What to Know About Menopause Fatigue

Medically Reviewed by Traci C. Johnson, MD on July 01, 2022
4 min read

Menopause is a natural biological process that marks the end of your monthly menstrual cycles. Menopause can happen in your 40s or 50s but it’s different for each woman. When you experience menopause, you’re likely to have vasomotor symptoms (VMS) such as hot flashes, or other symptoms during this time like emotional ups and downs, low energy, and extreme tiredness, also known as fatigue.

There are many effective treatments available, from lifestyle adjustments to hormone therapy. If you’re experiencing menopause, talk to your doctor about how they can help.

It’s normal for everyone to feel overtired or overworked from time to time. Such instances usually come and go and people are usually able to recover well.

Unrelenting exhaustion, on the other hand, lasts longer, is more severe, and isn't cured with rest. It’s a feeling of constantly feeling drained, zapping your energy and motivation, and causing issues with concentration and your overall quality of life. Fatigue at this level impacts your emotional and psychological well-being, too.

Many women experience symptoms like these while they’re going through menopause. The lack of sleep and constant battle to get consistent quality sleep might catch them off guard. After all, menopause fatigue is not something that is talked about much.

As a woman nears menopause, her hormone levels fluctuate dramatically, which causes the brain to wake up at all hours of the night. Also, lower levels of progesterone (hormones released by the ovaries during monthly menstruation) make some women short-tempered and less able to relax.

Hormones like progesterone and estrogen are suspected to help protect women from a condition called sleep apnea. Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. When women go through menopause, they no longer produce progesterone which means they’re no longer as naturally protected from this sleep disorder, ultimately putting them more at risk.

If you have sleep apnea, oxygen deprivation may cause you to awaken several times during the night.

But hormones aren’t the only thing that will keep women up at night. Other symptoms of menopause like hot flashes and night sweats are also likely culprits of poor sleep.

There are changes in the brain that lead to VMS like hot flashes, and those changes — not just the feeling of heat — can also be what triggers the body to wake up while you’re trying to sleep. Even women who don’t report having sleep disturbances as a result of hot flashes often say that they have more trouble sleeping than they did before menopause.

In short, the more uncomfortable you are, the more likely you’ll wake up throughout the night, often more than once.

Menopause fatigue is real. You can help relieve some of the symptoms by trying different things such as:

Soy-rich foods. Foods high in soy are high in a chemical that gives you the same benefits that estrogen has on your body. This can help even out some of the hormones.

Avoid eating spicy food. Spicy food is notorious for triggering hot flashes — avoid it if you can.

Dress in lightweight clothing. When you go to bed, wear lightweight clothing to help keep you cool in case a hot flash comes on.

Exercise. Exercising regularly can help you fall and stay asleep, improving your sleep quality overall.

Medication and therapies. Some medications called serotonin reuptake inhibitors (SSRIs) have been shown to help menopausal women with sleep symptoms.

Hormone replacement therapies may also help improve your sleep quality, although they come with some risks and potential health concerns. Starting hormone replacement therapy is a serious decision that your doctor can help you make.

Acupuncture. Some women have found that alternative therapies, like acupuncture, can help improve sleep and overall wellbeing.

Sleep aids. Sleep aids can be helpful from time to time, but you don’t want to become reliant on them. It’s helpful to try incorporating other things, too. You can wind down before you go to bed, go to bed at the same time every night, not watch TV in bed, and not look at your cell phone in bed.

Oral contraceptives. Although you’re exiting your childbearing years, oral contraceptives may still be prescribed to you. Birth control pills help regulate hormones and may ward off extreme hot flashes and help regulate unpredictable periods during this time of life.

Menopause is a completely natural and normal part of getting older, but that doesn’t mean you have to suffer in silence. A doctor can help you manage your symptoms and determine which treatments can make you more comfortable.

If you’re experiencing extreme symptoms of menopause that interfere with your daily life, it’s time to see your doctor. Mood changes and physical changes in your body are expected, but if you’re having trouble going into work, interacting with your family, or feel anxious and generally unwell, it’s a sign that you may need medical treatment.