Fatigue and menopause: tips to boost energy

Lost: Energy! If found, please return

• Why fatigue is a common symptom during perimenopause and menopause
• How hormone changes can impact your mood and energy levels
• Advice on how manage this symptom

Feeling utterly wiped out by everyday life is not an unusual experience for many women during the perimenopause and menopause. Fatigue, which can be emotional and physical, is one of the most common symptoms reported during the menopause.

You may find you feel tired, drained or simply worn-out. Some women describe a feeling like they are ‘wading through treacle’ and a constant feeling of juggling too much. So why are you feeling like this and what can help?

How common is fatigue in menopause?

If you’re struggling with low energy in menopause, then you’re not alone – fatigue consistently comes up as one of the most common symptoms of menopause. In a survey of 3,000 women over the age of 40, 67% said they were suffering from fatigue [1].

What can sap my energy in menopause?

Many different factors top up and deplete your energy levels every day, in the menopause at least part of that is likely to be changes caused by hormones.

In the perimenopause and menopause, your levels of oestrogen, progesterone and testosterone start to fluctuate and fall. Changing hormones can disrupt your sleep, which will leave you feeling tired.

If you experience low mood, which can be a menopausal symptom for many women, this can also make energy levels drop.

When you are feeling tired, it can be harder to be motivated to make the choices that energise you, like heading out for a walk or a run, or eating a healthy, balanced diet.

Joint pain and declining muscle strength, also connected to declining oestrogen, is also a common symptom from the menopause, and these can hit your motivation to be active.

With your perimenopause and menopause often happening in your 40s and early 50s, this can be a hectic time, with many other calls on your time and energy. Juggling work and caring for children and older relatives can be all part of busy schedules, and lead to you feeling worn out.

Other menopausal symptoms like anxiety, overwhelm or brain fog, can also erode your usual levels of resilience and ability to manage a hectic timetable.

Can fatigue be an early sign of menopause?

Everyone feels tired some of the time, especially when life gets busy. So it can be hard to identify when your fatigue tips from an occasional issue into a more sustained symptom.

Many women miss fatigue as an early sign of menopause, and only realise looking back that it is part of the picture. Tracking all symptoms you might be experiencing, including fatigue, can help guide diagnosis and discussions with your healthcare professional about what might help. Download the balance app to access a free and easy-to-use symptom tracker.

What role are my hormones playing?

Oestrogen helps regulate other hormones, including serotonin, the so-called happy hormone, which influences your mood and energy. When your oestrogen drops, so does serotonin, and this could have a role in depression and low mood, which can affect your energy levels [2].

Oestrogen produced in your brain also has a critical role in metabolism, regulating how much you eat, when you feel full and how you turn that food into energy for your body.

Many women have disturbed sleep during the menopause, this can involve being woken by hot flushes and night sweats, struggling to drop off or waking early.

Oestrogen and testosterone both have important effects on helping the quality and duration of sleep.  The hormone progesterone can be beneficial for sleep too as it increases the production of gamma aminobutyric acid (GABA), another chemical in our brain that works to help sleep.

RELATED: Sleep and hormones

It is common for perimenopausal and menopausal women to also have an underactive thyroid, according to the British Thyroid Foundation [4]. Your thyroid is a gland which releases hormones to helps regulate metabolism, which controls how much energy you release from food.

RELATED: Thyroid health and the menopause

The fall in your levels of testosterone can also affect muscle and bone strength, and lead to a lack of energy.

RELATED: The importance of testosterone for women

What can I do to boost my energy levels?

Physical activity can boost your energy levels while reducing your risk of many long-term conditions, protect your heart health, improve your sleep and reduce symptoms of depression and anxiety [5]. It also helps protect the strength of bones and muscles, which can decline from perimenopause onwards.

However, sometimes it can be hard to muster the energy and motivation, so you might need to tailor your movement to your energy levels. If high intensity interval training (HIIT) or spin classes feel too much, consider something else like lower impact such as swimming, yoga or Pilates.

Weight bearing exercise, which includes running, dancing, walking, tennis and aerobics, can build and maintain bone strength. Weight or strength training, which can include lifting weights, kettle bells and using resistance bands are also beneficial [5].

Consider trying a new activity, and remember it is never too late to start exercising.

RELATED: Exercising during the perimenopause and menopause

RELATED: Get stronger during the menopause

Diet is also key. For example, while you need carbohydrates for energy, eating lots of white refined carbohydrates, like white bread, pizza and white rice can lead to a cycle of energy increases and dips. Instead aim for a well-balanced diet, which has a multitude of health benefits and can boost your mood, and focus on eating carbs which give a steady, sustained release of energy, such as wholegrains.

RELATED: Healthy eating for the menopause

Don’t forget self-care

You may find yourself juggling many demands during the perimenopause and menopause. Carving out some to learn what makes you feel like you is important. Explore new ways to move that energise you.

You could discover the benefits of yoga and meditation: research suggests mindfulness can help with symptoms such as stress, anxiety and other mental-health conditions, which you may experience during the menopause.

RELATED: Does mindfulness help with the menopause?

Prioritise what matters

When energy levels are really low, use what energy you have on what matters most.

One approach recommended by many healthcare professionals is the three Ps of pacing, planning and prioritising [7]. This means spreading what you do throughout the day to manage your energy, building in rest breaks to recharge and planning ahead. Prioritise activities and aim for a balance of tasks that you need to do and want to do.

Consider hormone replacement therapy (HRT)

HRT is the first-line treatment recommended in the National Institute for Health and Care Excellence (NICE) guidelines for the treatment of menopausal symptoms.

HRT can improve sleep and reduce low mood and anxiety, all symptoms which may sap your energy. It can also help maintain muscle and bone strength [8].

But getting the right type, dose and combination of HRT is very individual, and getting that balance right can take time. If you are already taking HRT but are not feeling the benefits, talk to your healthcare professional and see if you need to alter the dose or type of HRT you are taking.

References

1. Harper J.C. et al (2022), ‘An online survey of perimenopausal women to determine their attitudes and knowledge of the menopause’, Womens Health (Lond). 18:17455057221106890. doi: 10.1177/17455057221106890

2. Rybaczyk L.A. et al (2005), ‘An overlooked connection: serotonergic mediation of estrogen-related physiology and pathology’, BMC Womens Health. 20;5:12. doi: 10.1186/1472-6874-5-12

3. Xu Y, López M (2018), ‘Central regulation of energy metabolism by estrogens’, Mol Metab. 15:104-115. doi: 10.1016/j.molmet.2018.05.012

4. British Thyroid Foundation Thyroid and menopause

5. NHS.uk Common symptoms of menopause and perimenopause

6. Mishra N., Mishra V.N., Devanshi (2011), ‘Exercise beyond menopause: dos and don’ts’, J Midlife Health. 2(2):51-6, doi: 10.4103/0976-7800.92524

7. Royal College of Occupational Therapists (2023) How to manage your energy levels

8. NHS.uk Benefits and risks of HRT