There are days when I feel energized and ready to take on the world. But the closer I got to the gates of midlife, extreme fatigue started to hit more often — like a dark cloud that just wrapped around me!
It’s interesting how we often label fatigue as “tiredness”, but it feels so much more than that, doesn’t it? It can be so frustrating because we know we’re supposed to enjoy life as we age. But here we are finding ourselves just wanting to curl up in bed!
Back then, there were many times I wished there was a quick fix or a magic pill to zap fatigue away. I bet you often feel this, too. But I’ve eventually learned about managing fatigue the right way — with lifestyle tweaks that truly work!
Some of the midlife health hacks to overcome fatigue are:
- Eating a hormone-balancing, anti-inflammatory diet
- Taking supplements and herbs
- Keeping a food diary
- Relieving stress through mindfulness, meditation and breathing techniques
- Doing light to moderate movements
- Enhancing sleep quality
- Maintaining good thyroid health
- Avoiding toxins from your environment, food, products (and even “social toxins”)
- Recharging your emotional batteries
These small tweaks in your diet and lifestyle can really make a difference!
So, stay with me as we tackle the root causes of fatigue before we get to those health hacks. It’s important that you first understand what’s going on in your system — before we do the fixing and make use of the solutions!
Table of Contents
Extreme Fatigue vs. Tiredness: What’s the Difference?
You know how we often say we’re feeling “tired”? It’s a word we toss around pretty casually, but fatigue is a whole different ball game in midlife!
Tiredness can hit us after a long day of work, chasing kids around, or running errands. We might feel that familiar weariness, and typically, a good night’s sleep or even a quick nap can help us bounce back!
Fatigue tends to be more severe and persistent. It’s not just about needing a little rest; it feels like you’ve been running on empty for ages. It’s that dragging sensation that doesn’t lift, no matter how many hours you sleep. It can make simple tasks feel overwhelming and drain your motivation.
Many women experience this deeper, more exhausting feeling, and it can be frustrating. If you find yourself feeling this way during menopause, trust me, you’re in good company. More importantly, know that there are steps you can take to climb this hill and reach that top-of-the-world feeling again!
What is Adrenal Fatigue?
When we’re under a lot of pressure — whether it’s from work, family responsibilities or those hormonal changes during menopause — our adrenal glands work overtime.
Imagine pushing a gas pedal down on your car for too long. Eventually, that engine is going to overheat. That’s kind of what happens with our adrenals with prolonged stress! After months of pumping out stress hormones, the whole stress system gets worn out and out of rhythm — leading to what’s called “adrenal fatigue”.
Quick honest note, though: “adrenal fatigue” isn’t an official medical diagnosis. A big 2016 review found no proof that the adrenals actually “run out”. What does seem to happen is that long-term stress throws the conversation between your brain and your adrenals (doctors call it the HPA axis) out of sync. So the exhaustion is very real — the name is just a little off!
With overworked adrenals, you might start to notice patterns: Feeling more tired than usual, struggling to get through the day, experiencing mood swings or even craving salty or sweet snacks. It can feel like you’re in a fog, and even a good night’s sleep doesn’t bring that refreshing feeling you’d expect.
It’s important to listen to your body at this time! If you think you might be dealing with adrenal fatigue, consider simple lifestyle changes like prioritizing sleep, managing stress levels, eating a balanced diet, and even getting a little more downtime. When exercising, try not to overwork your body and go for low-intensity and more relaxing workout routines!
How Does It Feel to Have Chronic Fatigue Syndrome?
Now, let’s talk about chronic fatigue syndrome (CFS), which can sometimes get mixed up with regular fatigue and adrenal fatigue.
You know that feeling when you’re just wiped out, like after a really long week? Well, CFS is way more intense and long-lasting.
Chronic fatigue syndrome (doctors now often call it ME/CFS) is a long-term illness where the extreme fatigue doesn’t get better with rest. Symptoms last at least three months (UK guidance; US doctors use six). Its telltale sign is a “crash” after even small efforts — a walk, a busy morning — that can knock you flat for days. It’s that overwhelming tiredness for so long that it affects your daily life and makes even simple tasks feel like a vertical mountain to climb. It can be frustrating, to say the least!
Along with the unrelenting exhaustion, CFS often comes with a flurry of other symptoms. You might notice issues like sleep disturbances, cognitive difficulties (ever feel like you’re in a mental fog?) and muscle or joint pain.
Some women also report having headaches or feeling lightheaded. It’s like your body is in a constant “low battery mode” — and that can really disrupt everything from work to personal relationships!
One of the trickiest parts about CFS is that it’s often misunderstood. People may assume you just need more rest or that you’re being lazy, but it’s much more than that. The exhaustion is profound and can be triggered by physical or emotional stress or viral infections.
If you think you might be experiencing something like CFS, it’s a good idea to check in with a healthcare provider who understands the condition. They can help you explore symptoms and develop a management plan that may include lifestyle changes, supportive therapies, and sometimes counseling — to help with the emotional toll it can take. And go gently: with ME/CFS, pushing harder with exercise can backfire. Pacing yourself is key.
Remember, you deserve to feel well and to have the support you need, especially during this phase of life! No one should have to navigate these challenges alone, so don’t hesitate to reach out for help. (More on tests further down!)
What Key Hormones Influence Feelings of Fatigue in Women?
This time, let’s unpack the key hormones that play a role in fatigue during menopause — and how they can impact your overall well-being!
Progesterone, estrogen, cortisol, serotonin and dopamine are among the key hormones and brain chemicals that lead to feelings of fatigue. The tricky part is, they all work hand in hand and influence each other — having an imbalance or decline can have a flow-on effect on the others!
It’s fascinating how these hormones intertwine, isn’t it? Let’s meet these tiny helpers in our body!
✅ Progesterone: As we enter menopause, progesterone levels begin to fluctuate and eventually drop. This hormone is important for regulating your sleep and mood!
That’s why lower progesterone often leads to unstable emotions and sleep disturbances — which we all know can leave us feeling drained and foggy in the morning. If you’re not getting quality sleep, it’s no surprise that fatigue follows closely behind!
✅ Estrogen: Similarly, estrogen also decreases during menopause, and this drop can contribute to feelings of fatigue. That’s because estrogen plays a role in maintaining energy levels and regulating mood!
When it’s low, you might find yourself feeling more sluggish and possibly experiencing mood swings — which can worsen fatigue. Plus, estrogen influences serotonin (feel-good chemicals) levels in the brain — more on that in a sec.
Low estrogen is also behind night sweats, which chop your sleep into little pieces. For some women, hormone therapy (HRT) helps energy simply by calming those night sweats — it’s worth a chat with your doctor.
✅ Cortisol: Often referred to as the “stress hormone”, cortisol is produced by the adrenal glands and helps us respond to stress. Now, chronic stress, the kind that’s constant and prolonged, can lead to raised cortisol levels. But over time, the pattern can flip — and cortisol can end up too low when you need it most.
This is something found by many studies, and also a personal experience I’ve discovered with my tests: Prolonged stress keeps the adrenal glands in a constant state of activation. Over time, your brain may turn the stress signal down to protect you. The result? A flat cortisol rhythm — low in the morning, when you should feel your perkiest.
This can leave you feeling fatigued, that crashing feeling, and even affect your ability to handle stress effectively. It’s a tricky cycle that can really impact your energy levels!
✅ Thyroid: Chronic stress can also slow down your thyroid. High stress hormones make it harder for your body to turn thyroid hormone (T4) into its active form (T3) — leading to symptoms like fatigue, weight gain and brain fog (often seen in hypothyroidism).
So if your thyroid tests look “fine” but you still feel flat, it’s worth looking at stress and cortisol, too. And if you already take thyroid medicine, never stop it on your own — talk to your doctor first. We can’t just take a pill for every symptom — we need to get to the root and listen to our body!
✅ Serotonin: This neurotransmitter is often called the “feel-good” hormone. It’s crucial for your mood, sleep and overall well-being!
Low serotonin is linked with anxiety and low mood — both of which can make fatigue feel even worse. Since estrogen influences serotonin production, the fluctuations during menopause can contribute to tiredness and emotional ups and downs!
✅ Dopamine: This neurotransmitter helps with motivation and energy levels. Just like serotonin, dopamine can be affected by other hormonal changes!
If your dopamine levels dip, you might find it harder to feel energized or engaged in activities you once loved. This can create a cycle where fatigue leads to less motivation and engagement — further adding to feelings of tiredness.
Navigating these hormonal changes during menopause can be challenging, yes, but being aware of how they interact can empower you to take the right steps!
Other than these imbalances, are there other common culprits that can lead to feelings of fatigue in midlife? Yes, there are diet and lifestyle factors behind fatigue and that’s what we’re going to talk about next. Don’t fret though, they can be managed and prevented — that’s for sure!
What are the Diet and Lifestyle Factors Behind Extreme Fatigue?
Among the common factors that cause extreme fatigue in midlife women are nutrient deficiencies, glucose spikes, stress, lack of physical activity, overexercise, poor sleep and dehydration. Keeping these factors in check will keep your energy levels up and stable!
When we talk about nutrient deficiencies, it’s essential to realize that our body requires certain vitamins and minerals to function optimally.
For instance, B vitamins play a crucial role in energy production and stress management. Having low B vitamins can result in feelings of fatigue!
Low magnesium is linked with a jumpier stress response, too. So a lack of nutrients can feed fatigue — and a stressed body burns through magnesium faster. Round and round it goes!
Fluctuations in blood sugar, also known as glucose spikes, can stress your adrenal glands, too. When you consume a lot of sugar, your body quickly releases insulin to bring your blood sugar down — and this process can create a rollercoaster effect, triggering cortisol production.
High cortisol levels over time can wear your stress system down, leaving you feeling exhausted and depleted! This can make it harder for your body to recover and sustain stable energy levels.
Chronic stress is perhaps the most significant player in adrenal fatigue. When you’re under constant pressure, your body is in a state of “fight or flight” — which means it’s continuously producing cortisol.
Over time, your body can become resistant to this hormone, leading to an imbalance that makes you feel exhausted. This persistent elevation in cortisol can also disrupt other hormones, like progesterone and estrogen, causing further fatigue and mood swings.
Now, while it might seem counterintuitive, physical activity is beneficial for adrenal health — but only low to moderate-intensity movements! Regular physical activity can help manage stress levels and balance your hormones, including cortisol. When you’re inactive, it can lead to increased fatigue and further exacerbate adrenal fatigue.
On the flip side, too much exercise can send your body into a state of stress, causing cortisol levels to spike. This can ultimately wear down your adrenal glands, leading to fatigue. Finding balance in your workouts is key! Aim for a mix of strength training, cardio and restful activities, like yoga, to promote adrenal health.
Sleep is crucial both for hormonal balance and adrenal recovery! During deep sleep, your body regulates hormone production, including cortisol. If you’re not getting enough quality sleep, your cortisol levels may remain elevated, leading to fatigue! Plus, poor sleep can throw off the balance of other hormones, like estrogen and progesterone, which can worsen feelings of tiredness.
And of course, hydration is vital for overall bodily functions, including hormonal balance. Even mild dehydration can leave you tired, foggy and a bit grumpy. And it’s one of the easiest fixes on this list! Keep a glass of water in sight and sip through the day.
By addressing these factors and understanding how they impact our body, we can take proactive steps toward feeling more energized! It’s all interconnected — it took me years to have that eye-opening realization. But believe it or not, small adjustments can lead to big improvements in how you feel daily!
Take Tests, Rule Out: Underlying Health Conditions Behind Extreme Fatigue
If you can’t seem to figure where all the tiredness is coming from, it’s best to take tests and rule out any possible health conditions.
Persistent feelings of fatigue could be due to underlying health issues, such as:
- Sleep apnea
- Iron deficiency anemia (or low iron stores)
- Low vitamin B12 or vitamin D
- Diabetes
- Thyroid problems (underactive or overactive)
- Fibromyalgia
- Kidney disease
- Chronic fatigue syndrome (CFS)
- Clinical depression
- Infections
- Heart and lung problems
- Autoimmune disorders
- Side effects of medication
A good starting point to ask your doctor for: a full blood count and ferritin (your iron stores), a thyroid test (TSH), vitamin B12, vitamin D and a blood sugar check (HbA1c). These simple blood tests catch the most common hidden causes of extreme fatigue.
I’m not saying you have to take tests for everything — that can be hard on the pocket! That’s why it’s really vital to listen to your body and pick up on the signals (symptoms) it sends you. This could save you a lot of time, money, effort and… misdiagnoses!
And if you took that test for something you suspect and everything turns out to be okay, then I celebrate with you! That only means one thing now: Your healing and recovery are in your hands. A few lifestyle tweaks here and there could do wonders, trust me. So, go check out what you can do with the tips in the next section!
9 Ways to Overcome Extreme Fatigue in Midlife
Okay, down to the good news: It’s absolutely possible to overcome fatigue and find relief in midlife!
Here’s what helps you overcome fatigue and regain your energy:
Eating a Hormone-Balancing, Anti-Inflammatory Diet
What you eat plays a huge role in how you feel. That’s undebatable! Just pay attention to your body — it often knows what it needs!
While aging, we should focus on a balanced diet filled with high quality proteins, healthy fats, fiber, whole foods and plenty of vegetables. They all help your body produce enough hormones and promote optimal bodily processes!
And try to minimize processed foods and sugar as they can lead to energy crashes!
What makes a good, healthy plate? Here are good sources to go for:
| Phytoestrogen-Rich Foods | High-Quality Proteins | Fiber & Healthy Fats |
|---|---|---|
| Plant-based foods are high in phytoestrogens. These plant compounds act a bit like a very mild estrogen. For some women, they may gently ease hot flashes. | Both plant and animal sources of protein are vital for your hormonal function and overall well-being. Get around 30 grams of protein in each meal (my Midlife Protein Calculator shows your number). Proteins are made up of amino acids — which are the building blocks needed to produce neurotransmitters. | Fiber-rich foods will support your digestion and blood sugar regulation. On the other hand, adding some healthy fats will optimize your cellular and hormonal functions! |
| Good Sources: Tofu, tempeh, edamame, flaxseeds, sesame seeds, chickpeas, lentils, pomegranates. These foods are rich in phytoestrogens and can also provide you with other essential nutrients! | Good Sources: Chicken breast, turkey, lean cuts of beef, eggs, salmon, mackerel, sardines, Greek yogurt, cottage cheese, lentils, chickpeas, quinoa, nuts, seeds. These are excellent sources of protein that can also supply you with other important vitamins and minerals! | Good Sources: Avocados, chia seeds, nuts, berries, quinoa, barley, oats, cruciferous vegetables, leafy greens, olives, olive oil, ghee. These foods not only contribute to your healthy intake of fiber and fats but also offer other beneficial nutrients! |
Taking Supplements and Herbs
Sometimes, it’s that little extra nutrient support that can make a big difference!
Consider adding supplements like B vitamins, magnesium or hormone-balancing herbs, like ashwagandha, to combat fatigue! Just a heads-up on ashwagandha: it isn’t for everyone. Skip it if you have an overactive thyroid or liver problems, and NCCIH has a handy safety page worth a quick read.
If you want a full list of the top vitamins, minerals and herbs that boost women’s health in midlife, check out my vitamins and minerals guide.
But make sure to consult with your healthcare provider before trying new supplements. We have to ensure they’re right for you!
Keeping a Food Diary
Keeping a food diary can help you identify patterns and see how certain foods affect your energy levels! It’s a great tool for recognizing which foods energize you and which ones might be draining your vitality.
📃 Here’s an example of a food diary to keep you guided. Try to write down everything you eat and drink throughout the day — for at least a week. The more details you include, the better!
| Date | I ate… | Quantity/Amount | I felt… | Other Notes |
|---|---|---|---|---|
Relieving Stress Through Mindfulness, Meditation and Breathing Techniques
One thing we can get from the earlier discussions is how stress can zap your energy faster than anything else!
So, try incorporating techniques such as meditation, mindfulness or breathing exercises into your daily routine. Even just a few minutes of quiet time can help clear your mind and refresh your spirit!
Doing Light to Moderate Movements
Gentle movements like yoga, qigong, Pilates and walking can help boost your energy without overtraining. Always listen to your body and choose what feels good!
Remember, the aim here is to have some movement that increases your blood flow, improves your mood and makes you feel restored. Your routine should be energizing — not draining!
Enhancing Sleep Quality
Prioritizing quality sleep is crucial for your mood, energy and hormonal health! So, why not create a calming bedtime routine and make your sleeping environment as comfortable as possible?
Here are some tips to achieve a restful night and wake up to better mornings:
- Try to go to bed and wake up at the same time every day, even on weekends. This will help you align your internal body clock and get into deep, peaceful sleep!
- Make your bedroom a sleep-friendly nook tonight by making it cool, dark and quiet. Consider using blackout curtains as well. Make it as dark as possible!
- Cut back on screen use at least one hour before bed. Screens’ blue light can mess with your sleep by tricking your brain into thinking it’s still daytime!
- Wind down by reading a book, journaling, meditating, stretching or taking a nice bath with some soothing Epsom salt. You can also enjoy your me-time with a nice, warm cup of chamomile tea!
If night sweats or 3 AM wake-ups are stealing your rest, my guide to sleep deprivation in menopause has lots more fixes that work.
Maintaining Good Thyroid Health
A healthy thyroid can greatly affect your energy levels. Your thyroid loves real food with iodine (seafood, eggs, dairy), selenium (just 1–2 Brazil nuts a day) and iron. But go easy on iodine supplements — too much can upset the thyroid, too, especially if you have Hashimoto’s.
If you suspect thyroid issues, don’t hesitate to consult your healthcare provider. Check out my thyroid article to know the common symptoms!
Avoiding Toxins from Environment, Food, Products — and Even “Social Toxins”!
Some food additives and everyday chemicals may add to your body’s toxic load — like extra work piled onto your liver’s to-do list!
These sneaky substances can hide in your food, home products and environments — and may be linked to some symptoms, like fatigue, brain fog and mood swings. So, aim to choose natural products and organic foods whenever possible.
Be mindful of your surroundings, too. That goes both for your physical environment and social circles! Sometimes, it’s the actual noise and energy around you that keeps you from feeling your best!
Recharging Your Emotional Batteries
It’s easy to over-commit socially, but it’s time to prioritize your own well-being. Don’t be afraid to take a step back and carve out time for yourself!
Don’t let your emotional batteries drain for the wrong reasons. Find what lights you up!
By incorporating a few simple strategies into your daily routine, you can reclaim that vibrant energy and truly enjoy every day. Remember, you’re not just capable; you’re unstoppable! You’ve got this!
FAQs About Extreme Fatigue in Menopause
Is extreme fatigue a symptom of menopause?
Yes — and a really common one, especially in perimenopause. Shifting hormones, night sweats and broken sleep all pile up. But don’t just blame menopause: get the basic blood tests done so nothing else gets missed.
Why am I so tired even after a full night’s sleep?
Often it’s the quality, not the hours. Night sweats, sleep apnea, a flat cortisol rhythm or low iron can all leave you waking up drained. Blood sugar swings through the day don’t help either!
When should I see a doctor about fatigue?
If it lasts more than a few weeks, or comes with weight loss, heavy periods, breathlessness, a racing heart or very low mood — book that appointment. Don’t wait it out.
Can HRT help with menopause fatigue?
For some women, yes — mostly by calming night sweats so you finally sleep through. It’s not a magic energy pill, though. Food, stress and movement still matter just as much.
References:
Tiredness and fatigue – NHS (www.nhs.uk)
Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) – NHS (www.nhs.uk)
Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management (NG206) – NICE (www.nice.org.uk)
What is ME/CFS? – CDC (www.cdc.gov)
Fatigue – Cleveland Clinic (my.clevelandclinic.org)
POTS: A Little-Known Cause of Extreme Fatigue – Johns Hopkins Medicine (www.hopkinsmedicine.org)
Adrenal fatigue does not exist: a systematic review – PMC (pmc.ncbi.nlm.nih.gov)
Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk – PubMed (pubmed.ncbi.nlm.nih.gov)
The serotonin theory of depression: a systematic umbrella review of the evidence – PubMed (pubmed.ncbi.nlm.nih.gov)
Mild dehydration affects mood in healthy young women – PubMed (pubmed.ncbi.nlm.nih.gov)
Ashwagandha – NCCIH (www.nccih.nih.gov)
Iodine: Fact Sheet for Health Professionals – NIH Office of Dietary Supplements (ods.od.nih.gov)
Written by Gita — Certified Fasting Therapist, Nutrition Coach and Keto Coach, and founder of My Menopause Journey since 2014. Every article is built on published research and trusted health sources, updated regularly, and shaped by her own journey through menopause. Read more about Gita and her credentials.
