Complete Symptom Guide to Menopause and Fatigue | Stella

Menopause and fatigue


Menopause and fatigue, tiredness, and low energy seem to go hand-in-hand for many people. This can happen as a direct result of hormonal changes and because other menopausal symptoms, like hot flashes, are disrupting your sleep.

These symptoms may also be due to other underlying medical conditions, so it is important to see your healthcare provider in certain circumstances. Read on to find out more about the causes of menopause tiredness, the treatments, and when to seek help.


Fatigue is when the feeling of tiredness is overwhelming and isn’t relieved by sleep or rest.

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  • Tiredness is one of the most common symptoms of menopause.
  • 40-60% are known to suffer from disturbed sleep and sleep disturbance at menopause, and most will feel fatigued as a consequence

Read more about the stages of menopause.


Feeling very tired or sleepy

Slowed reflexes and responses

Impaired judgement and decision-making



1. Increase exercise. Ensure that you are getting enough exercise – studies show that moderate to vigorous physical activity is related to increased energy levels. Avoid exercising within four hours of bedtime, as this can make it more difficult to sleep and increase tiredness. 

2. Take care of your diet. Certain vitamin and nutrient deficiencies, including low iron and low B12, can contribute to fatigue. Read more about weight gain during menopause.

3. Good sleep hygiene. Avoid naps in the late afternoon and evening and have a regular bedtime and wake time.

4. Reduce stimulants. Avoid any substances which can impact sleep, such as alcohol, caffeine, and tobacco, including eCigs and vapes.

5. Keep cool. Helpful tips include, wear lightweight layers you can remove quickly – you can buy menopause-friendly nightwear engineered to wick away sweat. Use sheets and blankets for bedding instead of a duvet, so you can adapt to your temperature easily. Invest in a cooling face spray and fan for when the heat hits.

6. Wind down before bed. Avoid using any screens before bed (including phones, computers, and televisions).

Would hormone therapy (HT) help?

Yes. HT improves sleep, mood and hot flashes, all of which may lead to tiredness. However, HT comes with risks and is not suitable for everyone.

Read more about HT risks and benefits.


During menopause, the hormones which regulate your menstrual cycle change, and this can impact your energy and leave you feeling tired.

The changes include a significant decrease in the amount of estrogen and progesterone released by the body.

These changes cause your periods to become irregular and eventually stop. They can also affect the body in other ways including causing feelings of tiredness and low energy.

Your sleep may be disrupted by other symptoms of menopause, as well as general tiredness and low energy.

One common menopausal symptom – hot flashes – is known to disrupt sleep. Hot flashes happen due to decreases in estrogen which cause the hypothalamus – which contains the body’s ‘thermostat’ – to become more sensitive. This causes the characteristic hot flashes, sweating, and palpitations, which are also known as vasomotor symptoms.

Mood changes including depression become more common at menopause, and these are also known to cause low energy and disrupt sleep.

Talk to a healthcare provider, nurse or mental health specialist, or someone you trust about menopause and anxiety if you feel that your symptoms are severe enough to make day-to-day living feel tough. 

Also if:

  • Your tiredness or low energy is persistent
  • You have unexplained weight loss
  • Your tiredness is having an impact on your life
  • You are concerned for any other reason
I often felt so exhausted I couldn’t function during the day”



Five reasons why stress and perimenopause are an issue. Read more

How Stella made me feel more in control and capable. Read more

10 steps for a good night’s sleep during menopause. Read more

See what treatments are right for you

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  • Supportive coaching to motivate you
  • Medical review & online doctor appointments