Perimenopause Fatigue: Causes, Symptoms, and Solutions

Jun 18, 2024 | 7 min read

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Perimenopause fatigue can significantly impact daily life, making routine tasks feel overwhelming and reducing overall quality of life. It's important to recognize these symptoms early and implement strategies to manage them effectively.

perimenopause fatigue

What is Perimenopause?

Perimenopause is the transitional period leading up to menopause, marked by hormonal fluctuations and various physical and emotional changes. 

It typically begins in a woman's 40s and can last several years, culminating in menopause, which is defined as the point when a woman has not had a menstrual period for 12 consecutive months.

According to The Conversation, up to 80% of women in perimenopause experience symptoms. These symptoms are not limited to hot flashes – they can be incredibly varied and range in severity, including night sweats, mood swings, fatigue, and sleep disturbances.

Does Perimenopause Cause Fatigue?

Yes, perimenopause can cause fatigue. This period is marked by significant hormonal changes that can disrupt sleep patterns and energy levels, leading to persistent tiredness.

Hormonal Fluctuations

One of the primary reasons perimenopause can cause sudden crashing fatigue is due to significant hormonal fluctuations. As estrogen and progesterone levels drop, the body undergoes various changes that can disrupt normal energy levels and sleep patterns. 

These hormonal shifts affect neurotransmitters in the brain, which play a crucial role in regulating mood and energy.

Sleep Disturbances

Sleep disturbances are a hallmark of perimenopause and a major contributor to fatigue.

Night sweats and hot flashes can wake you up multiple times during the night, preventing restful sleep.

Insomnia, or the inability to fall and stay asleep, is also common during this period, leaving you feeling exhausted during the day.

Increased Cortisol Levels

Cortisol, known as the "stress hormone," tends to increase during perimenopause, further complicating sleep and energy levels. Elevated cortisol can lead to feelings of stress and anxiety, which disrupt sleep patterns and contribute to daytime fatigue. 

Managing stress through relaxation techniques and mindfulness can help mitigate these effects.

What Does Perimenopause Fatigue Feel Like?

Physical Symptoms

Perimenopause fatigue is often described as a persistent, overwhelming tiredness that doesn't seem to improve, even with adequate rest. Women experiencing this type of fatigue may feel:

  • Constantly exhausted, with low energy levels throughout the day
  • Muscle weakness, making physical tasks more difficult
  • A general sense of lethargy, where even getting out of bed feels like a monumental effort

This persistent tiredness can significantly impact your ability to perform daily tasks and enjoy activities you once found easy and pleasurable.

Emotional Symptoms

In addition to physical tiredness, perimenopause fatigue can take a toll on your emotional well-being. Common emotional symptoms include:

  • Mood swings that can cause sudden and unpredictable changes in your emotional state
  • Increased irritability, making it harder to manage stress and interact positively with others
  • Feelings of anxiety and depression, which can be exacerbated by the constant fatigue

These emotional challenges can create a cycle where fatigue leads to stress and mood changes, which in turn worsen the feeling of tiredness.

Daily Impact

The daily impact of perimenopause fatigue can be profound. It can affect various aspects of your life, including:

  • Work: Difficulty concentrating, reduced productivity, and increased absenteeism
  • Social Life: Less interest in social activities and difficulty maintaining relationships
  • Home Life: Struggling to keep up with household chores, childcare, and personal care

Fatigue can make it challenging to enjoy life and fulfill responsibilities, emphasizing the importance of finding effective ways to manage and mitigate these symptoms.

How Long Does Perimenopause Fatigue Last?

The duration of perimenopause fatigue varies widely among women. Typically, this fatigue peaks during the last few years before menopause and may continue for some time afterward

On average, women can experience perimenopause symptoms, including fatigue, for 4-8 years.

Factors Influencing Duration

Several factors can influence how long and how severe perimenopause fatigue lasts:

  • Hormonal Changes: The degree of hormonal fluctuations can affect the severity and duration of fatigue.
  • Lifestyle: Diet, exercise, and sleep habits play a crucial role in managing symptoms.
  • Stress Levels: Higher stress levels can worsen fatigue and prolong its duration.
  • Overall Health: Pre-existing medical conditions and overall health can impact the severity and duration of perimenopause symptoms.

By addressing these factors, you can potentially reduce the length and impact of perimenopause fatigue.

Identifying Perimenopause Fatigue

While perimenopause can cause fatigue, it's important to consider other potential causes. Fatigue can be a symptom of various medical conditions, including:

  • Thyroid Problems: Hypothyroidism or hyperthyroidism can both lead to fatigue.
  • Cardiovascular Issues: Heart problems can cause tiredness and a lack of energy.
  • Mental Health Disorders: Conditions like depression, anxiety, and ADHD often present with fatigue.
  • Autoimmune Diseases: Conditions such as lupus or rheumatoid arthritis can lead to persistent tiredness.

Understanding these potential causes can help you and your healthcare provider determine the root cause of your fatigue and find the appropriate treatment.

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When to See a Doctor

It's essential to seek medical advice if your fatigue is accompanied by any of the following symptoms, as they could indicate a more serious condition:

  • Shortness of breath
  • Chest, arm, or upper back pain
  • Irregular, fast, or pounding heartbeats
  • Muscle weakness or tiredness in your legs or arms
  • Thoughts of harming yourself or others
  • Abdominal bloating, pain, nausea, or vomiting
  • Skin rash
  • Vision changes
  • Persistent headaches

Consulting a healthcare professional can help you identify any underlying conditions and receive the appropriate care.

For personalized advice, consider using our Symptom Checker to understand your perimenopause symptoms better and discuss them with your doctor.

Strategies for Perimenopause Fatigue Treatment

Managing perimenopause fatigue effectively requires a combination of medical treatments and lifestyle changes. Here are some strategies to help alleviate fatigue and improve your overall well-being.

Menopause Hormone Therapy (MHT)

Menopause Hormone Therapy (MHT) can be an effective way to manage perimenopause symptoms, including fatigue. 

MHT helps by supplementing the body with hormones like estrogen and progesterone, which decrease during perimenopause. By stabilizing these hormone levels, MHT can:

  • Improve Sleep Quality: Reducing night sweats and hot flashes can lead to less interrupted sleep.
  • Boost Energy Levels: Stabilized hormone levels can help reduce feelings of fatigue and increase overall energy.
  • Enhance Mood: MHT can help alleviate mood swings and emotional disturbances that contribute to fatigue.

According to the Cleveland Clinic, healthcare providers recommend that people who opt to use hormone therapy start it within 10 years of beginning menopause symptoms and use it for less than five years. 

While MHT can be beneficial, it is essential to discuss with your healthcare provider to determine if it is the right option for you, considering potential risks and benefits.

Lifestyle Changes

Making certain lifestyle changes can significantly impact your energy levels and overall health during perimenopause.


A balanced diet plays a crucial role in managing perimenopause fatigue. Focus on:

  • Lean Proteins: Include sources like chicken, fish, tofu, and legumes to support muscle health and energy.
  • Complex Carbohydrates: Choose whole grains, fruits, and vegetables to provide sustained energy and stabilize blood sugar levels.
  • Hydration: Drink plenty of water throughout the day to stay hydrated and energized.

Avoiding simple sugars and highly processed foods can help prevent energy crashes and maintain a more stable energy level throughout the day.


Regular physical activity is essential for combating perimenopause fatigue. Benefits of exercise include:

  • Increased Energy: Engaging in moderate to vigorous physical activities can boost your energy levels.
  • Improved Sleep: Regular exercise helps regulate sleep patterns, leading to more restful nights.
  • Strength and Flexibility: Incorporating strength training and aerobic exercises helps maintain muscle mass and cardiovascular health.

Start with activities you enjoy, such as walking, swimming, or yoga, and gradually increase the intensity and duration.

Sleep Hygiene

Good sleep hygiene is vital for reducing fatigue. Here are some tips:

  • Regular Sleep Schedule: Go to bed and wake up at the same time every day, even on weekends.
  • Limit Caffeine and Alcohol: Avoid these substances, especially in the afternoon and evening, as they can interfere with sleep.
  • Minimize Screen Time: Reduce exposure to screens at least an hour before bedtime to improve sleep quality.

Creating a calming bedtime routine, such as reading or taking a warm bath, can also help signal to your body that it’s time to wind down.

Stress Management

Managing stress effectively can reduce fatigue and improve overall well-being. Techniques include:

  • Mindfulness and Meditation: Practice mindfulness exercises and meditation to reduce stress and promote relaxation.
  • Relaxation Exercises: Incorporate deep breathing exercises and progressive muscle relaxation into your daily routine.
  • Prioritize Self-Care: Make time for activities you enjoy and that help you relax, such as hobbies, spending time with loved ones, or listening to music.

Practical Tips for Daily Energy Boosts

To manage perimenopause fatigue, it’s essential to incorporate both quick fixes for immediate relief and long-term habits for sustained energy.

Quick Fixes

Here are some practical tips for immediate energy boosts:

  • Short Walks: Take a brisk walk to increase your energy and improve your mood.
  • Hydration: Drink water to stay hydrated and prevent fatigue.
  • Power Naps: Take a short nap (20-30 minutes) to recharge without interfering with nighttime sleep.

These quick fixes can help you get through particularly challenging moments during the day.

Long-term Habits

Establishing long-term habits can promote sustained energy levels:

  • Balanced Diet: Maintain a nutritious diet with balanced meals throughout the day.
  • Regular Exercise: Incorporate physical activity into your daily routine for long-term energy benefits.
  • Consistent Sleep Routine: Follow good sleep hygiene practices for better sleep quality and overall energy.
  • Stress Reduction: Practice ongoing stress management techniques to maintain emotional well-being and prevent fatigue.

By integrating these strategies into your daily life, you can effectively manage perimenopause fatigue and improve your overall quality of life.

Frequently Asked Questions

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Key Takeaways

  • Perimenopause can cause significant fatigue due to hormonal fluctuations, sleep disturbances, and increased cortisol levels.
  • The duration and severity of perimenopause fatigue vary, typically peaking in the years leading up to menopause.
  • It is essential to differentiate perimenopause fatigue from other medical conditions such as thyroid problems, cardiovascular issues, and mental health disorders.
  • Effective management strategies include Menopause Hormone Therapy (MHT), a balanced diet, regular exercise, good sleep hygiene, and stress management techniques.
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