Can Menopause Make You Tired? Yes, Here’s How to Treat It

Many women feel tired during menopause. Fluctuating hormones, sleep disorders, and weight gain can all cause sleep problems and fatigue.
Updated
2024-02-17
18 MINS
Written by
Jeff Kahn, M.S., Rise Science Co-Founder
Reviewed by
Chester Wu, MD, Rise Science Medical Reviewer
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Can Menopause Make You Tired? 

  • Menopause can make you tired. Fluctuating hormones, increased anxiety and body temperature, weight gain, and sleep disorders can make it harder to get the sleep you need.
  • Lowering your sleep debt, getting in sync with your circadian rhythm, exercising, and trying cognitive behavioral therapy and hormone replacement therapy can help reduce menopause fatigue.
  • The RISE app can work out how much sleep you need and guide you through 20+ good sleep habits each day to help you get it.

Hot flashes, weight gain, mood swings. You probably already know about a few of the common menopause symptoms. But can menopause make you tired, too? 

The short answer is yes, and there are quite a few causes of menopause fatigue. Luckily, there are also quite a few ways to get more energy during menopause. 

Below, we’ll dive into the causes of menopause fatigue, how long it’ll last, and how you can fix it. 

Disclaimer: The scientific literature uses gendered language when talking about menopause. We have used the term “women” in this article, but this advice is for anyone who experiences menopause fatigue.

Ask a Sleep Doctor

For an expert take, we spoke to Dr. Chester Wu, Rise Science sleep advisor and medical reviewer. Here’s what he had to say:

“Menopause can cause fatigue. It causes hot flashes, night sweats, sleep disorders, and stress, which can all make it hard to get enough sleep at night. Try to squeeze in some extra sleep when you can with afternoon naps or by heading to bed a little earlier than usual. This should improve your energy levels.”

Can Menopause Make You Tired?

Yes, menopause can make you tired. Research shows general fatigue is a common symptom of menopause, and menopause symptoms can also disrupt your sleep, which will make you tired.

Menopause is linked to: 

You can learn more about menopause sleep problems here. 

What is Menopause Fatigue?

Menopause fatigue is fatigue caused by menopause. Women may also experience fatigue during perimenopause (the time leading up to menopause) and postmenopause (after menopause, when your periods have completely stopped). 

Symptoms of menopause fatigue include: 

  • Feeling tired
  • Needing more breaks or recovery than usual 
  • Lowered mental performance
  • Crushing fatigue or extreme fatigue that gets in the way of daily life
  • Feeling irritable 
  • Feeling low on motivation 

Sleep problems during menopause can also cause cravings, digestive issues, and trouble concentrating — just to name a few.

If you struggle to sleep during menopause, you’re not alone. Research shows 25% of perimenopausal women and 30% of postmenopausal women say they get a good night’s sleep a few nights a month or less. And it’s thought 38% to 60% of peri- and postmenopausal women have insomnia.

You’ll be more at risk of menopause fatigue if: 

  • You’re stressed 
  • You’ve got mental health issues like anxiety or depression
  • You’ve got physical health issues like high blood pressure, type 2 diabetes, or anemia
  • You’ve got a sleep disorder like insomnia or sleep apnea 
  • You’ve got poor lifestyle habits like a bad diet, drinking a lot of alcohol, or smoking 
  • You’re overweight or obese
  • You’re on a diet or taking weight loss drugs like Ozempic or Wegovy (the brand names for semaglutide)

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What Causes Menopause Fatigue?

Menopause fatigue is most likely caused by changes to your hormone levels, which can lead to feelings of fatigue and sleep problems. 

Hormones 

Hormones can cause poor sleep throughout a woman’s life, including during your period, pregnancy, and menopause. 

During menopause, your ovaries stop producing estrogen and progesterone. 

Declining estrogen levels can cause hot flashes and sleep-disordered breathing. Estrogen also helps to regulate your body temperature, and it’s much harder to fall and stay asleep when you’re too warm

Lower progesterone can cause anxiety and sleep apnea, both of which can ruin your sleep. 

Testosterone is usually associated with men, but women produce it, too. But testosterone declines with age and it’s linked with insomnia, needing to use the bathroom more at night, and more sleep-disordered breathing. 

These hormone fluctuations can also affect adrenal and thyroid hormones, which can cause fatigue.

Plus, to make matters worse, research shows cortisol levels increase as you move through menopause. This may be caused by fluctuating estrogen levels. High cortisol can cause sleep problems, weight gain, and brain fog — all of which may contribute to menopause fatigue.   

You can learn more about the link between cortisol and sleep here. 

Sleep Debt 

Sleep debt is the amount of sleep you owe your body. When you don’t meet your sleep need — the genetically determined amount of sleep you need — you’ll build up sleep debt. 

It’s easy to build up sleep debt during menopause as: 

  • Symptoms like hot flashes can keep you awake and are linked with chronic insomnia
  • You may develop sleep disorders like insomnia, sleep apnea, and restless leg syndrome 
  • Hormone changes can cause an increase in your body temperature, sleep-disordered breathing, anxiety, or mood changes  
  • You may gain weight during menopause, and being overweight is linked to sleep problems 
  • You’re stressed or mentally exhausted — either from menopause itself or from daily life
  • You’re getting older and sleep becomes harder to get as we age 

Unfortunately, sleep debt can make menopause symptoms like brain fog, irritability, and low libido worse, which can cause more stress and more sleep loss. 

RISE can work out how much sleep debt you have

RISE app screenshot showing how much sleep debt you have
The RISE app can work out how much sleep debt you have.

We looked to RISE users to see if women really get less sleep during menopause. Unfortunately, our data backs it up. Women have more sleep debt at age 50 to 59 — the time they may be going through menopause — than at any other age. The only exception is age 18 to 23. We can’t say for sure whether menopausal women have more sleep debt and RISE users don’t accurately represent the general population as they turn to RISE to get more energy.  

Learn more about how to know if you’re getting enough sleep here.

RISE users on iOS 1.202 and above can view their sleep debt here

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Circadian Misalignment 

Circadian misalignment is when you’re living out of sync with your circadian rhythm. This is your roughly 24-hour body clock. 

You could be out of sync if you: 

Even if you’re getting enough sleep overall, if you’re getting this sleep at the wrong times for your body clock, you can feel tired. 

It’s easy to get out of sync at any time of life, but it can happen during menopause as you may have given up work and have kids moving out of the house, meaning your usual sleep pattern is thrown off. 

Learn more about how to find the timing of your circadian rhythm here. 

Other Reasons You’re Tired 

Menopause may not be the only thing making you feel tired. 

You may have low energy if: 

  • You have a medical condition like hypothyroidism, anemia, type 2 diabetes, cardiovascular disease, or chronic fatigue (early menopause or menopause caused by surgery has been linked to chronic fatigue syndrome, but more research is needed)
  • You’ve got anxiety or depression 
  • You’re taking medications like antihistamines and antidepressants
  • You’ve got a nutritional deficiency like iron, vitamin B12, or vitamin D 
  • You’re overweight, don’t do much exercise, or eat an unhealthy diet 
  • You’re stressed — this is likely around midlife as you may be caring for aging parents and troublesome teens, taking on more responsibility at work or planning for retirement, and going through big life changes like divorce.

We’ve covered more reasons for female fatigue here.

How Long Does Menopause Fatigue Last?

There’s no set time that menopause fatigue will last. It may last the entire menopause transition, which can be about eight years. But you may also feel tired during perimenopause (which can start about six years before your periods end) and postmenopause. 

It depends on what’s causing your fatigue, too. For example, hot flashes, a common sleep disruption during menopause, can last 4.5 years after your final period.

How to Treat Menopause Fatigue?

You can treat menopause fatigue by lowering your sleep debt, getting in sync with your circadian rhythm, improving your sleep hygiene, and considering cognitive behavioral therapy, and hormone replacement therapy. 

Here’s more on how to beat menopause fatigue: 

1. Lower Your Sleep Debt

If you’ve got a lot of sleep debt, you’re going to feel tired, whether you’re going through menopause or not. We recommend keeping your sleep debt below five hours for maximum energy. 

You can lower your sleep debt by: 

  • Taking afternoon naps (check RISE for the best time to nap) 
  • Going to bed a little earlier 
  • Sleeping in a little later
  • Improve your sleep hygiene (more on that soon)

RISE will automatically track how much sleep debt you have as you work to lower it. 

Learn how long it takes to recover from sleep deprivation here. 

Expert tip: Don’t just aim for eight hours of sleep — find out how much sleep you need exactly. The RISE app uses our phone use behavior and proprietary sleep-science-based models to work out your sleep need. 

More research needs to be done to find out whether women need more sleep than men. But women do suffer from more sleep problems than men, so need more time in bed to get enough shut-eye.

Beyond your sex, your sleep need is highly individual. We looked at 1.95 million RISE users aged 24 and up and found their sleep needs vary quite a bit. Some only need five hours of sleep, whereas others need a whopping 11 hours 30 minutes.

The RISE app can tell you how much sleep you need.
The RISE app can work out how much sleep you need.

RISE users on iOS 1.202 and above can click view their sleep need here.

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2. Get in Sync With Your Circadian Rhythm 

Getting in sync with your circadian rhythm can boost your energy levels and it’s good for your mental and physical health, too, which can help your energy in the long run. 

Here’s how to get in sync with your circadian rhythm: 

  • Keep a consistent sleep schedule: Aim to get to bed and wake up at roughly the same times each day all week.
  • Eat meals at roughly the same time: And avoid eating too close to bedtime as this can keep you awake or wake you up in the night. 
  • Go to bed in your Melatonin Window: This is what we call the one-hour window when your body’s rate of melatonin production is at its highest. Melatonin is your sleep hormone, so try to go to bed during this roughly one-hour window. Check RISE for when it is nightly. 

RISE predicts your circadian rhythm each day, so you can easily stay in sync. 

RISE app screen shot showing energy peak and dip times
The RISE app can predict the timing of your circadian rhythm each day.

Expert tip: Your circadian rhythm dictates your energy levels throughout the day. Check RISE to see when your energy levels are higher (usually mid-morning and early evening) and schedule your most important tasks during this time to make the most of the times you may feel less menopause fatigue. We’ve covered how to be more productive here.

RISE users on iOS 1.202 and above can see their circadian rhythm on the Energy screen here

3. Improve Your Sleep Hygiene 

Sleep hygiene is the name for the set of daily habits that can help you fall and stay asleep. They’re important at all times of life, but especially when menopause symptoms can so easily disrupt your rest. 

Here’s what to do: 

  • Get out in sunlight for at least 10 minutes each morning
  • Spend as much time in daylight during the day 
  • Avoid bright light about 90 minutes before bed 
  • Avoid alcohol, large meals, intense exercise, and caffeine too close to bedtime 
  • Make sure your bedroom is dark, quiet, and cool (this is even more important when hot flashes keep you up) 

You can learn more about how to improve your sleep hygiene here. 

RISE can guide you through 20+ sleep hygiene behaviors every day and tell you the most effective times to do them. 

RISE app screenshot showing sleep hygiene habit reminders
The RISE app can tell you when to do 20+ sleep hygiene behaviors each day.

RISE users on iOS 1.202 and above can set up their 20+ in-app habit notifications here

4. Lower Your Stress Levels 

Stress and anxiety can keep you up at night and make you feel drained during the day. 

Here’s what you can do to lower your stress: 

  • Do a calming bedtime routine to wind down before bed. Try reading, listening to music, or doing yoga (bonus: yoga may reduce menopause symptoms).
  • Journal or do a brain dump if racing thoughts keep you up at night. Do your brain dump in the RISE app and you’ll get a reminder of what you write down the next day. 
  • Try acupuncture. One study found acupuncture was linked to increased estrogen levels and reduced sleep disturbances in menopausal women.
  • Try breathing exercises like diaphragmatic breathing and relaxation techniques like progressive muscle relaxation. RISE has audio guides on these exercises to get you started. 
  • Ask for help from friends and family or reach out to a therapist to discuss mental health issues during menopause. 

Learn more about how to sleep with anxiety here.

5. Get a Foot Massage

Here’s a quick fatigue fighter — get a foot massage. 

A 2022 study found postmenopausal women who got a foot massage once a day for seven days slept for an hour longer each night and had lower levels of anxiety and fatigue. 

6. Lose Weight if You Need to 

Getting down to a healthy weight can help you have more energy and sleep better. 

And a 2023 paper states menopause weight gain and changes to your body composition can make hot flashes worse. 

It’s tough to lose weight during menopause, but you can make it happen by cutting your calories, upping your exercise, getting enough sleep, and considering hormone replacement therapy.

Learn more about how to lose weight during menopause here.

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7. Do More Exercise 

One study found when postmenopausal women did more physical activity, they felt more energy. 

Exercise can also help you fall asleep, reduce stress, and keep your weight in check — all of which can boost your energy levels. Yoga and tai chi have also been shown to reduce menopause symptoms like hot flashes. 

Learn more about how exercise can improve your sleep here.

Just be sure to avoid intense exercise within an hour of bedtime as it can keep you up. RISE can tell you when exactly to skip a workout. 

RISE app screenshot showing when to do your workouts
RISE can tell you when to avoid workouts before bed.

RISE users on iOS 1.202 and above can set up their avoid late workouts reminder here.

8. Try Cognitive Behavioral Therapy for Insomnia

Cognitive behavioral therapy for insomnia (CBT-I) is a type of therapy that aims to change the way you think about sleep. It’s often a first-line treatment for insomnia. 

One study found CBT-I can help women with insomnia during perimenopause and postmenopause. 

9. Consider Supplements 

Supplements may help you get more energy during menopause.

One study found taking a daily 1,200-milligram soy lecithin supplement for eight weeks helped women aged 40 to 60 with fatigue feel more energy. It also lowered their blood pressure — a win-win. 

Omega-3 fatty acid supplements have been shown to reduce how many hot flashes you have. 

And a 2023 study found fennel-valerian extract can help to reduce hot flashes and improve sleep disorders in postmenopausal women. 

Overall, eating a healthy diet high in fruits, vegetables, whole gains, and legumes can help to reduce fatigue. 

10. Consider Hormone Replacement Therapy 

Hormone replacement therapy (HRT) replaces the hormones that decline during menopause. HRT may be able to reduce fatigue as a symptom and reduce menopause symptoms that are stopping you from getting enough sleep — like night sweats.

For example, estrogen therapy can reduce hot flashes, headaches, sweating, and how often you wake up during the night. Hormone replacement therapy may also help you lose weight, improve your mood, and increase your response to antidepressants (if needed). 

HRT may not help with sleep-disordered breathing, however. More research is needed. 

HRT isn’t right for everyone, though. Some experts believe HRT isn’t safe for those with a high risk of breast cancer. But recent research disagrees. 

A 2022 review states when started in women younger than 60 and/or close to menopause, HRT “significantly reduces all-cause mortality and cardiovascular disease.” It adds that the risks of health issues like breast cancer and stroke are rare and comparable to other medications. 

HRT may make some women feel tired, but for many, it can improve their sleep and therefore energy levels. 

Speak to your healthcare provider to see if HRT is right for you. They may suggest other medications like low-dose birth control pills, which contain estrogen and progesterone, or selective serotonin reuptake inhibitors (SSRIs). 

11. Use the RISE App 

RISE can help you get more energy during menopause by: 

  • Working out how much sleep you need and how much sleep debt you have
  • Predicting your circadian rhythm each day, so you can get in sync
  • Guiding you through breathing exercises and relaxation techniques to reduce stress and help you drift off 
  • Telling you when to do 20+ sleep hygiene habits to make it easier to get a good night’s sleep 

We’ve covered more tips on how to feel more awake here and how to use the RISE app to boost your energy here.

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When to See a Doctor About Menopause Fatigue?

Talk to a doctor about menopause fatigue if it’s affecting your quality of life and well-being. They can test you for sleep disorders and health issues that may be causing fatigue like sleep apnea, depression, chronic fatigue, or heart disease.

A healthcare provider can also recommend the best course of action, whether that’s medical treatments like hormone replacement therapy or lifestyle changes. 

Get More Energy Before, During, and After Menopause

Many women experience menopause fatigue, and you may have trouble sleeping during perimenopause, menopause, and postmenopause. 

To get more energy during menopause, try lowering your sleep debt, getting in sync with your circadian rhythm, doing more exercise, lowering your stress, and trying hormone replacement therapy.  

The RISE app can work out how much sleep you need, so you know what you should be aiming for each night. RISE can also tell you how much sleep debt you have and help you lower it, and predict your circadian rhythm each day to help you stay in sync. 

To make it easier to get a good night’s sleep, RISE will guide you through 20+ sleep hygiene habits, too. 

You can get more energy fast — 80% of RISE users get better sleep within five days. 

Summary FAQs

What is menopause fatigue?

Menopause fatigue is fatigue that’s caused by menopause. Fatigue is a common symptom of menopause and you may experience sleep problems during perimenopause, menopause, and postmenopause. This can be due to fluctuating hormones, symptoms like night sweats, stress, anxiety, and sleep disorders.

Is extreme tiredness a symptom of menopause?

Yes, extreme tiredness can be a symptom of menopause. Fatigue is reported as a common symptom during perimenopause, menopause, and postmenopause, and sleep loss and sleep disorders are common.

How long does menopause fatigue last?

There’s no set time that menopause fatigue lasts, it’ll affect everyone differently. However, you may experience menopause fatigue for the entire menopause transition, which can last eight years. You may also experience hot flashes 4.5 years after your last period, and hot flashes can lead to sleep loss and fatigue.

Does menopause fatigue go away?

Menopause fatigue may go away. You may experience menopause fatigue for the duration of menopause, which can last eight years. However, some women continue to feel fatigue postmenopause. Getting more sleep, exercising, and lowering stress levels can help menopause fatigue go away.

What helps with menopause fatigue?

Lowering your sleep debt, getting in sync with your circadian rhythm, exercising, yoga, foot massages, losing weight, cognitive behavioral therapy, and hormone replacement therapy can help with menopause fatigue.

Diet for menopause fatigue

Eating a healthy diet high in fruits, vegetables, whole grains, and legumes can help with fatigue. And research shows supplements like soy lecithin, omega-3 fatty acids, and fennel-valerian extract may help with menopause fatigue, other menopause symptoms like hot flashes, and sleep problems. If you’re on a diet, you may feel more fatigue.

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