Menopause fatigue. It’s so much more than "tired." It’s waaaaaay worse than "exhausted."

Fatigue – and you’ll know this if you’ve been there – is bone-deep. This isn’t “I don’t want to exercise today” tired, this is “I’m not sure I can get out of bed today” tired.

And it’s common. Really really common. Common enough to make menopausal fatigue our Symptom of the Month.

Why am I so #$%@ing tired?!

If it’s menopausal fatigue, it’s due in large part to hormone changes and the “downstream effects” of hormone changes.

First the level of several energy-supporting hormones in your body are in flux or on the decrease: estrogen, testosterone, progesterone, and thyroid and adrenal hormones can all be changing at once, leaving your body exhausted and trying to adapt.

Remember, your brain has a lot of estrogen receptors, and when that level of estrogen declines, so does some of the regulation estrogen provides. For example, estrogen helps control cortisol, the stress hormone. When that regulation is weakened, the increased stress response can result in crashing, crushing fatigue.

Some of the downstream effects of reduced estrogen can include poor sleep due to night sweats, restless leg syndrome, sleep apnea, frequent need to urinate, and so on. When your sleep is poor quality and often interrupted, it’s little wonder the next day is more challenging than it should be.

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Other reasons for fatigue

There are other issues that could be causing or contributing to your fatigue, so be sure to check with a doc to identify and treat all the factors. You need to know what you’re solving for.

  1. Hypo or hyperthyroidism. An under- or over-active thyroid can cause extreme tiredness.
  2. Anemia. Getting enough iron is problematic for women generally, and if you’ve been having heavy and/or more frequent periods in perimenopause, you’ll want to get your levels checked.
  3. Autoimmune disorders. Fatigue is often a factor in arthritis, lupus, multiple sclerosis, chronic fatigue syndrome, and scleroderma.
  4. Fibromyalgia, coronary artery disease or other heart-related concerns, diabetes
  5. Nutrient deficiencies. Like iron and anemia, not getting enough Omega 3s, B, D, and magnesium can also lead to fatigue and other health issues. Making sure you combine certain foods and supplements can help boost the healthy effects of each.
  6. Prescription and OTC drugs. Check with your doc to be sure your meds (or combination of meds) isn’t contributing to your fatigue.

Solutions for menopausal fatigue

Like so much else in menopause, fatigue is likely temporary, but that “temporary” can be years long. If your fatigue is impacting your quality of life, let’s talk about what you can do to alleviate or manage it.

  1. Exercise. I know – IT’S THE LAST THING YOU WANT TO DO. But it helps. It’ll help you sleep better (if you don’t exercise too close to bedtime), and boosts the feel-good hormones that may be in short supply at this time.
  2. Hydration. As Laura Boulay of One Million Women Walking told me, “I slam two big glasses of water in the afternoon to fight fatigue.” (And then, not surprisingly, she goes for a walk. See “exercise” above.)
  3. Nutrition choices and timing. Even if your fatigue isn’t directly caused by nutrient deficiency, the right foods can boost mood and energy levels. Iron-rich leafy greens and lentils, bananas, chia seeds according to Greatist, fruit and nuts, lean proteins. Many of us reach for sugar, cheap carbs (white bread, crackers), and caffeine when we’re tired, but these only give us a temporary boost followed by a crash we could have avoided. Eating smaller meals more frequently might also help you keep blood sugar levels even.
  4. Prioritize sleep. For many women in perimenopause and menopause, trying to get a good night’s sleep is an exercise in frustration. It’s tough when your body and brain won’t cooperate, but be sure you’re giving yourself every advantage. Practice good sleep hygiene, curtail caffeine, shut off screens.
  5. Expand your options. It might take a bit of experimentation to find the right relief for your fatigue. CBD oil, black cohosh, and valerian have all been reported by some women to provide relief, as have magnesium supplements (glycinate in particular). Before adding any supplement (“natural” or otherwise) to your regimen, check with your doc to make sure it won’t conflict with other medications or conditions.
  6. Rest when you need it. Rediscover the glory of naps. Maybe you haven’t napped since your mom made you, but you may find you embrace them with a bit more enthusiasm now. Ask your HR department if accommodations might be made to put a couch in a quiet corner or take half of your lunch for a quick snooze in your car.

As with so many “invisible” menopause symptoms, it can be hard for your partner, kids, colleagues, and others to understand that you’re dealing with a real health issue.

If you can, communicate to others what you’re dealing with as openly as possible. Talk to HR and try to get your workplace to make some reasonable accommodations. It’s hard, we know, but just think of it this way: you’ll be a hero for the next generation of women who’ll enjoy the benefits of your awkward conversations.

Do you deal with fatigue? How has it impacted your life, and what do you do to manage it? We’re all ears over here. Catch us in the forum thread on fatigue (must be signed in), or find us on Facebook or in Midlife & Menopause Solutions, our closed Facebook group.

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Shannon Perry

Shannon is a celebrated author and global educator. Whether she’s interviewing a physician or producing a podcast, her appetite for research, facts, and truth culminates in credible health education and programming that women can rely on. An avid runner, cyclist, and climber, Shannon knows a thing or two about thriving in midlife and lives in Seattle with her cat, dog and boyfriend.

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