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Menopause and Fatigue – Understanding the Connection

Cassie Hart

It’s not quite noon and you’re ready for a nap—again. Fatigue can impact quality of life at any age, but it’s especially common to feel zapped of energy during your menopausal years. If you’ve been feeling noticeably more tired and unmotivated than usual, you may be experiencing menopause-related fatigue.

Fatigue can be physical and/or mental. In a study of 300 individuals conducted by the National Institute of Health (NIH), 85.3% of postmenopausal women reported experiencing both types of fatigue during their menopausal years. It is one of the most common symptoms of the menopausal transition, and, in severe cases, can be considered to be disabling.1 So, what’s the root cause of this fatigue and can you do anything about it?

What Causes Menopause Fatigue?

Fatigue can begin in perimenopause and persist for the duration of the menopause transition, which can last 8 years or more.2 Much like many menopause symptoms, hormonal changes experienced during this time are mainly the cause for an increased feeling of exhaustion – as the ovaries produce less estrogen, other hormones are also affected by the imbalance, like progesterone, as well as adrenal and thyroid hormones, which help regulate energy levels. With so many hormone levels running amok, it’s not unusual for fatigue to set in.3

Other factors contribute to fatigue, too. Hot flashes, night sweats, and anxiety—all hallmark symptoms of menopause—can make it difficult to fall asleep and stay asleep, so it’s not surprising that menopausal women may feel fatigued during the day as a direct effect of poor sleep quality from the night before. This is actually a very common occurrence; in fact, studies have shown as many as two-thirds of women experience sleeping difficulties, and up to 90% admit to feeling exhausted during their menopausal years.4

Fighting Fatigue During Menopause

In order to reduce the severity of fatigue during menopause, women may want to consider incorporating a few simple techniques and lifestyle changes into their daily routines. Fortunately, there are several ways to lessen the impact of fatigue during menopause that can be implemented at any time; here are a few to consider.

Exercise Daily

You may not feel like moving too much when you’re tired, but a full-blown workout isn’t always necessarily required to recoup energy—even smaller efforts can help. A yoga routine in the morning or a short walk after lunch are great ways to perk up, and if you’re able to work in a higher-intensity cardio workout or lift a few weights, the energy-inducing benefits can be even greater. Regardless of your level of physical activity, try to aim for at least 30 minutes of exercise each day, to start out.5

Rethink Your Diet

Eating smaller meals throughout the day can be better for your body than having three larger meals throughout the day. A diet rich in fruits, vegetables, whole grains, and lean protein, such as the Mediterranean Diet, is often best. Limiting snacks late in the day into the evening is also a good idea, as food consumption before bed can cause heartburn—and who sleeps well when they’re uncomfortable? Also, consider avoiding caffeine and alcohol (in excess and later in the day) as they can also contribute to sleep issues.6

Set the Stage for Sleep

Maintaining a regular sleeping and waking schedule each day is good way to improve rest quality. Before turning in for the night, consider engaging in relaxing activities like taking a warm bath or listening to calming music. Avoid stimulating activities, such as watching television or using your computer or phone. It’s also a good idea to turn down the thermostat—keeping the room temperature cool can reduce risk of overheating at night and may promote better sleep.7

Try Meditation

We all feel overwhelmed at times, which can contribute to feelings of increased stress as well as exhaustion. Since fatigue is often worse during the menopausal years, consider reducing stress and anxiety by practicing calming, meditative techniques as you approach perimenopause. There are many types of reflection to engage in, from mindful meditation (sitting quietly in one spot and concentrating on breathing as you clear your mind) to more physical forms like yoga and tai chi.8

Consider Prescription Medications or Dietary Supplements

If you’re finding that lifestyle changes alone just aren’t cutting it, there are also prescription medications and over the counter solutions that can help to address menopause-related fatigue.

Hormone replacement therapies (HRT) are commonly recommended during menopause as they target changing hormone levels and work to regain balance, ideally alleviating symptoms—particularly vasomotor symptoms like night sweats and hot flashes—which can contribute to daytime fatigue by negatively impacting sleep quality at night. HRT isn’t for everyone, however, so we do recommend speaking with your healthcare provider if you’re interested in exploring a hormonal treatment option. In addition to HRT, your healthcare provider can also help determine if a prescription sleep medication should be considered, based on the severity of your symptoms.

If you’d prefer to avoid hormones and prescription medications, dietary supplements can also be an effective option for reducing your menopause fatigue. Melatonin is one of the more well-known supplements, as it has been shown to help promote better quality sleep. Women may also choose to look to specific dietary supplements or natural alternatives that can help to calm their menopausal hot flashes and night sweats, which often contribute to poor quality of sleep, and in-turn, worsen fatigue.9  Remember to speak with your healthcare provider first before starting a new medication or supplement program as they know your medical history best.

When to Talk to Your Healthcare Provider

Not all fatigue is caused by menopause. Other conditions that can contribute to increased fatigue include thyroid problems, autoimmune disorders (e.g., arthritis or chronic fatigue syndrome), diabetes, anemia, Lyme's disease, certain cancers or heart conditions.10 If extreme exhaustion and fatigue is interfering with your daily routine, it’s time to check in with your healthcare provider to help identify what may be going on, assess your symptoms, and recommend a treatment option.

Fatigue during menopause isn’t just annoying— but it can also lead to an increased risk of serious health consequences if not addressed. Recent research has linked sleep deprivation to a greater incidence of high blood pressure, stroke, Alzheimer’s disease, and diabetes.11

At the very least, menopausal fatigue can rob you of the energy needed to do the things you love. Consider giving the above tips a try when it comes to combatting menopause fatigue so you can continue to work, play, and fully enjoy your family, friends, and favorite activities. 



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* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

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