Perimenopause and the Agony of Crashing Fatigue

While most women associate menopause with symptoms like fatigue, many are often surprised to find that this sort of exhaustion can begin years before menopause technically starts. Throughout that period of pre-menopausal change – better known as perimenopause – fatigue can become a seriously disruptive problem.

For women, there often seems to be no end to the number of ways in which they can become fatigued. Like men, they can experience exhaustion due to problems with the hypothalamus, the adrenals, anemia, and virtually every other fatigue-related issue. Unlike men, however, there are some issues that only women experience. Things like pregnancy and menopause are, after all, life changes that no man will ever endure.

Perimenopause – that period of several years prior to menopause – is yet another source of fatigue for women. During that period, as the ovaries reduce their estrogen output, many women experience high levels of exhaustion that often come on in waves. The fatigue is often so powerful that even the most minor of tasks can become almost impossible to accomplish. To more effectively manage this period in life, women need to understand why the fatigue happens, how it can impact their lives, and how they can overcome its effects.

Why Perimenopause Fatigue Occurs

The main cause for fatigue during this period prior to menopause is the way in which a woman’s hormone levels drop. As the body prepares for the onset of menopause, it naturally decreases the amount of estrogen that it produces. Since estrogen serves as a counterweight to progesterone, when there is less estrogen there is a disruption in the balance of the two hormones. And since progesterone can make you sleepy, its effects can be magnified with less estrogen in your system.

Estrogen also serves as a control on cortisol levels. Again, with less estrogen, cortisol’s negative effects become magnified – leading to the same type of cortisol rush you see in any stress response. As those levels remain out of balance, women can experience the same type of energy crashes people endure in the wake of any stressful situation.

Finally, many of the other symptoms associated with these hormonal changes can, when taken together, enhance that fatigue effect. For example, sleep can be disturbed, causing increased tiredness. Night sweats can contribute to that sleep disruption, of course. The sex drive is usually diminished, which can cause both mental and emotional stress. Even the memory can be affected as hormone levels fall out of balance.

How Perimenopause Fatigue Can Affect You

The fatigue associated with perimenopause can have a variety of negative impacts on patients. The symptoms associated with this exhaustion can be extremely disruptive in any woman’s life:

  • Fatigue is often in the form of a “crash” that appears out of nowhere. That can make it difficult for any woman to enjoy a normal day’s activities, since she can go from being full of energy one moment to feeling completely exhausted the next.
  • The hormonal disruption and tiredness can leave women irritable
  • Fatigue can affect brain function, reducing the ability to concentrate on tasks, diminishing attention span, and making it more difficult to remember things.
  • Ongoing fatigue can cause muscle and joint discomfort, which can make it difficult to exercise or do any of the other things that might mitigate the tiredness.
  • A general sense of apathy can develop, and that can often lead to depression.

How You Can Overcome Perimenopause Fatigue

Fortunately, there are steps you can take to somewhat reduce the worst of these effects. While it is all but impossible to avoid exhaustion completely, changes to your rest patterns, a focus on diet and exercise, and the addition of supplements can all have a positive impact on your overall level of fatigue during perimenopause.


Rest and relaxation are critical during perimenopause. That means that you need to have a sleep schedule that is as closely adhered to as possible. While sleep may not be the easiest thing to do during those years, it is something for which there truly is no substitute! Naturally, when sleep is insufficient for proper rest, and you feel those waves of exhaustion wash over you, it is important to acknowledge them for what they are and respond accordingly. That means napping when necessary, or using other relaxation techniques to help reduce stress.

Yoga is an excellent choice for these relaxation efforts. Tai chi and similar disciplines can also be helpful. These physical relaxation techniques have the advantage of getting your body in motion as well, which can help to ensure that your internal energy is active. That can assist in relieving tension and centering your mind. Various oils such as lavender or jasmine can also help you to relax.

Diet and Exercise

Both diet and exercise remain key components of every fatigue management plan. With perimenopause, they can often make the difference between hard crashes in energy level and a gentler rollercoaster of fatigue symptoms.

Where diet is concerned, the emphasis should be on eating as cleanly as possible. That means avoiding as many processed foods, sugary sweets, and caffeinated stimulants as you can, while focusing on complex carbohydrates, lean proteins, and healthy fats. Snacks should be eaten frequently, and should be just as healthy as the meals you consume. Raw vegetables like carrots are ideal, as are most nuts and even dairy products like cottage cheese.

Exercise should be consent, but of a low intensity and short duration. You can engage in some strength training as long as that first principle is maintained. Though it might seem strange to suggest physical activity as a way to counteract exhaustion, the research on the subject is quite clear: exercise helps to promote bodily energy and stave off severe exhaustion. That is, provided that you don’t overdo it.

If exercise is new to you, there are plenty of sites online that can help you to find a workable routine that you can manage to do during perimenopause. In addition, most areas have local gyms where management or patrons are only too happy to assist anyone who needs help in this area.


Another important aspect of perimenopause fatigue management is nutritional supplements. These can include a variety of nutritional additives that can improve restfulness, alleviate mood swings and anxiety, and reduce stress. Vitamins B, C, D, and E are all important for overall health, as are critical minerals like calcium, iron, magnesium, and fish oil. Talk with your doctor about developing a nutritional supplementation plan that can cover all of these critical areas.

There is no denying the fact that some level of fatigue is almost unavoidable during perimenopause. After all, any time your hormones are that far out of balance for such a lengthy period of time, you can’t help but experience negative consequences. The good news, however, is that you don’t have to suffer needlessly. The right plan for managing fatigue can go a long way toward helping you to maintain your quality of life.

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Comments (1)

  • Crushing fatigue

    I need to know witch vegetables and fruits can eat?

    posted this comment on Aug 18, 2015

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