As an acupuncturist, I see many female patients around mid-life (during perimenopause) who are experiencing extreme (also known as “crashing”) fatigue. Does perimenopause cause fatigue? It absolutely can. Many women going through perimenopause, or the initial stages of menopause, experience this overwhelming fatigue. It is absolutely debilitating. Often, the sufferer finds herself unable to continue with her regular day, as she simply must lie down and nap. If she is driving, she may need to pull over at a rest stop and close her eyes.

The Reality of Fatigue and Perimenopause

The fatigue that women going through perimenopause go through is unique and devastating. It is not “feeling a bit tired” or something a quick cat nap will solve. This sort of fatigue is complete and thorough, often preventing regular day-to-day activities. The legs feel heavy, the body feels heavy, and there is simply no way the sufferer can continue.

People who have not experienced perimenopausal fatigue have a hard time wrapping their brains around it. “Just have a coffee!” they might say. Or “Come on, buck up–it can’t be that bad!” Sometimes even when the woman gets more sleep at night, up to 10 or 11 hours the fatigue is still there. It can be very frustrating, and women will often feel guilt or shame that they can’t keep up with their regular activities. If they have children, they’ll have to explain to them their fatigue, as it’s not easy to hide.

The Difference between Chronic Fatigue and Perimenopausal Fatigue

Chronic fatigue is ongoing, constant and is often accompanied by extreme body aches and soreness. Sleeping more doesn’t help. The crashing fatigue associated with perimenopause has a very sudden onset and is overwhelming, but can also disappear for days at a time. Sleep often does help, but only temporarily.

During perimenopause, women’s hormone levels fluctuate tremendously, particularly estrogen. These fluctuating hormone levels can cause you to feel very tired at odd times of the day.

What Can Be Done to Alleviate Fatigue due to Perimenopause?

First off, acknowledge this phase of your life. Acknowledge that there will be times you need to say no to activities, outings and people.  You might feel guilty, especially if it’s your children asking you to play a game with them or take them to the mall, and you know you just. Can’t. Do it. It’s important to recognize that this fatigue is not something you can just snap your hands and magically wish away. This fatigue is REAL. It is NOT in your head, and it is not easily ignored. When you feel it, you must listen to it. 

-Sit down. Close your eyes. Lean back. Relax. Succumb to the fatigue. It’s okay.

-If you’re at work, try and go to the ladies’ room for a 5 minute break or go for a walk outside for 15 minutes.

-Avoid caffeine if you can, but sometimes you can’t–sometimes it’s only a cup of coffee that has gotten me through the afternoon, and you know what? That’s okay too.

-Take 1000 mg of liposomal Vitamin C.

-Go to bed earlier. As in…8:30 pm earlier (yes, that early!) I know, everyone says to do this, but really, just do it.

-Exercise GENTLY. A 30 minute walk, not too fast. A leisurely bike ride. A mellow yoga class (lots of child’s poses please!)

-Eat small, frequent meals with plenty of healthy protein: walnuts, almonds, a hard-boiled egg.

-Drink lots and lots of water.

-Support your adrenals by avoiding stressful situations whenever possible.

You are not alone in experiencing this crashing fatigue. Other women are going through it, and you WILL get through it. But remember you need to listen to your body–don’t push yourself too hard. This part of your life will eventually pass, and your energy will return.

For the moment, ignore the naysayers and focus on listening to your body. You may not be an Energizer Bunny, but you WILL feel better about yourself. Good luck and hang in there, women!