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 either as a direct result of hormonal changes, or because other menopausal symptoms (like hot flushes) are disrupting your sleep.

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


Fatigue is when the tiredness is often overwhelming and isn’t relieved by sleep and 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 fatigue 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. However, avoid exercising within four hours of bedtime, as this can make it more difficult to sleep and increase menopause 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 daytime naps and have a regular bedtime and wake time.

4. Reduce stimulants. Avoid any substances which can impact on sleep, including alcohol, tobacco and caffeine

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).


Yes. HRT is known to improve sleep, mood and hot flushes, all of which may disrupt your sleep and lead to tiredness. However, HRT comes with risks and is not suitable for everyone. Speak to your doctor about your personal treatment options.

Read more about the HRT debate.


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

The changes include a marked decrease in the amount of oestrogen and progesterone released by the body.

These changes cause your periods to become irregular and eventually stop. However, they can also affect the body in other ways and are thought to also cause feelings of tiredness and low energy.

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

One common menopausal symptom – hot flushes – is known to disrupt sleep and cause night-time waking. Hot flushes happen due to hormonal changes which cause the hypothalamus – the body’s ‘thermostat’ – to become more sensitive. This causes the characteristic flushing, 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.

  • Your tiredness or low energy is persistent
  • You have any unexplained weight loss
  • You have any other new or unexplained symptoms
  • 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”



Why can’t I sleep anymore – is it menopause? Read more

How HRT and ambition got my energy and libido back. Read more

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

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