Tackling Fatigue: How to Reclaim Your Energy During Perimenopause

Fatigue can feel like one of the most frustrating aspects of perimenopause. You might wake up feeling exhausted, drag yourself through the day, and even after a full night’s sleep, you still don’t feel rested. Perimenopausal fatigue is a multifaceted issue, often linked to a range of physical, hormonal, and emotional changes. It’s not just about getting more sleep — though that’s a big factor — it’s about understanding the root causes and addressing them holistically.

In this post, we’ll break down the causes of perimenopausal fatigue and offer practical tips for reclaiming your energy through lifestyle changes, diet, exercise, and the holistic approach of naturopathy.

1. Understanding Perimenopausal Fatigue

Fatigue during perimenopause can feel overwhelming because it’s often hard to pinpoint a single cause. More than likely, it’s a collective result of hormonal fluctuations, sleep disturbances, nutrient deficiencies, and stress. Fatigue can also be worsened by pre-existing conditions or lifestyle factors that get exacerbated during perimenopause.

This is why it’s essential to take a holistic approach to understanding your health during this time. Many fatigue-associated symptoms overlap with perimenopausal symptoms, and it’s difficult to distinguish between them. This complexity makes treating the whole body, rather than just focusing on isolated symptoms, absolutely crucial.

2. The Importance of Treating the Whole Body

Naturopathy excels at addressing perimenopausal fatigue because it looks at the body as a whole, considering not only the symptoms but also their underlying causes. When I see new patients, I dedicate an hour to understanding their full health history, lifestyle, stress levels, and more. This in-depth approach helps me identify patterns and factors that may contribute to fatigue, like past medical conditions, medication use, or nutritional deficiencies.

Perimenopausal fatigue can stem from multiple areas, including sleep disturbances, metabolic imbalances, and even emotional health. By treating the entire body, we ensure that we’re not just masking symptoms but addressing the root causes. This helps my patients regain their energy in a more sustainable way, often through diet, lifestyle adjustments, and natural therapies.

3. Sleep Disturbances: A Major Contributor to Fatigue

One of the biggest causes of perimenopausal fatigue is poor sleep. Many women experience new sleep issues during perimenopause, from difficulty falling asleep to waking up in the middle of the night. Hormonal fluctuations, especially declining oestrogen and progesterone, can disrupt your sleep cycle in various ways.

Common sleep issues during perimenopause include:

• Insomnia: Trouble falling asleep or staying asleep.
• Night Waking: Waking up in the early hours of the morning with a racing mind.
• Night Sweats and Hot Flushes: Sudden heat surges that make you uncomfortable and disrupt your sleep.
• Anxiety: Heightened anxiety during the night can keep your mind active and prevent deep rest.

Addressing these sleep issues is critical for combatting fatigue. Creating a calming bedtime routine, keeping your bedroom cool, and managing anxiety through techniques like meditation or breathing exercises can help improve your sleep quality.

Additionally, if night sweats and hot flushes are causing significant disruptions, you may want to explore hormonal support or natural remedies like black cohosh, zizyphus or magnesium and glycine, which can help reduce these symptoms.

4. Blood Tests: Identifying Hidden Causes of Fatigue

A holistic approach involves considering whether underlying health conditions are contributing to your fatigue. Regular blood tests are a key step in identifying hidden causes, which is why I recommend getting a comprehensive blood test annually. This can help detect nutritional deficiencies and metabolic changes that might be contributing to your fatigue.

Here are a few important factors to check in your bloodwork:

• Iron Levels: Heavy periods are common during perimenopause, and they can lead to low iron or even iron-deficiency anaemia. This is one of the most common causes of fatigue. If you have heavy periods, it’s essential to check your iron levels and consider supplementation if needed.
• B12 Deficiency: Vitamin B12 is crucial for energy production and brain function. A deficiency in B12 can lead to fatigue, brain fog, and even mood changes. Ensuring you get enough B12 through your diet (especially if you’re vegetarian or vegan) or through supplements can make a big difference in your energy levels.
• Thyroid Function: Fatigue can also be a sign of an underactive thyroid, a condition known as hypothyroidism. This becomes more common during perimenopause, as hormonal shifts can impact thyroid function. If your thyroid isn’t producing enough hormones, you may feel tired, sluggish, and mentally foggy. Thyroid hormone levels can be easily checked through a blood test, and if necessary, medication can help restore balance.

5. Diet: The Energy Connection

Your diet has a direct impact on your energy levels, and during perimenopause, it’s more important than ever to make sure you’re eating foods that nourish your body. One common issue is blood sugar instability, which can lead to energy crashes throughout the day. Hormonal changes can affect the way your body processes carbohydrates, making it harder to maintain steady blood sugar levels.

Tips for an energy-boosting diet:

• Prioritise Protein: Protein helps stabilise blood sugar and supports muscle health, which is critical as muscle mass naturally declines with age. Aim to include high-quality protein (lean meats, fish, eggs, legumes) in every meal.
• Reduce Simple Carbohydrates: White bread, sugary snacks, and processed foods can cause rapid spikes and drops in blood sugar, leading to feelings of fatigue. Focus on complex carbohydrates like whole grains, vegetables, and legumes, which provide more sustained energy.
• Healthy Fats: Omega-3 fatty acids, found in fatty fish like salmon, sardines and in flaxseeds or chia seeds, can help reduce inflammation and support brain health, helping you feel more alert and energised.
• Stay Hydrated: Dehydration can lead to feelings of fatigue, so be sure to drink plenty of water throughout the day. Herbal teas can also be a soothing and hydrating addition.

6. Metabolic Conditions: An Energy Drain

Perimenopause is often a time when metabolic conditions, such as type 2 diabetes, fatty liver disease, and weight gain, become more common. These conditions can contribute to increased inflammation and make you feel more tired than usual.

As your oestrogen levels decline, it can become harder to regulate insulin and blood sugar, putting you at a higher risk for these metabolic changes. Maintaining a healthy diet, managing stress, and staying active are key to reducing your risk and combating fatigue.

7. Pain and Fatigue: The Joint Connection

Many women in perimenopause begin to experience joint pain or stiffness, particularly if they are also dealing with conditions like osteoarthritis. Chronic pain can be physically exhausting and drain your energy over time. The inflammatory response in the body is also heightened during this time due to hormonal shifts, leading to more joint discomfort.

To manage joint pain and support energy levels:

• Incorporate Anti-inflammatory Foods: Foods like turmeric, ginger, and leafy greens can help reduce inflammation.
• Exercise: Regular low-impact exercise, such as walking, swimming, or yoga, can help ease joint pain and improve your energy. Exercise also boosts endorphins, which naturally increase energy levels.
• Supplements: Consider taking supplements like omega-3s or glucosamine, which can help reduce joint pain and inflammation.

8. Medications and Fatigue

Certain medications can also contribute to fatigue. Some common medications prescribed during perimenopause, such as antidepressants or medications for anxiety, can have side effects that make you feel more tired. If you suspect your medication is impacting your energy levels, talk to your healthcare provider about adjusting your dosage or exploring alternative treatments.

9. Adrenal Support: Your Secret Weapon for Boosting Energy

The adrenal glands, which produce stress hormones like cortisol, play a key role in managing your energy levels. During perimenopause, many women experience increased stress, which can lead to adrenal fatigue or burnout. When your adrenal glands are overworked, it can leave you feeling exhausted, anxious, and unable to cope with daily stressors.

Supporting your adrenal glands and nervous system can help restore your energy:

• Reduce Stress: Incorporate stress-relief practices like yoga, meditation, or breathing exercises into your daily routine. Taking time to relax is crucial for balancing cortisol levels.
• Adaptogenic Herbs: Herbs like ashwagandha, rhodiola, and holy basil can help support adrenal function and balance your stress hormones, leading to improved energy and resilience.

Conclusion: Treating Fatigue Holistically

Perimenopausal fatigue isn’t something you just have to live with. By understanding the root causes and taking a holistic approach, you can start making targeted changes to boost your energy levels. Whether it’s adjusting your diet, incorporating adrenal support, or simply prioritising your sleep, reclaiming your energy during perimenopause is possible with the right approach.

As a naturopath, I spend the time to fully understand their health history and challenges. By treating the whole body, rather than just individual symptoms, we can develop a plan that addresses the root causes of your fatigue and helps you regain your energy in a sustainable, balanced way.

Ready to dive deeper into understanding and managing perimenopause?

Join my upcoming masterclass, Navigating the Perimenopause Rollercoaster – finding balance between the hormonal highs and lows, where we’ll explore how to tackle common symptoms like fatigue, mood changes, and more. This masterclass is your guide to reclaiming your vitality and feeling more like yourself again.