Why Do We Feel So Lethargic During Perimenopause?

You might have noticed it: the mid-afternoon slump that feels heavier than ever, mornings where you can’t seem to shake off the grogginess, or days when you feel like you’re running on empty—maybe even after a good night’s sleep. Fatigue during perimenopause is a common but frustrating reality for many women. But what causes it, and more importantly, what can you do about it?

The Perimenopausal Energy Drain

Perimenopause is a time of significant hormonal shifts, and these changes directly affect your energy levels. Fluctuating & then declining oestrogen can disrupt your body’s ability to regulate energy production. Oestrogen helps maintain stable blood sugar levels and supports healthy mitochondrial function (the energy powerhouses of your cells). As levels drop, energy dips often follow.

Similarly, fluctuating progesterone can lead to poor-quality sleep, and change your tolerance to stress leaving you feeling drained during the day. Add to this the life stressors of midlife—career, family, aging parents and other personal demands—and it’s no surprise that energy can feel in short supply.

Additional Factors Behind Low Energy

While hormonal changes are key players, they’re often not the whole story and more often than not, in my clinical experience the hormonal shifts are being amplified by one or more of the following: 

1. Nutrient Deficiencies:
   • Deficiencies in B vitamins, magnesium, iron, and coenzyme Q10 (CoQ10) can impair energy production.
2. Thyroid Function:
   • Perimenopause can unmask or exacerbate thyroid imbalances. Hypothyroidism, in particular, is closely linked to fatigue and sluggishness. 
3. Blood Sugar Imbalances:
   • Midlife changes in insulin sensitivity can lead to erratic energy levels throughout the day.
4. Chronic Stress:
   • Persistent stress can disrupt cortisol rhythms, leaving you feeling wired at night and exhausted during the day.

The Impact of Fatigue on Your Life

Feeling constantly tired isn’t just inconvenient—it can be life-altering. Low energy can make it harder to stay active, prepare nourishing meals, or keep up with work and family responsibilities. Over time, it can also dampen your mood, reduce motivation, and create a cycle of inactivity that exacerbates fatigue further.

Regaining Your Energy: Practical Strategies

The good news? You don’t have to accept low energy as your new normal. Here are some actionable steps to help restore your vitality:

1. Balance Your Blood Sugar:
   • Focus on meals that combine protein, healthy fats, and fibre. This helps stabilise your energy throughout the day and avoids sugar spikes and crashes. You can grab my free balanced meal planner to help with this
2. Optimise Nutrient Intake:
   • Include foods rich in B vitamins (leafy greens, eggs, nutritional yeast, tahini, whole grains), magnesium (nuts, seeds, dark chocolate), and iron (red meat, legumes, spinach). Supplements like CoQ10 may also be beneficial, but my recommendation is to work with a  professional like myself for personalised advice as there are other options that may be a better fit.
3. Support Your Mitochondria:
   • Regular movement, particularly low-impact activities like walking, swimming or yoga, can enhance mitochondrial function. Antioxidant-rich foods like berries and green tea also support energy production.
4. Check Thyroid Health:
   • If fatigue persists despite lifestyle changes, it’s worth investigating your thyroid function. If your GP has tested your thyroid only using TSH or even TSH and free T4 I would still not rule out a thyroid problem. A comprehensive thyroid panel can identify imbalances that may need addressing and also a complete symptom appraisal. Think of your thyroid as the spark plug for the engine that is your body.
5. Manage Stress:
   • Incorporate daily stress-reduction practices, such as deep breathing, mindfulness, or journaling. Lowering cortisol levels can significantly improve energy and overall well-being.
6. Prioritise Quality Sleep:
   • While sleep issues may stem from hormonal changes, consistent routines, a cool and darkened room, morning sun and calming bedtime rituals can help set the stage for restorative rest. You might find this blog helpful

Take the First Step Towards Renewed Vitality

Feeling consistently energised is possible, even during perimenopause. By addressing both the hormonal and lifestyle factors contributing to fatigue, you can regain the stamina and vibrancy to fully engage with your life.

Want tailored support to feel energised again?

• Book a Priority Plan session to identify key areas of improvement, from nutrition to stress management.
• For a deeper dive, explore my Transformation Package and uncover the root causes of your fatigue with practitioner-only testing and personalised solutions.

Don’t let low energy hold you back. Let’s work together to help you thrive through perimenopause and beyond