What is menopause fatigue?
Menopause fatigue isn’t just feeling tired after a long day. For many it’s a deep, unshakeable exhaustion that seeps into your bones, your brain, and your mood. It can hit without warning and linger for hours, days, or longer. And for many women, it’s one of the most disruptive symptoms of perimenopause and menopause [1, 2].
What does it feel like?
It feels like running on empty. Like no amount of sleep can restore your spark. It’s not just physical tiredness, it’s mental and emotional too.
Many women describe:
- Waking up tired, even after a full night’s sleep
- Hitting a wall mid-morning or mid-afternoon
- Struggling to focus, remember words, or stay motivated
- Feeling overwhelmed by simple tasks
Feeling tired all the time can affect everything from your performance at work to your relationships at home. It can make you feel like a shadow of yourself. And because it's invisible, it often goes unrecognised by others, and even by yourself.
How long does it last? That depends. Some women experience it for a few months, others for years. But you don’t have to wait it out in silence. There are ways to feel better [3, 4].
Why it happens: The hormone connection
As you move through perimenopause and into menopause, levels of key hormones like oestrogen, progesterone, and testosterone fluctuate and decline. These hormones don’t just affect your reproductive system, they play a key role in energy, sleep, mood and focus [5, 6].
Oestrogen, in particular, influences how your brain uses serotonin and other chemicals that affect alertness and motivation. It also affects your ability to get deep, restorative sleep. So when oestrogen drops, your sleep quality often suffers, even if you don’t wake up in the night. Night sweats, anxiety, and an overactive stress response can also keep your body in a state of overdrive, wearing you out [7].
Fatigue can also be compounded by other health issues common in midlife, such as thyroid dysfunction, low iron or B12 levels, and poor sleep hygiene [8].
How do you treat it?
There’s no one-size-fits-all solution, but there is hope. Here’s what can help:
- Hormone Replacement Therapy (HRT): Replacing lost oestrogen (and sometimes progesterone or testosterone) can improve sleep, mood, and energy. Studies show HRT is effective for many women when tailored to their needs [9,10,11].
- Better Sleep Habits: Aim for a regular sleep schedule. Keep screens out of the bedroom. Create a cool, dark space that signals rest. If night sweats are waking you, speak to your clinician — you deserve proper sleep [2, 7].
- Check Your Bloods: Ask about thyroid function, ferritin, vitamin D and B12. These are often missed and treating any conditions identified can make a big difference to energy levels [8].
- Gentle Movement: When you’re exhausted, the last thing you want is to exercise. But low-intensity movement like walking, yoga or swimming can actually boost energy, ease stress and improve sleep [12].
- Nourish Yourself: Fuel your body with slow-release energy foods, hydration, and protein. Limit alcohol and caffeine, which can interfere with sleep and increase anxiety.
- Rest Without Guilt: You’re not lazy. You’re not weak. You’re navigating hormonal changes. Give yourself permission to pace, pause, and prioritise your wellbeing.
¹
