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Struggling to Stay Awake and Energized? A Doctor Shares It Could Be Perimenopause Exhaustion

Fatigue is more common during this time because of hormonal imbalances, sleep disturbances and more

We all love our sleep. However, when you’re desperately awaiting bedtime to get those much needed zzz or constantly craving a midday nap, you may be more than just tired. Perimenopause exhaustion could be the real reason you find yourself struggling to stay awake and energized. Luckily, perimenopause and fatigue are common, and there are easy ways to get yourself out of a rut and boost your energy levels. Keep reading to learn more about how perimenopause symptoms impact your life and easy methods to combat them. 

What is perimenopause exhaustion? 

If you’re always tired and can’t quite pinpoint why, it could be perimenopause exhaustion. Feeling tired, fatigued, drained or lethargic are all signs that you’re dealing with this issue, and poor sleep quality could be contributing to your lessened energy.

The state of being extremely tired can be tied to sleep disturbances from other perimenopause symptoms including “hot flashes, nights sweats, insomnia and vaginal dryness” says Catherine Hansen, MD, MPH, FACOG, FRCSC, NCMP, a board-certified ob-gyn, certified menopause practitioner, and head of menopause at Pandia Health.  

Other underlying medical conditions and the expected hormonal imbalances this time bring could also contribute to fatigue. All these factors can intertwine, making determining the cause of perimenopause exhaustion even more difficult.  

Signs of perimenopause exhaustion 

Dr. Hansen says exhaustion will feel different than more typical sleep disruption or sleep apnea if it’s related to perimenopause, and it won’t be alleviated by remedies that worked previously such as going to bed earlier or adjusting your sleep space for maximum rest.  

Also, it’s more likely to be perimenopause exhaustion “when you cannot attribute your fatigue to the ‘usual suspects’ (things like a glass of wine in the evening, not getting to bed on time or having to wake up earlier than usual, a last minute work project, a family dynamic that is stressing you out, etc.,” says Dr. Hansen.  

exhausted woman
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How can perimenopause exhaustion impact your life? 

During perimenopause, your hormones — especially estrogen and progesterone — will fluctuate or drop which results in a variety of potentially distressing symptoms. “When hormone imbalances related to perimenopause cause insomnia (a common problem in perimenopause), the effects ripple into all aspects of life including physical fatigue, lack of concentration, poor memory, emotional lability, anxiety and a sense of hopelessness or fear,” says Dr. Hansen.  

Perimenopause exhaustion can also cause a loop of unhealthy behaviors. Dr. Hansen points out that habits including “emotional overeating, craving carbs or sweets, being too tired to exercise and ‘doom scrolling’ on devices” are all ways to try and numb the exhaustion. Outside of perimenopause exhaustion, lack of sleep can result in increased stress, diminished quality of life, mental health issues and more. 

Easy ways to treat perimenopause exhaustion 

While perimenopause and fatigue can be difficult, there are methods to ensure you’re getting proper rest. Here, Dr. Hansen shares her best tips to help with perimenopause exhaustion. 

Sleep hygiene is important  

Dr. Hansen says sleep hygiene is essential. She suggests making “adjustments to sleep patterns that involve a more stringent routine than you needed previously,” “keeping the same bed and wake time every day,” and finding calming routines such as aromatherapy, yoga, or a warm bath to regulate the nervous system prior to sleep.” Improving sleep while keeping good sleep hygiene in mind can lead to fatigue relief for both perimenopausal and menopausal women. 

Naps are also an important part of sleep hygiene. “Regular naps have excellent scientific evidence for health benefits including improvement of mental concentration, hormone balance, and alleviating exhaustion (regardless of what causes it),” says Dr. Hansen. 

Hormone replacement therapy (HRT) can minimize perimenopause exhaustion 

While HRT can help with hormone levels, it’s important to talk to your doctor or healthcare provider before starting this form of treatment. Another alternative is low-dose oral contraceptives. “These will stabilize hormones and can alleviate more perimenopausal symptoms — making life more sane, stable and serene,” says Dr. Hansen.  

Self care can alleviate stress and anxiety 

Taking the time to destress after the day comes to an end can help women experiencing perimenopausal exhaustion.  Walking in nature, reading a book, engaging in creative activities or talking to a friend or loved one are easy options.  

Dr. Hansen notes that doing these things can help you feel less alone. Also, “these routines will not eliminate the hormone imbalances but can do wonders to regulate the nervous system and create relaxation instead of anxiety.” 

Getting proper sleep is essential to survive, so Dr. Hansen says it’s necessary to pay attention to your body if you notice you’re struggling with perimenopause exhaustion.  

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