Why Am I So Tired During Perimenopause? 10 Ways to Support Your Energy | Perimenopause Fatigue

If you've found yourself wondering, "Why am I so tired all the time?" you're certainly not alone. Fatigue is one of the most common symptoms women experience during perimenopause. And while it's easy to dismiss it as simply getting older or having too much on your plate, the reality is far more complex.

Fatigue during perimenopause is rarely caused by one thing alone. The hormonal changes of perimenopause create the perfect storm for low energy. As oestrogen levels fluctuate, blood glucose regulation can become less stable, contributing to energy highs and lows, cravings and that familiar afternoon slump. At the same time, falling oestrogen and progesterone can disrupt sleep through hot flushes, night sweats and frequent waking, while the competing demands of midlife often leave stress levels running high, further draining your energy. 

For some women, heavier periods during the early stages of perimenopause can also lead to iron deficiency, reducing the body's ability to transport oxygen and leaving you feeling tired and breathless. If fatigue is persistent, particularly alongside heavy periods, it's worth speaking to your healthcare professional about checking your iron levels, as well as other possible causes such as thyroid function, vitamin B12 and folate.

The encouraging news is that many of these drivers can be improved through the right nutrition and lifestyle strategies.

Top tips for fighting fatigue

1.     Get good in bed. Prioritise your sleep. Sleep is when your body restores and repairs itself. If you're consistently getting less than seven hours, work gradually towards 7–8 hours a night. Even an extra 30 minutes can make a difference. Head to bed before you want to be asleep to give yourself time to wind down.

2.     Stay hydrated. Even mild dehydration can leave you feeling tired, sluggish and less focused. Start the day with a glass of water and keep sipping throughout the day. If plain water isn't appealing, add lemon, cucumber or berries, and use reminders if you need them.

3.     Unshackle yourself from sugar. When energy dips, it's tempting to reach for something sweet, but this often fuels the blood glucose rollercoaster. Instead, focus on wholegrains, natural yoghurt instead of flavoured varieties, and fruit to sweeten breakfasts. Remember, honey and maple syrup are still sugars, and treats should remain occasional rather than everyday habits.

4.     Get to the root of sugar cravings. Cravings are often a symptom rather than the problem itself. Poor sleep, stress, dehydration, low protein intake and blood glucose fluctuations can all drive them. Rather than relying on willpower, ask yourself what's really going on.

5.     Choose a smarter afternoon snack. A banana paired with a handful of nuts makes a balanced afternoon snack, providing carbohydrate for energy alongside healthy fats and protein to help keep you going until your next meal.

6.     Limit caffeine and alcohol. Both can temporarily mask fatigue while disrupting sleep later. Enjoy them in moderation, and try to avoid caffeine later in the day if sleep is becoming a struggle.

7.     Move more. It may feel like the last thing you want to do, but movement is one of the best natural energy boosters. Go for a walk, stretch, do a few squats while the kettle boils or build short movement breaks into your day. Every little bit counts.

8.     Manage stress. Stress is one of the biggest drains on energy. Learn to say no when needed, spend time with people who fill your cup, and prioritise activities that help you recharge as much as those that fill your diary.

9.     Get some sunlight. Natural daylight helps regulate your body clock, supporting both energy and sleep. Aim to get outside every day, even if it's just for a short walk. During darker months, a light therapy box may also be worth considering.

10.  Check your nutrient status. If fatigue persists despite improving your lifestyle, speak to your healthcare professional. Nutrient deficiencies such as iron, vitamin B12 or folate deficiency can contribute to fatigue. If your diet has been lacking or a deficiency is confirmed, a supplement may be appropriate, but food should always be the foundation.

Ready to feel more like yourself again?

Fatigue may be common during perimenopause, but it shouldn't be something you simply accept. Understanding the underlying causes of low energy can help you make meaningful changes that support your health, wellbeing and quality of life.

Dr Linia Patel helps women navigate perimenopause and menopause with evidence-based nutrition strategies tailored to their individual needs and lifestyle.

Explore Master Your Menopause or book a consultation to discover how personalised nutrition support can help you regain your energy and thrive through midlife.