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MENOPAUSE: WHAT'S HAPPENING

Suffering From Menopause Fatigue? Read This!

Hormonal changes can add a special little layer onto the exhaustion you may already be experiencing. Here's how to jumpstart your energy.



“If life in general is the cake of why you have low energy and fatigue, menopause is the probable icing.”— Dr. Kourtney Sims

Whatever life stage you’re in, you’re no stranger to burnout. Shortlisted for the 2021 Word of the Year, the term continues to gain traction in 2022 thanks to ongoing Covid, war, inflation, etc. Daily headlines warn of everything from burnout in school-aged kids to burnout-induced early retirement. So, if utter mental exhaustion is everyone’s baseline, what of the fatigue that affects a reported 46.5% of perimenopausal women?

Can one kind be distinguished from another? Probably, with some effort. And does that distinction even matter when all you want is relief? Yes, says Kourtney Sims, M.D., a Houston-based board-certified integrative gynecologist, certified member of the North American Menopause Society, and Phenology’s Chief Medical Advisor, and who goes by Dr. K. “You shouldn’t simply say, ‘I’m 45, so I’m tired solely because I’m perimenopausal,’ and leave it at that.”

Instead, she encourages patients to view fatigue as multifactorial—or multilayered, as befits a metaphor she likes: “If life in general is the cake of why you have low energy and fatigue, menopause is the probable icing.”

Two women standing side by side, one holding a pear and one holding a glass of water.

Why You May Feel Fatigue During Perimenopause

Taking the metaphor to its logical extreme, with apologies to bakers everywhere, we’d add that this particular cake is double-frosted. Atop a base layer of perimenopausal estrogen loss— which in and of itself can lead to fatigue—hot flashes and night sweats make a good night’s sleep feel all the more elusive.

Complicating matters further? Certain conditions may not be specific to midlife, but they can still turn up at this juncture and present as fatigue, from anemia to thyroid issues. “Even some cancers present as fatigue,” cautions Dr. Sims.

Then there are the external factors that so often contribute to midlife exhaustion: caring for increasingly fragile parents, parenting increasingly stressed-out kids, managing an increasingly demanding career—and sometimes all three at once.

What To Do If You Feel Fatigued

“Because fatigue can be so multifactorial, and some of those factors can be serious, don’t make any assumptions,” advises Dr. K. For starters, see your doctor. Clinical evaluation and lab work are key to determining what’s going on.

But Dr. Sims also suggests discussing your fatigue with a mental health professional: “If there are any underlying issues you haven’t been dealing with, they can really come to the fore during this hormonal transition and compound feelings of exhaustion.”

How To Boost Your Energy During Perimenopause

As individual as all of these fatigue factors are—and as much as the remedies might depend on your doctors’ findings—there are energy-boosting steps anyone can take immediately.

One biggie: Get at least some exercise every day. “Recognize and honor the value of daily movement, however that shows up for you,” Dr. K says.

“Look at your diet, too,” she says. While energy-boosting foods can be specific to each person, good general tenets include avoiding processed foods and sugars, limiting saturated fats in favor of healthy fats (nuts, seeds, olive oil) and leaning heavily into plant-based food. And don’t underestimate the energy-boosting powers of eating the rainbow. “If all the produce in your cart is one or two colors, you have an issue,” says Dr. K. “Even if that color is green.”

And while she’s quick to acknowledge that no diet or person is perfect, she suggests you aim for a 90-10 ratio of virtue to vice when you’re eating for maximum energy. “Maybe go to 80-20 when you’re on vacation, and 70-30 when you’re in Italy.”

Another area where she likes to remain flexible: “With almost half of women feeling physically and mentally exhausted, I’m not going to be the one to tell them they can’t have their caffeine,” she says. (Ideally, to no more than eight ounces per day before 3pm.) “But if you need three cups of coffee to get through your day, let’s look at what else can we put in place—even if it's a caffeine-free alternative with chicory or dandelion or even mushrooms—to help you cut back.” For a quick mental boost, consider Lucid Lift Clarity Mints, formulated with L-theanine and naturally derived caffeine to support improved mental focus without caffeine jitters.

Of course, the ultimate fatigue fighter is sleep itself, and you can probably start improving yours with a few strategies, all aimed at restoring circadian rhythms. “You want to support your innate cues that it’s time to restore, relax and recover from the stress of the day,” says Dr. K.

Here are some of Dr K's tips to get better quality sleep:

  • - Try to establish a consistent bedtime (within an hour), and back away from the electronics a couple of hours before then.

  • - Incorporate a nighttime gummy that supports restful sleep and also helps reduce the frequency and duration of hot flashes, like Phenology's Elevated Evening gummies.

  • - Sleep in a cool, dark room—ideally with blackout curtains, and even more ideally with blackout curtains on a timer that lets natural light fill the room as you’re waking up.

  • - Whatever the curtain or shade situation, try to be consistent about your wakeup time, and to have natural light hit your eyes for 10-15 minutes within the first hour you’re up. If you need to incentivize yourself, think coffee on the porch (or balcony, or fire escape…whatever works).

Sure, “we’ve obliterated a lot of our natural sleep cues with days that are all over the place,” says Dr. Sims. But mercifully, “the body still knows what to do.”


Rafaela Marcus
Rafaela Marcus has spent most of her career in magazines, sometimes in the Glamour/Cosmo/Allure universe, sometimes in the National Geographic Traveler/Conde Nast Traveler/Travel + Leisure universe. After 25 years in New York, she now lives in Los Angeles.

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