Medically reviewed by Dr. Tamara Neuhaus MD

The Hormones That Affect Fatigue and Exhaustion During Perimenopause

Most days I feel like a floppy, deflated innertube. I just have no energy—or worse, no motivation—to do anything. Not even the things I love, like rowing or hanging out with friends. And if I do drag myself out, I’m too tired to enjoy myself. I don’t know if it’s depression or if something is physically wrong with me. Feels like both. - Mel, 50

What is it?

Fatigue is exactly what it sounds like—an unshakable weariness or even exhaustion that saps your energy and keeps you from the things you love or need to do. It affects you both physically and mentally, and those feelings can feed off each other. 

Why does it happen?

Not surprisingly, your hormones may be playing a role. As your estrogen levels start to fluctuate then taper off, your energy levels may taper with them. They can also impact your mood, especially if you’ve been prone to depression or anxiety. And that can also suck your energy. Other menopause symptoms, like hot flashes/night sweats, insomnia, and urinary urgency, can also take a toll on your sleep, causing or adding to your feeling of fatigue. 

What can you do about it?

Our first recco sounds obvious, but we know it’s easier said than done: make sure you’re getting 7-8 hours of sleep every night. Let’s get to the how:

If night sweats or the urge to pee are disrupting your sleep, the first thing you want to do is nip them in the bud. Click on those two links to learn about the treatment options ranging from natural supplements to hormone therapy (HRT) to non-hormone prescription meds. 

We also have a whole symptom page dedicated to insomnia with a bunch of lifestyle and natural supplement recommendations that you can explore. 

But what if you ARE getting 7-8 hours of sleep every night, but still feel exhausted? It could be that your fatigue is a symptom of depression. There are also health conditions like diabetes, hypothyroidism, or even cancer that can sap your energy. So if you’re regularly feeling wiped out, even after a solid night’s sleep, talk to your doctor to make sure there aren’t other forces at play.

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Dr. Tammy with a patient

At The Cusp, we provide expert menopause care. We are a comprehensive, convenient virtual healthcare service dedicated to help you feel better.