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Perimenopause Fatigue: What Causes it and How to Manage

June 24, 2021
Menopause
Perimenopause Fatigue

During the menopause transition, many women describe a persistent decrease in energy or a feeling of exhaustion. Fatigue can be frustrating and impact your daily activities and quality of life. Fortunately, there are a number of good ways to manage perimenopause fatigue.

What Causes Perimenopause Fatigue?

A combination of factors can contribute to feeling tired during perimenopause. The changing levels of hormones including estrogen and  progesterone can make you feel tired because these hormones are involved in regulating cellular energy within your body. When they’re fluctuating and out of balance, you may feel exhausted or fatigued for no obvious reason.

Also, many women experience insomnia or sleep disruptions during the menopause transition  due to hot flashes and night sweats. According to the North American Menopause Society (NAMS), night sweats have been shown to interrupt the most restorative phase of sleep. Sleep may also be interrupted because of more frequent trips to the bathroom at night.

Managing Perimenopause Fatigue

There are several ways to alleviate perimenopause fatigue, from  lifestyle changes to  treatments prescribed by your doctor.

Get Moving



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One of the simplest and best ways to boost your energy is to get regular physical activity. It’s hard to get started when you’re feeling tired and run down, but getting moderate or high-intensity exercise can result in better sleep at night and higher energy levels during the day.

Exercise can also help with mood swings, weight gain, and even hot flashes. Choose ways to move that are manageable and enjoyable like a 15 minute walk or a fun group activity. That will make it more likely you’ll stick to your routine and make it a habit. And be careful not to be a weekend warrior or over-exercise because that can just make you tired again and put you at risk for injuries.

Make Your Environment Comfortable and Relaxing

Making smart changes to your sleep environment may help you get more rest. Wear light and breathable nightwear.  Make your bed with layers that can easily be removed or added during the night. Try bedding made with moisture-wicking materials that will help keep you drier when you sweat.  If you experience night sweats, keep an electric fan nearby to cool down. Keeping the ambient temperature of the room cool helps too.

Take a Brief Daytime Nap

If you can, schedule a quick 20 minute nap in your day.  This is usually just enough to restore your energy for the rest of the day without making it difficult to sleep at night.  If you are at work, this may not be easy to do, but some people find a quiet spot during their lunch breaks to shut their eyes for a few minutes. Taking that time to be quiet and rest your mind can be refreshing, even if you don’t actually fall asleep.

Stick to A Regular Bedtime 

Going to bed and getting up at the same time each day, even on the weekends is one of the most effective things you can do to improve your sleep. Set aside time before bed each night to wind down by taking a bath, reading, or listening to relaxing music. TV or other screens before bed have been linked to sleep disturbances, but many women tell me they enjoy relaxing by watching TV in bed, so experiment to see whether that makes a difference for you.

The important point is that having a set bedtime and routine facilitates getting good sleep on a regular basis which is good for your health.

Talk to Your Doctor

If  lifestyle and behavioral changes aren’t enough to address your perimenopause fatigue, talking to a menopause practitioner who is trained to help women manage the symptoms of perimenopause and menopause can help. 

Final Thoughts

The menopause transition doesn’t need to be a frustrating and confusing time.

To learn more about how to manage perimenopause fatigue and take charge of your menopause transition and midlife health, sign up for my Mastering Menopause course so you’ll have all the tools you need when the time comes. 

Dr. Ellen Johnson

I have been listening to women’s health concerns for over two decades and noticed one recurring theme; that it’s hard to get questions answered about the changes we notice in our bodies as we approach midlife, and even more difficult to understand the ever-changing guidelines about how to manage symptoms. My mission is to bring you the most up-to-date, proven medical information so you can make educated decisions about your health. It’s women’s health, simplified.



menopause checklist

Instantly Access The Ultimate
Mastering Menopause Checklist

Join the movement of women who are learning to reinvent and reimagine menopause with my comprehensive menopause checklist.

Plus, get health and wellness advice in your inbox weekly.



BEFORE YOU GO!Download The Ultimate Menopause Checklist

You’ll get access to the most comprehensive menopause checklist available online to help you take charge and thrive before, during, and after your menopause experience.

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