Many women going through menopause and in the years after report feeling tired and fatigued more often. There are several factors that can contribute to feelings of exhaustion and tiredness during this time and the loss of energy can be a struggle. Understanding the common causes can help women identify any lifestyle changes or treatments that may help.

Please note, while the menopause usually affects women between the ages of 45 and 55, it can happen earlier. Perimenopause is when you have symptoms, but your periods have not stopped, and is classified as menopause only when you have not had a period for 12 months. This can start in your late 30’s and last up to eight years (although average is four years).

Menopause and perimenopause can both cause other symptoms such as anxiety, mood swings, brain fog, hot flushes and irregular periods.

menopausal woman tired and headache
Brain fog and tired are common menopausal symptoms

Hormonal Changes

One of the biggest reasons for menopausal fatigue is shifting hormone levels. Oestrogen and progesterone start declining during perimenopause, the transition period leading up to menopause. The drop in oestrogen speeds up during menopause itself. This directly impacts energy levels and can leave women feeling drained. Low oestrogen can also interfere with getting good quality sleep, which leads to daytime tiredness.

In addition to oestrogen dropping, post-menopausal women often have lower testosterone. Testosterone plays a role in providing energy. When testosterone levels are lower, it can be another cause of low energy after menopause.

Top tip: Studies have shown oestrogen fluctuations during menopause can be a factor for depression, so look out for warning signs.

Sleep Disturbances

Many women going through menopause struggle to get enough high quality sleep. Hormonal fluctuations during this transition lead to several issues that disrupt sleep. Hot flashes and night sweats are common causes of sleep interruptions and can make it difficult to fall back asleep. Anxiety and mood changes related to menopause may also interfere with sleep.

Sleep disorders like insomnia and sleep apnoea also become more common in women after menopause. Lack of restorative sleep is one of the biggest factors leading to increased fatigue. Focusing on improving sleep quality and duration can significantly help fight fatigue.

Top tip: You want to avoid caffeine after lunchtime for a better nights sleeps. Glucose energy chews can also help reduce tiredness if you need a quick boost on a busy day.

excessive caffiene is not the answer to fatigue
Excessive caffeine is not the answer to being fatigued

Nutritional Deficiencies

Post-menopausal women have increased nutritional needs, but diets sometimes lack optimal levels of vitamins and minerals. Being deficient in iron, vitamin B12, vitamin D, magnesium or omega-3 fatty acids can all cause or worsen fatigue. It is important for post-menopausal women to eat a balanced diet with emphasis on including fatigue-fighting nutrients. Supplements may also help fill any nutritional gaps.

Decreased Muscle Mass

A natural part of aging is losing muscle mass and strength, a process known as sarcopenia. The rate of muscle loss tends to increase during menopause due to hormonal changes. Having less muscle mass not only reduces strength for daily activities, but also directly decreases energy reserves in the body. Doing regular strength training and exercise helps counteract this loss of muscle.

Perimenopausal fatigue
Tiredness and dizziness could be signs of being anaemic

Anaemia

Anaemia, a condition where there are not enough healthy red blood cells to carry oxygen to tissues, is more common in postmenopausal women. The most common causes are iron deficiency or a lack of vitamin B12. Anaemia can also be due to health conditions like thyroid disorders or diabetes. Symptoms like weakness, fatigue, light-headedness, rapid heartbeat, and shortness of breath should be evaluated for anaemia.

Several medical issues become more common after menopause and can cause fatigue as a symptom. For example, thyroid disorders often arise around menopausal years and make people feel tired, sluggish and weak. Diabetes, autoimmune disorders, heart disease, and arthritis are some other conditions that may develop with age and menopausal hormonal shifts that include exhaustion as a symptom. Having annual well-woman exams helps identify any new health problems that could be making fatigue worse.

Discussing concerning exhaustion levels with a doctor is recommended to rule out any underlying illnesses.

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Holly MacDonald
Holly studied Digital Journalism at University of Strathclyde. A single mum, her young son Thomas battles for adulation with her love of wine and chocolate, and the very occasional guilt-driven Gym appearance. Other than writing, Holly has a love for making jewellery, thanks to her beloved grandmother.