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Why Am I So Exhausted? Menopause Fatigue Explained

What… the Menopause?

Each week we spotlight an unexpected and frustrating symptom of menopause that no one warned you about. Because menopause is more than just hot flashes and missed periods.

This week’s spotlight: Fatigue / Crushing Tiredness

What’s going on?

Menopause fatigue is driven by hormonal fluctuations that disrupt sleep, metabolism, mood, and energy production.

Let’s break that down.

During perimenopause and menopause, your levels of estrogen and progesterone start to fluctuate and eventually decline. These hormones don’t just regulate your cycle, they impact your brain, sleep, stress response, and energy systems.

Here’s how it may look and feel for you:

Poor sleep quality: Lower progesterone reduces your ability to fall and stay asleep. Night sweats and anxiety don’t help either.

Blood sugar instability: Estrogen helps regulate insulin sensitivity. When it drops, energy crashes become more frequent.

Increased cortisol (stress hormone): Hormonal imbalance can dysregulate your HPA axis, leaving you wired but tired.

Mitochondrial slowdown: Your cells become less efficient at producing energy (ATP), which can leave you feeling physically drained.

Menopause fatigue isn’t just “being tired,” it’s a biological shift in how your body produces and manages energy.Here’s a relevant episode from my podcast Hack My Age: Menopause Upgrade where energy, hormones, and midlife health are explored. 

You’re not alone in feeling this exhausted

Fatigue is one of the most common, and most overlooked, symptoms of menopause.

Studies suggest that a significant number of women in perimenopause and menopause report persistent fatigue, often alongside:

  • Brain fog
  • Mood swings
  • Sleep disturbances
  • Low motivation

And yet, many are told their labs are “normal.”

Sound familiar?

This is partly because conventional testing doesn’t always capture hormonal fluctuations, only static levels. So you can feel completely depleted while your results appear fine on paper.

If you barely recognize your energy levels these days, there’s a real reason for it, and many other women are going through the same thing.

What can you do to boost your energy in menopause?

You need to support hormones, stabilize blood sugar, and protect your sleep.

Here’s where to start:

1. Prioritize sleep like your life depends on it (because it does)

  • Keep a consistent sleep schedule
  • Limit alcohol and caffeine (especially after noon)
  • Try magnesium glycinate* or glycine for deeper sleep

2. Stabilize blood sugar

  • Eat protein + healthy fats at every meal
  • Avoid the one or two meal a day thing or relying on carbs alone
  • Start your day with a high-protein breakfast. Grab my cookbook for ideas.

3. Support your nervous system

  • Incorporate daily movement (walking, strength training, Pilates)
  • Try breathwork or meditation to lower cortisol
  • Reduce overstimulation (news, social media, late-night scrolling)

4. Consider targeted supplementation

  • Magnesium*
  • B vitamins* (especially B12)
  • Omega-3 fatty acids*
  • Adaptogens (like ashwagandha or rhodiola)
  • Urolithin A*
  • Mitoquinol*
  • Minerals*

5. Look at your hormones and other labs

Work with a practitioner to explore:

  • Hormone Replacement Therapy (HRT)
  • Thyroid health
  • Iron levels (low ferritin is a hidden fatigue culprit)
  • B vitamins
  • Metabolic panel

There is no one-size-fits-all fix. Energy in menopause improves when you address multiple systems at once.

What worked for me? 

It wasn’t one thing, but it was a lifestyle shift.

I often share that my energy didn’t come back from a magic pill. It came from experimenting, tracking, and listening to my body.

Some of the changes I’ve spoken about across my Hack My Age: Menopause Upgrade podcast include:

  • Prioritizing strength training and movement to boost mitochondrial health
  • Dialing in my nutrition (more protein, less processed carbs, fewer blood sugar spikes)
  • Exploring biohacking tools like cold exposure, watching a sunrise and light therapy
  • Being intentional about sleep hygiene and recovery
  • Nurturing my network and prioritizing the important people in my life

I also emphasize something most of us overlook: energy is not just physical, it’s emotional and mental too.

Letting go of stress, overcommitment, and burnout patterns played a huge role in giving me my vitality.

Your energy comes back when you work with your body, not against it.

FAQ: Menopause Fatigue

Why do I feel exhausted even after a full night’s sleep?

Because menopause affects sleep quality, not just duration. Hormonal shifts can reduce deep sleep, leaving you unrefreshed.

Can menopause fatigue feel like burnout or depression?

Yes. Fatigue, low motivation, and brain fog can overlap with burnout and depression, which is why it’s often misdiagnosed.

Does exercise help or worsen menopause fatigue?

The right kind helps. Low-impact movement and strength training boost energy, but overtraining can make fatigue worse.

How long does menopause fatigue last?

It varies. Some women experience it during perimenopause, while others feel it into postmenopause depending on lifestyle and hormone support.

Are there tests I should ask my doctor for?

Yes, consider checking:

Recommended by Zora

Magnesium – Bioptimizers Magnesium Breakthrough. Code HACKMYAGE 15% off

B Vitamins – Body Bio Vitamin B+ Code ZORA 15% off

Omegas – Puori Omega 3 Code HACKMYAGE 20% off

Urolithin A – Timeline Mitopure code ZORA 10% off

Mitoquinol – MitoQ ZORA 10% off

Minerals – BEAM code ZORA 20% off

Download the Menopause Symptom Tracker to help you figure it all out.

Zora Benhamou is a gerontologist who studies aging and is dedicated to challenging menopause stigma and ageist stereotypes. As the host of the Hack My Age podcast, she focuses on empowering women navigating the menopausal transition through evidence-based techniques that support your 80 year old self.

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