Menopause Fatigue: Causes, Treatment, Supplements & Tips

Last updated 01.16.2024 | by Sabrina Johnson | 13 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.

According to a study published in the Journal of the North American Menopause Society, more than 85% of postmenopausal women regularly feel fatigued. In comparison, less than 20% of younger women reported the same symptoms.

And it’s no surprise. Fatigue is one of the most common symptoms of menopause, and its effects can remain long after the menopausal journey is complete. But thankfully, with the right knowledge and tools, it’s possible to ease the feeling of exhaustion and regain your energy. 

I first noticed menopause-related fatigue around 3 years into my menopause journey. I began taking regular afternoon naps, something I’d never needed to do in the past. On certain days, by the time I was done with work, I felt too exhausted to do anything except take a bath and go straight to bed. But after researching various supplements and treatment options for fatigue, I’m relieved to say that my symptoms have improved. And so, I’d like to share what worked for me, in the hopes that you too can combat fatigue and feel like your old self again.

So, are you experiencing menopause-related fatigue? Are you searching for a way to regain your energy and vitality as you journey through this phase of life? If so, this post is for you. Below, I’ll explain why menopause can take such a toll on our energy levels. Then, I’ll share some treatments, supplements, and lifestyle changes that can help bring back your premenopausal mojo.

What Causes Menopause Fatigue?

As with most menopause-related symptoms, fatigue and psychological changes associated with menopause are usually a result of hormonal changes in the body.

As we enter perimenopause or menopause, the amount of estrogen produced by the ovaries begins to fluctuate. Estrogen works in conjunction with other vital hormones in the body. So, when estradiol levels soar or plummet, this delicate hormonal balance is disrupted. This can lead to feelings of crashing fatigue.

Another contributing factor is insomnia. Changes in sleep patterns are a common complaint among perimenopausal and menopausal women. Imbalances in hormones such as adrenaline and cortisol can have a knock-on effect on the body’s natural circadian rhythms. This can lead to some long, sleepless nights.

Even if you can fall asleep normally, if you suffer from regular night sweats, you’re unlikely to be getting the deep and restorative rest you need.

All of these factors can leave us feeling exhausted and fatigued the following day.

What Are the Signs and Symptoms of Menopause Fatigue?

What Are the Signs and Symptoms of Menopause Fatigue?

Anyone going through perimenopause, menopause, or postmenopause can suffer from fatigue associated with menopause. However, the fatigue symptoms appear to be more prominent in the later stages of the menopausal transition time.

Menopause fatigue can be mild or severe. It affects people on a physical and mental level.

Here are some of the most common signs and symptoms of menopause fatigue:

Feeling Tired Throughout the Day

It might be hard to get out of bed in the morning. You may also find yourself falling asleep during the day or having to take regular naps.

Difficulty Exercising

Menopause fatigue can make physical activity feel more strenuous than usual. It may take you longer to catch your breath after walking up a flight of stairs, and your body may feel heavy and sluggish. This can affect your ability to carry out your regular exercise routine.

Poor Concentration

Mental fatigue can also make it harder to think clearly and concentrate on individual tasks. Your short-term memory and ability to make quick decisions may also be affected.


Hormonal shifts combined with a lack of sleep can lead to mood changes such as irritability. This can have a negative effect on your relationships with family, friends, and colleagues.

A lack of Enthusiasm and Motivation

Menopause fatigue may leave you feeling not only physically exhausted but emotionally drained too. You may find it harder to enjoy activities you once loved and begin to withdraw from others.

Stress and Overwhelm

Fatigue can limit our sense of resilience and lead to crushing feelings of stress and overwhelm. If left unchecked, this can become a vicious cycle. Stress triggers the release of cortisone, which can contribute to a lack of sleep and increased fatigue.

Speak to Your Doctor

Although menopause fatigue is a common complaint, its symptoms can also mimic other illnesses, such as depression. If you’re experiencing any of the above symptoms, speak to your doctor. They can help you determine if your issues are related to menopause or something else.

What Treatments Are Available for Menopause Fatigue?

In recent years, the medical community has shifted its focus when it comes to treating menopause fatigue.

In the past, doctors were quick to prescribe hormone replacement therapy (HRT) and other medications. However, these interventions carry potential side effects. And so, a holistic approach involving a blend of conventional medicine, natural medicine, and lifestyle changes is also an option.

Conventional Medicine for Menopause Fatigue

Here are some commonly prescribed pharmaceutical treatments available for menopause fatigue:

  • HRT

The most widely prescribed medical treatment for menopause symptoms is hormone replacement therapy (HRT).

There are various forms of HRT. Each of them works by topping up crucial hormones that the body is no longer producing enough of. As a result, many of the menopausal symptoms can be alleviated, including tiredness and fatigue.

HRT has also been shown to help reduce perspiration and hot flashes. This can help you sleep better, further enhancing its energy-boosting potential.

Yet, while HRT can significantly improve a variety of menopause symptoms, it’s not for everyone.

This treatment comes with a long list of potential side effects, including, but not limited to, crampsheadaches, bloating, indigestion, migraines, nausea, mood changes, and depression. It also increases your risk factor for serious illnesses such as stroke, cancer, and heart disease.

  • Non-hormonal medications

Antidepressant medications such as selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) are sometimes used to treat menopause symptoms.

In particular, they have been shown to reduce the severity and frequency of sweating and hot flashes during the night. This can lead to better sleep and a decrease in fatigue during the day.

However, SSRIs and SNRIs also come with the risk of side effects. It can even induce insomnia in some people. So, this line of treatment should be used with caution and under proper medical supervision.

Natural Supplements for Menopause Fatigue

Natural herbs and supplements may be effective at reducing the symptoms of menopausal fatigue.

The supplements below are generally considered to be safe. However, they may interact with other medications, and they may not be suitable for everyone. Always talk to your doctor before incorporating a new supplement into your routine. The dietary or herbal supplements you can take to treat fatigue and other symptoms are listed below. 

  • Phytoestrogens

Phytoestrogens are compounds found in many types of plants. These compounds closely resemble the chemical structure of the naturally occurring estradiol produced by the body.

When we consume phytoestrogens, they bind to our estradiol receptors, taking the place of the missing hormone. As a result, many of the most troublesome menopausal symptoms can be alleviated.

After I began increasing my intake of phytoestrogens I noticed a marked increase in my own energy throughout the day. But that’s not the only benefit I observed. Several other bothersome menopause symptoms, like hot flashes and sleep hyperhidrosis, also improved.

Phytoestrogens can be found in a wide range of natural food sources, including soybeans and soy products, seeds, nuts, beans, fruits, and vegetables. You can also find phytoestrogens in supplement form and herbs such as black cohosh, ginseng, and dong quai.

  • Maca

Maca is a Brassica vegetable from Peru. It’s been used in traditional folk medicine for centuries.

Maca has a wide variety of purported benefits, including enhancing mood, boosting libido, and balancing hormone levels. And so, it’s become one of the most popular natural supplements to help combat menopause symptoms.

Maca comes in a variety of colors, all of which are used in plant medicine. Yet anecdotal reports suggest black maca is the most effective form to improve fatigue and psychological changes, so this is the one I use.

  • Valerian

Valerian is a powerful sleep aid and natural sedative. It’s often referred to as ‘nature’s Valium.

The herb can induce feelings of relaxation and calmness. So, while it’s not something you should consume in the morning, a cup of valerian tea in the evening could help you to drift off quicker and stay asleep for longer. It certainly seems to work for me, and as a result, I feel my problem of dealing with fatigue is significantly reduced.

Valerian isn’t just a remedy for insomnia. It’s also shown promise in reducing the frequency and severity of menopausal hot flashes and night sweats.

  • Coenzyme Q10

Coenzyme Q10, or CoQ10 for short, is a powerful antioxidant. Taken regularly, it can help to generate energy from your food and deliver it to your cells.

Our bodies naturally produce CoQ10. However, as we age, the amount we produce diminishes. This fat-soluble nutrient helps to charge up mitochondria, leaving us feeling more energetic. Plus, it also helps to reduce systemic inflammation that can lead to crashing fatigue.

Another interesting property of CoQ10 is its ability to protect ovarian reserves from oxidative stress. So, if you’re in a perimenopausal phase and would still like to conceive, this supplement is worth considering.

  • Ashwagandha

Ashwagandha is a traditional Ayurvedic herb that can help balance hormones and tackle adrenal fatigue.

The adrenal glands are responsible for pumping out hormones, including estradiol and cortisol. But when the adrenal glands aren’t functioning as they should, it leads to excess cortisol and not enough estrogen.

Ashwagandha works by rebalancing the adrenal glands. This can help with a wide variety of menopause symptoms, including menopause fatigue.

Lifestyle Changes for Menopause Fatigue

Alongside conventional medicine and natural supplements, several lifestyle changes can help to combat menopause fatigue.

These include:

  • Regular exercise

Hitting the gym or going for a run might be the last thing you want to do during a bout of menopause-related fatigue. But engaging in exercise is one of the quickest ways to boost your energy.

There are many days that I feel less than enthusiastic about going to the gym, but when I push myself to complete my workout, I always feel much more energetic and invigorated afterward.

And science can back up my observations. A study published in the Journal of the North American Menopause Society concluded that moderate-to-vigorous physical activity in postmenopausal participants resulted in feelings of increased energy and vigor.

  • Cut out coffee

It can be tempting to rely on stimulants such as caffeine when menopause fatigue strikes. But even a small amount of caffeine each day can disrupt your sleep patterns. This can lead you to feel even more tired during the day.

  • Avoid alcohol

While it might be tempting to have a drink or two before bed to induce sleep, alcohol actually lowers sleep quality. Even one glass of wine can exacerbate feelings of drowsiness the next day.

Alcohol also dilates blood vessels. This has been shown to trigger hot flashes and excessive sweating in perimenopausal, menopausal, and post-menopausal women.

  • Eat a balanced and nutritious diet

Feeding your body wholesome, nourishing food is one of the best things you can do to boost your energy and overall health.

Try to incorporate foods rich in phytoestrogens. These can help to mimic the effects of estradiol on the body and alleviate several symptoms.

Include plenty of sources of iron, such as leafy greens, eggs, chicken, brown rice, and broccoli. And be sure to eat plenty of omega-3 fatty acids found in oily fish, flax seeds, and walnuts. All of these nutrients have been shown to relieve fatigue and raise energy levels when consumed regularly.

  • Practice stress-relieving activities

Stress contributes to feelings of fatigue. So, finding a stress-relieving hobby can leave you feeling more energetic in the long term.

My favorite ways to de-stress are yoga, meditation, and taking a walk in nature. All of these activities help to lower cortisol levels and promote feelings of relaxation. 

  • Stick to a sleep routine

Try to go to bed and wake up at the same time each day, even on the weekends. Sticking to a sleep routine helps your body to balance its circadian rhythms. This allows you to fall asleep faster and stay asleep for longer.

Avoid the use of screens for at least one hour before you go to bed each night. Blue light triggers your body to release cortisol, which suppresses the all-important sleep hormone, melatonin.


When does menopause cause fatigue?

Fatigue is a common symptom that can happen at any time during your menopausal journey. However, studies show that it’s significantly more prevalent in post-menopause than during perimenopause.
46.5% of women report fatigue during perimenopause, compared to 85%, almost double, in post-menopause.

How long does menopause fatigue last?

Fatigue due to hormonal shifts in menopause can continue well into your post-menopausal years before the symptoms begin to fade away.
However, fatigue is also part of the natural aging process in many women and men. So while the hormonal reasons behind your tiredness and brain fog may no longer be there, the tiredness itself may remain.

When should I worry about menopause fatigue?

Fatigue is a normal part of the journey when you’re in menopause. However, if you have other symptoms unrelated to menopause that are concerning to you, it’s always a good idea to speak with your doctor. They can rule out any underlying conditions and recommend a treatment plan to suit you.


Fatigue is one of the most common menopause symptoms. Fluctuating hormones and disruption to your normal sleep cycle can take their toll both physically and mentally. 

Menopause fatigue can range from mild or severe. And in some cases, it can be downright debilitating. But if you’re struggling with the effects of menopause fatigue, you don’t have to suffer alone. Speak to your doctor or reach out to a therapist who can help guide you through this challenging time of change.



  • Sabrina Johnson

    Meet Sabrina Johnson, a compassionate author and a seasoned expert in Obstetrics and Gynecology. She is a driving force behind Simply Menopause, where her extensive medical knowledge and empathetic nature come together to empower women in their menopausal journey. Sabrina offers culturally sensitive guidance and support through her approachable writing, making her a trusted friend on the path to menopause wellness.