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About Menopause & Fatigue

By Susan Wessling ; Updated August 14, 2017

The hormonal changes a woman undergoes during menopause can cause a number of physical symptoms, including fatigue. The extent of that fatigue can range from feelings of tiredness to what has been defined as "crashing fatigue." Even when fatigue occurs with or as a side effect of menopause, it can be a symptom of other serious diseases, so it should not be ignored.

Hormonal Changes

As a woman goes through menopause—the permanent end of menstruation and fertility—physical and emotional conditions cause a host of symptoms. Many of these are because of hormonal issues as a woman's body produces less estrogen and eventually no progesterone.


The most common menopausal symptoms are hot flashes, night sweats, mood changes, sleep disturbances and irregular bleeding, says JoAnn V. Pinkerton, MD, the director of the Midlife Health Division at the University of Virginia. "Fatigue is often seen during the menopausal transition, but it is not clear in an individual if it is a primary symptom related to hormonal changes or a secondary symptom related to not sleeping, stress, less coping skills or anemia," Pinkerton says. "Some women do seem to get a significant or profound fatigue when their estrogen levels drop, particularly before menses, during hormonal fluctuations or after menopause."

Extreme Fatigue

Cases of extreme fatigue during menopause has been called "crashing fatigue," though it is not a term used in all medical or expert circles. The website 34 Menopause Symptoms devotes an entire page to the condition, which should not be confused with Chronic Fatigue Syndrome. "Crashing fatigue is defined as sudden and overwhelming feelings of weakness, exhaustion and reduced energy level, which can strike at any moment of the day," the website reports. "It is important to recognize, however, that crashing fatigue is a normal symptom of menopause that is caused by temporary hormonal imbalance."


The website All 4 Natural Health's also points out that one of most common ailments facing post-menopausal women is fatigue. The website lists the common physical characteristics of menopausal fatigue to include drowsiness, a sudden onset of tiredness, a feeling of fatigue in the muscles and crashing feeling after eating. Crashing fatigue can occur at any time, and despite its name, it doesn't mean a woman has an uncontrollable urge to sleep. Woman suffering with this condition might not feel sleepy at all, the website notes. Instead, you could find yourself feeling exhausted and weak, and you might not have the energy to carry out your normal activities.


Pinkerton says there are a number of things that can be done to manage fatigue. Some simple fixes can include improving sleeping habits and doing regular aerobic exercise. "Exercise is a great way to increase your energy level and immediately find new sources of energy," she says. "As little as walking for 20 minutes a day can improve your mental outlook." Medical intervention can include taking hormonal supplementation with an estrogen patch before menses, suppression of hormonal fluctuations with oral contraceptives during perimenopause or hormone therapy after menopause.


Other medical conditions, some quite serious, can contribute to fatigue around menopause. These include anemia; diabetes; hypothyroidism and hyperthyroidism; inflammatory conditions such as celiac disease or rheumatoid arthritis; kidney and liver disease; coronary artery disease; heart failure; or other undiagnosed medical problems. "Fatigue is often symptomatic of an area of your life that is poorly managed or a combination of hormonal changes, stress, a busy lifestyle and other medical problems," Pinkerton says. "When fatigue persists for more than two weeks and is accompanied by other serious symptoms such as difficulty breathing, abnormal bleeding or a change in weight, a health evaluation should be sought."

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