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Perimenopause is a natural phase in a woman's life, marking the transition towards menopause — but let’s face it, the experience is a rollercoaster. One minute you're feeling fine, and the next, you're ready to crawl under your desk for a nap, like someone's quietly siphoning your energy reserves when you're not looking.
If you've been feeling like your get-up-and-go has got up and gone, you're not alone. For many women in their 40s and early 50s, dealing with constant tiredness during this transition is all too real — in fact, it’s one of the most common symptoms of perimenopause, affecting about 60-70% of perimenopausal women.
Understanding what perimenopause fatigue is, why it happens, and how to manage it can help keep your energy levels up and your spirits high.
What does perimenopause fatigue feel like?
Perimenopause fatigue isn’t just your everyday tiredness. It’s that lingering exhaustion that doesn’t seem to go away, no matter how much you sleep. You might wake up after a full night's sleep, only to feel like you've just run a marathon.
Feeling drained both physically and mentally makes it hard to focus, stay motivated, or enjoy your favorite activities. This kind of fatigue can sneak up on you, disrupting your work, relationships, and personal goals, leaving you feeling frustrated and stuck.
Unlike regular tiredness, perimenopause fatigue can linger all day and doesn’t always follow a predictable pattern. It's not your garden-variety tiredness that a cup of coffee can fix.
What is "crashing fatigue" in perimenopause?
“Crashing fatigue” is a non-medical term for when your energy levels suddenly plummet without warning. One minute you’re feeling okay, and the next, you’re completely wiped out.
These unexpected energy dips can be triggered by hormonal swings, poor sleep, stress, or even certain foods. The unpredictability of crashing fatigue makes it tough to manage, as it can throw off your daily routine and responsibilities out of the blue.
Some people going through perimenopause often report feeling fine in the morning, only to crash hard in the afternoon, leaving them struggling to make it through the rest of the day.
Why does perimenopause make you so tired?
The culprit behind all this fatigue? Hormones, of course!
During perimenopause, your body's estrogen and progesterone levels start to fluctuate wildly. These hormones don't just affect your reproductive system; they play a crucial role in regulating your energy levels, sleep patterns, metabolism, and mood. When they're out of whack, it can throw your whole system off balance.
Estrogen, in particular, is a key player in energy regulation. As it decreases, you might find yourself feeling more sluggish.
Plus, these hormonal changes can lead to other perimenopause symptoms like night sweats and insomnia, which don't do your energy levels any favors. It's like a domino effect: poor sleep leads to daytime fatigue, which can lead to stress, which can further disrupt your sleep... and round and round we go.
But there's more to the story. Chronic fatigue in perimenopause can also be linked to how your body handles stress hormones like cortisol and how your thyroid functions. Cortisol, known as the "stress hormone," helps regulate your energy levels throughout the day.
During perimenopause, cortisol patterns can get disrupted, leading to persistent tiredness. Similarly, thyroid issues can play a significant role, which is why it’s worth getting your thyroid tested if you haven’t recently. As Dr. Caledonia Buckheit says, “...thyroid dysfunction can mimic perimenopause symptoms.”.
Other factors like increased stress, lifestyle changes, other health conditions, and the natural aging process can make fatigue even worse during perimenopause. But there are some things that can help.
How do you fight perimenopause fatigue?
While you might not be able to completely avoid perimenopause fatigue, there are ways to manage it and reclaim some of your energy. First things first: prioritize sleep — introduce a relaxing bedtime routine, aim for no screens at least 30 minutes before sleep, keep your bedroom cool and dark, steer clear of caffeine after 12pm, and try to stick to a consistent sleep schedule, even on weekends.
Exercise might be the last thing you feel like doing when you're exhausted, but regular physical activity can actually boost your energy levels. Start small if you need to — even a 10-minute walk can make a difference. Yoga and gentle stretching can also be great options, helping to reduce stress and improve sleep quality.
Speaking of stress, finding ways to manage it is crucial. Whether it's meditation, deep breathing exercises, or just taking a few minutes each day to do something you enjoy, stress-reduction techniques can help combat fatigue. Talk therapy, like CBT (cognitive behavioral therapy), can also be effective.
It can be worth looking into how your body handles stress and thyroid function. Sometimes, working with a healthcare provider to check your cortisol levels or thyroid health can uncover hidden issues contributing to your fatigue. Simple tests can provide insights that lead to more targeted treatments, helping you regain your energy and feel like yourself again.
It’s also a great idea to reach out to healthcare professionals who can offer personalized advice and treatment options tailored to your needs.
What vitamins are good for perimenopause fatigue?
While a balanced diet should be your first line of defense, certain vitamins may help combat perimenopause fatigue. B vitamins, especially B12, play a crucial role in energy production. Iron is another important nutrient, as iron-deficiency anemia can contribute to fatigue and is more common in perimenopausal women.
Vitamin D is also worth mentioning. Often called the "sunshine vitamin," it's important for bone health and may help with mood and energy levels. Many women are deficient in vitamin D, especially as we age.
Magnesium also helps your muscles relax and supports energy production, while omega-3 fatty acids are great for brain health and reducing inflammation.
But the best way to get these vitamins is through your diet, according to Dr. Caledonia Buckheit: “Working to incorporate foods rich in these vitamins can go a long way to improving perimenopause symptoms, including fatigue.”.
You can also talk with your healthcare provider about your concerns, and they may want to run tests to check for certain deficiencies. If deficiencies are identified, supplements in addition to dietary changes can often be helpful.
Does HRT help with fatigue?
Hormone Replacement Therapy (HRT) can be a game-changer for some women when it comes to managing perimenopause symptoms, including fatigue. By supplementing the hormones your body is producing less of, HRT can help restore balance and potentially alleviate that dragging tiredness.
However, HRT isn't a one-size-fits-all solution. It comes with potential risks and side effects, and it's not suitable for everyone. The decision to start HRT should be made in consultation with your healthcare provider, taking into account your individual health history and risk factors.
As Dr. Buckheit explains, “Luckily, for the majority of women in the perimenopause years, the benefits of HRT will outweigh the risks. It is important to discuss your unique health history with your healthcare provider though, as there are certain conditions that would make HRT unsafe, such as a personal history of breast cancer or blood clotting disorders.”.
It’s important to talk with your healthcare provider to weigh the benefits and risks specific to you and decide if HRT is the right choice for you.
What are the best foods for perimenopause fatigue?
Your diet can play a big role in managing perimenopause fatigue. Focus on foods that provide sustained energy rather than quick fixes.
Complex carbohydrates like whole grains, legumes, and vegetables release energy slowly, helping to keep your blood sugar stable. Pair these with lean proteins and healthy fats for meals that will keep you fueled for hours.
Some specific foods that may help combat fatigue include:
- Fatty fish, like salmon, which is rich in omega-3 fatty acids and vitamin D
- Lean proteins, like chicken, fish, tofu, and beans, which are essential for muscle repair and energy production
- Leafy greens like spinach and kale, which are packed with iron and B vitamins
- Nuts and seeds, which provide protein, healthy fats, and minerals
- Avocados, nuts, seeds, and olive oil for healthy fats, which support your brain and reduce inflammation
- Berries, which are high in antioxidants and can help reduce inflammation
- Whole grains like quinoa and oats, which provide sustained energy
On the flip side, try to limit foods that can zap your energy. This includes sugary snacks that cause energy crashes, excessive caffeine that can interfere with sleep, and alcohol, which can disrupt your sleep patterns and leave you feeling sluggish the next day.
Staying hydrated by drinking plenty of water is also crucial to keeping fatigue at bay, so keep a big bottle of water by your side!
Perimenopause fatigue can be a real drag, but remember: this too shall pass.
In the meantime, be kind to yourself. Listen to your body, rest when you need to, and don't hesitate to reach out for support, whether that's from friends, family, or your healthcare provider.
With some lifestyle tweaks and the right support, you can navigate this transition and come out the other side feeling like your energetic self again. Understanding what’s behind your perimenopause fatigue and finding ways to manage it can make a big difference.
After all, perimenopause might be draining, but it doesn't define you!
Tassia O'Callaghan is an experienced content writer and strategist, having written about a vast range of topics from chemical regulations to parenting, for brands like Peanut App Ltd, Scary Mommy, Tally Workspace, and Office Christmas. She's an advocate for realistic sustainable living, supporting small businesses (author of A-Z of Marketing for Small Businesses), and equity across all walks of life. Follow her on LinkedIn or TikTok, or see more of her work on Authory or her website.
