a woman experiencing menopause fatigue sitting on the edge of her bed

Menopause Fatigue: Is It Wearing You Down?

By Christina Hanna, MPH, CHES • Published 09/18/2023

Medically Reviewed by Dr. Jill Liss, MD

You’re not alone if you find yourself having less energy than you used to even if you’ve had a full night of sleep. You may find you need to take more breaks during regular tasks (like cleaning the house), find it more difficult to walk upstairs, or take longer to recover from exercise.

And fatigue can not only affect the body, but also the mind. Mental fatigue is real and can lead to difficulty thinking, concentrating, remembering, or decision making.

The emotional toll of menopause, coupled with physical discomforts like vaginal dryness, hot flashes, and night sweats, can intensify the feeling of being mentally and physically drained.

Since the menopausal transition can last 7 to 14 years and happens during a time of life when there’s a lot going on, it’s no wonder that physical and mental exhaustion are common menopause symptoms. It's so common that almost half of females ages 40-65 say they have physical and mental fatigue.*

All of us have “off” days. But when you have weeks, months, or even years of feeling drained, it can have a huge impact on your wellbeing and affect many parts of your life.

Menopause is truly a marathon and something many of us may not be prepared for.
a woman with a hand on her forehead while coping with perimenopause fatigue

Why does menopause make you tired?

Changing hormones

Physical and mental exhaustion during menopause is likely the result of several different factors. The first is the changes in your hormones. The significant fluctuations in estrogen and progesterone can have an effect on other hormones in the body. These hormones help regulate energy in the body, so if they’re affected, it may cause you to feel tired.

Low quality or less sleep

As estrogen levels start to fluctuate and begin to decrease, many people can develop night sweats, which can interrupt sleep and cause someone to wake up multiple times. These disrupted sleep patterns can lead to insomnia or fragmented sleep. This lack of quality sleep can contribute to daytime fatigue, irritability, and difficulty concentrating. All of these can make exhaustion feel much worse.

A lot of responsibilities

Many people in perimenopause and postmenopause are balancing a lot of responsibilities. Not only are they often working outside the home, but they’re also the primary person caring for children, the home, and possibly aging family members. Although many of us may have been carrying around the weight of all these responsibilities for many years. What’s different is increased irritability and fatigue and not coping and adapting to stress the same as you previously have.

Other health-related changes

As we age, there may be other health-related issues that can affect our energy and how awake we feel each day:

  • Sleep apnea
  • Sleep disorders
  • Stress or anxiety

If you’re experiencing fatigue, it’s a good idea to talk to your doctor. While it may be related to menopause, it may also be caused by another condition, and you’ll want to have your doctor rule that out.

How might menopause exhaustion affect me?

As you’ve probably experienced many times over, when you’re tired, everything seems harder. So, when you’re experiencing mental and physical exhaustion, it can affect various parts of your daily life:

  • Getting through everyday tasks. If you’re extremely tired even after a full night’s sleep, it can be difficult to do everyday tasks, to work, and or to socialize. You may choose not to do those things at all, or not be fully present if you do.
  • Staying focused and on task. Many people with mental exhaustion find it tough to focus, have memory lapses, and have trouble doing any type of multitasking. You may find it harder to stay as organized as you’re used to or may feel overwhelmed by tasks that used to feel manageable.
  • Feeling level-headed. In addition to being exhausted, you may also be experiencing an increase in mood swings and irritability – and the more tired you feel, the worse those can feel. Managing more emotions can further drain your energy.
  • Enjoying things in your life. Physical and mental exhaustion can lead to a decreased interest in doing things we would normally find enjoyable. You may have less interest in hobbies, social gatherings, or relationships and those can be affected.
a woman who struggles with symptoms of menopause and exhaustion plays with her dog as a way to improve her energy during menopause

How can I boost my energy levels?

  • Exercise! While it may seem counterintuitive, some studies suggest that physical activity can improve energy during menopause. Regular exercise can help you feel more energetic and helps prevent osteoporosis. It also helps improve heart health.
  • Menopausal hormone therapy (MHT). For some people, hormone replacement therapies can provide relief from menopause-related symptoms, including poor sleep and exhaustion. However, this option should be discussed thoroughly with a healthcare professional to see if this would be the right option for you.
  • Keep an eye on caffeine and alcohol. While we think of these as effective ways to stay awake (caffeine) and feel sleepy (alcohol), both have the potential to disrupt our sleep. Too much caffeine (and being too close to bedtime) can disrupt sleep. And although alcohol may help you feel drowsy, it disrupts your sleep later in the night. For some people, alcohol is also a trigger for night sweats, which will also disrupt your sleep.
  • Practice good sleep habits. Sticking to a regular sleep routine can help with getting more consistent (and possibly better) sleep. You can build a regular routine by going to bed and waking up at the same time every day, avoid using screens and devices before bed, and finding a relaxing activity you do each evening to signal to your body that it’s time to sleep. You may also consider adding a supplement to help your body wind down for sleep. Talk to your doctor about whether supplements are right for you.
  • Talk to a professional. It may be helpful to seek therapy, either individually or in a group setting, to talk about the emotional challenges associated with menopause. Counseling can provide coping strategies and tools to navigate this transition more effectively.
  • Consider medications. In the case of severe symptoms, a healthcare provider (or a telemedicine provider) might recommend medication to manage sleep disturbances, mood swings, or anxiety. These medications should be used under professional supervision.
  • Be honest and open. Share what you’re going through with trusted people in your life — friends, family, or support groups. This may help you feel less alone and realize that what you’re feeling is normal. And often when you open to others, they will also share with you, and you can provide each other advice on different coping techniques you’ve tried for managing menopause exhaustion.
  • Consider supplements. Consider trying a dietary supplement for energy support. Talk to your doctor about whether supplements are right for you.

Menopause-related physical and mental exhaustion can be a daunting challenge and can impact your quality of life. However, with awareness and a proactive approach, you can navigate this phase more smoothly. By embracing some of these strategies, you may find that you start to gain energy back to help get you through this transformative phase.

 

*Data from Attitudes & Usage study conducted in August 2021 with 4,578 female participants ages 40-65. Funded by Kenvue.

Last Updated 09/05/2024

REFERENCES

MedicalNewsToday. (2021). Causes and treatments for menopause fatigue. Accessed 8/15/23 from https://www.medicalnewstoday.com/articles/menopause-fatigue

Endocrine Society. (2022). Thyroid and parathyroid hormones. Accessed 8/15/23 from https://www.endocrine.org/patient-engagement/endocrine-library/hormones-and-endocrine-function/thyroid-and-parathyroid-hormones

Sleep Foundation. (2022). Menopause and sleep. Accessed 9/7/23 from https://www.sleepfoundation.org/women-sleep/menopause-and-sleep

Taylor-Swanson, L., Wong, A.E., Pincus, D., Butner, J.E., Hahn-Holbrook, J., Koithan, M., Wann, K., & Woods, N.F. (2018). The dynamics of stress and fatigue across menopause: Attractors, coupling and resilience. Menopause, 25(4): 380-390. doi: 10.1097/GME.0000000000001025

Ward-Ritacco, C. L., Adrian, A.L., O’Connor, P.J., Binkowski, J.A., Rogers, L.Q., Johnson, M.A., & Evans, E.M. (2015). Feelings of energy are associated with physical activity and sleep quality, but not adiposity, in middle-aged postmenopausal women. Menopause, 22(3): 304-311. DOI: 10.1097/GME.0000000000000315

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