Sleepwalking into the menopause? How to help relieve your fatigue

Are you a woman in your 40s or 50s experiencing utter exhaustion? Do you feel like you are walking through treacle every day? Are you too exhausted to cook supper and feel like you are running on empty throughout the day? You’re not alone. Fatigue during the perimenopause and menopause years is a common symptom that many women face but often don’t fully understand. In this blog, I delve into the reasons behind why “meno-tiredness” can be so debilitating, and explore various lifestyle changes, dietary adjustments and supplements that can help manage your tiredness.

What is the perimenopause and menopause?

In a nutshell, your menopause is when your ovaries stop producing eggs resulting in a drop in hormone levels (of oestrogen, progesterone and testosterone). Women are said to have gone through the menopause once they have not had a period for 12 months. The average age for women in the UK to hit menopause is 51, but there is a wide age variation and some women experience primary ovarian insufficiency from their mid thirties.

Your perimenopause is the transitional phase leading up to your menopause, which can last for a few months or quite a number of years (some up to twelve years). You may have lighter or irregular periods and start to experience some of the common peri and menopausal symptoms, such as poor sleep, hot flushes, brain fog, mood swings and tiredness.

Why do I feel so tired during perimenopause and menopause?

During the perimenopause, the ovaries gradually produce less oestrogen. Oestrogen plays a crucial role in regulating sleep patterns, mood and energy levels, so its decline can disrupt these, leaving you feeling utterly exhausted. As the menopause approaches, oestrogen levels decline, further resulting in hormonal fluctuations and therefore increased tiredness.

Additionally, the other symptoms commonly associated with perimenopause and menopause, such as night sweats can also cause disturbed sleep and dehydration which can both in turn contribute to your fatigue.

This is also a time of life when the thyroid gland can slow down and become underactive or autoimmune. The key symptoms for an underactive thyroid is fatigue, feeling cold all of the time, a sluggish bowel, weight gain and thinning hair. Thyroid markers can easily be tested by a medical doctor if these symptoms ring a bell.

How to manage your tiredness through lifestyle changes

While tiredness during perimenopause and menopause can be challenging, you can make changes to your lifestyle that can really help reduce symptoms and help you to feel more energised:

Take regular exercise – taking regular exercise can boost energy levels, improve sleep quality, and reduce stress. Try gentle exercise most days of the week, such as brisk walking, swimming or cycling, without doing anything too overly intense. Many women benefit from using weights which can help support testosterone levels (which is not just a male hormone!) which in turn improves both physical and mental stamina as well as energy levels.
Avoid ultra-processed foods – these foods are typically found in packets with additives written on the label that you would not normally find in a domestic kitchen such as preservatives, emulsifiers, artificial sweeteners, acidity regulators and some plant-based proteins. They are usually lacking in some of the key nutrients that are important for providing energy such as protein, iron and B vitamins. Eating more ultra-processed food is also associated with an early menopause in some women.
Eat more protein – protein is a mid-life woman’s friend and many peri and menopausal women have more constant energy over the day when they eat more protein such as meat, fish, shellfish, tofu, eggs, Greek yoghurt, cheese, pulses, nuts and seeds. Aim to have 25-30 grams of protein at each meal (including breakfast) and your energy levels should feel much more balanced.
Balance your blood glucose levels – if you eat too much refined sugar and white carbs such as pastries, biscuits and sweets to ‘boost energy levels’ you can end up feeling even more tired and exhausted within a couple of hours. A quick spike, then rapid drop, in blood glucose levels can significantly reduce energy levels and if not managed effectively can lead to insulin resistance. In a nutshell, refined carbs are not your friend during your mid-point years.
So instead of reaching for that digestive biscuit when you’re in need of more energy, reach for food rich in both protein and healthy fats such as a handful of nuts or seeds, a boiled egg or two, or Greek yoghurt or cottage cheese to help keep your blood sugars more stable. If you enjoy baking, check out my recipe pages which are full of healthy sweet and savoury snack recipes.
Be kind to your adrenals – chronic stress can put pressure on your adrenal glands which can make you feel wired and tired or even burnt out from the moment you wake until you head to bed in the evening. Take part in stress-reducing activities such as yoga, meditation and deep breathing exercises, or simply spend time in nature going for walks or runs to help restore the adrenal response to day to day stressors.
Prioritise quality sleep – aim for 7-9 hours of uninterrupted sleep each night and create a relaxing bedtime routine to help your body to wind down. Put all technology away at least an hour before bed, have a warm bath, write a diary and read a book to help you drop off to sleep calmly.
Limit caffeine and alcohol – while caffeine and alcohol may provide temporary energy boosts, they can increase night sweats, disrupt sleep patterns and exacerbate tiredness. Switch to decaff coffee and tea after lunch, and enjoy a cup of herbal tea in the evening instead of a glass of wine and see your energy soar!

Vitamins and minerals to help relieve your fatigue

In addition to some lifestyle changes, these vitamins and supplements may help you to feel more energised and less tired. A medical doctor can carry out tests for B12, folate and iron levels, but you would need to seek out testing through a nutritional therapist to test for vitamin D and magnesium:

B vitamins – B vitamins, including B12, B6 and folate (B9), play a crucial role in energy metabolism. Foods rich in B vitamins include salad leaves, green veggies, eggs, fish, offal and meats, or you could take a B-complex supplement.
Iron – if you are prone to having low iron levels or iron deficiency anaemia, eat iron-rich foods such as leafy greens, legumes (which includes lentils, chickpeas and beans), offal and red meats. You will be more susceptible to this if you have very heavy clotting periods. If you have stopped menstruating then your ferritin levels might rise quite quickly, so if you are unsure whether to focus in on iron then it is good to have a blood test. Aim for your ferritin levels (a blood test marker for iron stores) to be around 70-100 ng/mL.
Vitamin D – low levels of vitamin D, often known as the sunshine vitamin, have been linked to tiredness, anxiety and depression. Vitamin D can be found in oily fish, shellfish, beef liver, eggs, some mushrooms, grass-fed meat, and organic milk from grass-fed cows. However, there is often a limited availability of vitamin D through foods, so it is important to find a good quality vitamin D supplement to support energy levels.
Magnesium – a magnesium deficiency is associated with tiredness and muscle weakness. Magnesium is an essential mineral that is important for good health and plays a role in many bodily processes including the production of energy and regulating carbohydrate metabolism. It also helps to improve sleep quality to help boost energy levels. This important mineral works as a buddy with vitamin D, helping these levels to optimise. Increase your intake of magnesium-rich foods, such as nuts, seeds (like pumpkin and sunflower seeds), dark chocolate/cacao, whole grains, and green vegetables, or take a magnesium supplement.

Herbal support

There are many herbs, spices and mushrooms that can help to perk you up if you are experiencing perimenopause and menopause related fatigue and here are three of my favourites:

Asian or Korean ginseng root, also known as Panax Ginseng, is renowned for its ability to enhance alertness, vitality and also combat fatigue. Studies have found Korean Ginseng helpful for women whilst navigating the peri and post menopause as its benefits also include aiding cognitive function, increasing libido and bolstering the immune system.
Rhodiola rosea is a potent adaptogen herb that helps women to stay in balance during the key transitions of their life. It has been found to be a selective oestrogen receptor modulator (SERM), which may in turn help to mitigate a whole host of menopause related symptoms including fatigue. View Rhodiola as a herbal hug can help when long term stress has worn down your energy levels.
Cordyceps mushroom is taken by many women to help boost their energy levels and strength and it can also help with mental stamina at the same time.

Round up

Fatigue during the perimenopause and menopausal years is a common but manageable symptom that many women experience due to the fluctuations of our female hormones. By making some healthy lifestyle changes, adjusting your nutritional intake by eating the right food, and taking some targeted supplements, you will feel less exhausted and much more energised during this important transitional phase. Remember to listen to your body, prioritise your self-care and seek support when needed.

If you are seeking one to one support and would like to learn how to glide through your mid-point years, then book in with our women’s health and hormones clinical team.

If you need further individualised support, please get in touch with our clinical team for a one-to-one consultation.

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