From the Research
Women suffer from fatigue during perimenopause, particularly around irregular periods, primarily due to hormonal fluctuations, as evidenced by a recent study published in 2024 1. This transition period is marked by erratic estrogen and progesterone levels, disrupting sleep patterns and energy regulation. The declining estrogen can cause hot flashes and night sweats that interrupt sleep, while progesterone fluctuations may lead to insomnia. Key factors contributing to fatigue include:
- Iron deficiency from heavy menstrual bleeding
- Hormonal changes affecting thyroid function and cortisol production
- Mood changes like depression and anxiety, which can both cause and worsen fatigue To manage these symptoms, women can benefit from:
- Regular moderate exercise
- Maintaining consistent sleep schedules
- Eating iron-rich foods
- Practicing stress reduction techniques
- Considering supplements like iron, vitamin B12, or magnesium after consulting with a healthcare provider Hormone replacement therapy might be appropriate for some women with severe symptoms, typically starting with low-dose estrogen patches or pills combined with progesterone if the uterus is intact, as supported by recent guidelines 2, 3, 4. It is essential to address the root hormonal causes of perimenopausal fatigue, and a study from 2017 highlights the importance of iron therapy in treating iron deficiency anemia and restoring quality of life 5.