of the most effective ways to combat fatigue during menopause. Exercise helps boost energy by improving circulation, enhancing mood, and regulating sleep patterns. Moderate aerobic activities, such as walking or cold water swimming during menopause, and strength training can help maintain muscle mass and bone health, which tend to decline during this stage of life.

Additionally, exercise releases endorphins, which can counteract mood swings and anxiety, improving overall well-being and energy levels. It's important, however, to strike a balance. Overexerting yourself can lead to exhaustion, so start slowly and build up your routine until you reach the recommended NHS goal of 2 hours 30 minutes of moderate-intensity aerobic exercise.