Feel like you're running on empty? You're not alone
- Why fatigue is a common symptom during perimenopause and menopause
- How hormone changes can impact your mood and energy levels
- Advice on how manage this symptom
Feeling utterly wiped out by everyday life is a common experience for many women during perimenopause and menopause. Fatigue, which can be emotional and physical, is one of the most common perimenopausal and menopausal symptoms.
You may find you feel tired, drained or simply worn-out. Some women describe a feeling like they are ‘wading through treacle’ and a constant feeling of juggling too much. So why are you feeling like this and what can help?
How common is fatigue in perimenopause and menopause?
If you’re struggling with low energy, then you’re not alone – fatigue consistently comes up as one of the most common symptoms of menopause. Balance users can log their symptoms in the app - low energy and tiredness is not only the sixth most commonly reported symptom (with more than 354,000 women reporting it to date), it scores the highest in severity rating, which demonstrates the huge impact it can have [1].
What can sap my energy?
Many different factors top up and deplete your energy levels every day. In perimenopause and menopause, your levels of estradiol, progesterone and testosterone start to fluctuate and fall. Changing hormones can disrupt your sleep, which will often leave you feeling tired.
If you experience low mood, which can be a common symptom for many women, this can also make energy levels drop.
When you are feeling tired, it can be harder to be motivated to make the choices that energise you, like heading out for a walk or a run, or eating a healthy, balanced diet. Joint pain and declining muscle strength, also connected with declining and low hormones, are common symptoms.
RELATED: Hormones and inflammation
Can fatigue be an early symptom of perimenopause or menopause?
Most people feel tired some of the time, especially when life gets busy. It can sometimes be hard to identify when your fatigue tips from an occasional issue into a more sustained symptom.
Tracking all symptoms you are experiencing, including fatigue, can help guide diagnosis and discussions with your healthcare professional about treatment with hormones.
What role are my hormones playing?
Estradiol, progesterone and testosterone work to regulate other hormones, including serotonin, the so-called happy hormone, which influences your mood and energy. When your hormone levels drop, so does serotonin, and this could have a role in depression and low mood, which can also affect your energy levels [2].
Hormones produced in your brain also have important roles in metabolism, regulating how much you eat, when you feel full and how you turn that food into energy for your body.
Many women have disturbed sleep when their hormone levels change, this can involve being woken by hot flushes and night sweats, struggling to drop off or waking early.
Your hormones also have important effects on helping the quality and duration of sleep. Progesterone can be beneficial for sleep as it increases the production of gamma aminobutyric acid (GABA), another chemical in your brain that works to help sleep.
It is common for perimenopausal and menopausal women to have an underactive thyroid, according to the British Thyroid Foundation [3]. Your thyroid is a gland that releases hormones to help regulate metabolism, which controls how much energy you release from food.
RELATED: Thyroid health and the menopause
The fall in your levels of testosterone can also affect muscle and bone strength, and lead to a lack of energy.
RELATED: The importance of testosterone for women
What can I do to boost my energy levels?
Being prescribed the right dose and type of hormones can improve both your symptoms and your future health. They can improve sleep and reduce low mood and anxiety - symptoms that often sap your energy. They can also help maintain muscle and bone strength [4].
But getting the right type, dose and combination of hormones is very individual, and getting that balance right can take time. If you are already taking hormones but are not feeling the benefits, talk to your healthcare professional and see if you need to alter the dose or type of hormones you are taking.
Physical activity can boost your energy levels, plus reduce your risk of many long-term conditions, protect your heart health, improve your sleep and reduce symptoms of depression and anxiety [5]. It also helps protect the strength of your bones and muscles, which can decline from perimenopause onwards.
However, sometimes it can be hard to muster the energy and motivation, so you might need to tailor your movement to your energy levels. Weight-bearing exercise, which includes running, dancing, walking, tennis and aerobics, can build and maintain bone strength. Weight or strength training, which can include lifting weights, kettle bells and using resistance bands are also beneficial [6].
Consider trying a new activity, and remember it is never too late to start exercising.
RELATED: Exercising during the perimenopause and menopause
RELATED: Get stronger during the menopause
Nutrition is also key. For example, while you need carbohydrates for energy, eating lots of white refined carbohydrates, such as white bread, pizza and white rice, can lead to a cycle of energy increases and dips. Instead, aim for a well-balanced diet, which has a multitude of health benefits and can boost your mood, and focus on eating carbs that give a steady, sustained release of energy, such as wholegrains.
RELATED: Healthy eating for the menopause
Prioritise what matters
When energy levels are really low, use what energy you have on what matters most. One approach recommended by many healthcare professionals is the three Ps of pacing, planning and prioritising [7]. This means spreading what you do throughout the day to manage your energy, building in rest breaks to recharge and planning ahead. Prioritise activities and aim for a balance of tasks that you need to do and want to do.
