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Crashing fatigue in menopause

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If you’re in menopause, you may have experienced sudden fatigue that grips you with a rush of exhaustion and even muscle weakness. This is crashing fatigue, and it can shut down your life fast.

Fatigue is a main symptom of menopause

Crashing fatigue in menopause causes abrupt loss of energy and intense lethargy that can come on at any time of day. It hits your body with a wave of exhaustion that women describe like this: “I could be fine one minute and the next minute I can’t keep my eyes open,” and “some days my head was so foggy I started to doubt myself at work. I would just feel so drained.”

Crashing fatigue in menopause causes its own problems

Along with deep tiredness, crashing fatigue has its own symptoms:

  • Irritability in menopause
  • Anxiety
  • Difficulty concentrating
  • Frequent hunger
  • Inability to sleep well, waking up tired
  • Racing thoughts at night
  • Reduced enthusiasm about life
  • Lack of motivation
  • Feeling overwhelmed or emotionally stressed

Conventional doctors may be familiar with crashing fatigue, but still tend to offer only prescription drugs like antidepressants, which may not even relieve the problem of extreme tiredness. And there’s no way that kind of medication can resolve the source of the issue.

If you’re being laid low by crashing fatigue in menopause, you can find your way back to feeling energetic and active with a few simple steps. But you have to know what causes crashing fatigue in the first place.

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What causes crashing fatigue in menopause?

If you think crashing fatigue in menopause has to do with hormones, you’re 100% right. During perimenopause and menopause, the ovaries naturally respond less effectively to the pituitary gland’s signal to increase estrogen. This results in estrogen levels that are excessive on some days, and bottomed out on others.

Serious fluctuations in estrogen can also interrupt the delicate balance of stress hormones. Adrenaline sometimes floods the body, which can leave you even more fatigued afterward. If you are still menstruating, you may already be dealing with crashing fatigue right before your period.

But crashing fatigue also has a maddening side effect: you can’t sleep even though you’re bone tired. That’s because as estrogen rises and falls unpredictably during perimenopause, the body experiences the fluctuation as a hormonal emergency. The brain triggers the release of cortisol and adrenaline, the adrenal fight-or-flight hormones that derail the normal sleep cycle.

The adrenal glands also help make estrogen with dehydroepiandrosterone, or DHEA, but chronic stress depletes DHEA. Without enough, it’s hard for your body to maintain hormone balance, which makes you more prone to crashing fatigue in menopause.

The solution to crashing fatigue in 3 steps

If you’re experiencing crashing fatigue, you want to interrupt that pattern and reestablish your normal sleep-wake cycle. Careful attention to hormones can restore their natural rise-and-fall patterns and allow them to interact in a healthy way.

1. Let your hormones send the right messages to your body.

Crashing fatigue is linked tightly to fluctuating estrogen levels, especially when the changes are severe or rapid. The correct balance between naturally declining estrogen and other hormones smooths out the hormonal spikes and crashes that drain energy and disturb sleep. Women in menopause are more vulnerable to the effects of stress and adrenal hormone responses. That means remembering to pace yourself during the day, and allowing for more time-outs as needed.

You can help your body coax its hormones back into balance using herbal extracts. The best formulas contain combinations of phyto-ingredients that have adaptogenic qualities that allow them to continually adjust as necessary. Look for red clover, ashwagandha and especially black cohosh — these shift naturally to the changing hormonal needs of your body and they function well together.

2. Take snacking seriously.

Since women with crashing fatigue are often hungry a lot, it’s essential to give the metabolism what it needs during the day to protect energy stores. This matters more than you might think, especially because adrenal function has been affected. It’s crucially important to stabilize your blood sugar to help prevent crashing fatigue and to recover from an episode.

with crashing fatigue in menopause you need to protect energy and support adrenal function by eating healthy snacks throughout the day

Eating regularly is important to fuel energy and prevent crashing fatigue. If you’re a meal skipper, you’ll need to change your ways, at least for a while. Eat every 3 to 4 hours throughout the day and keep snacks super simple, healthy and fast — but not junky.

Have snacks ready if you can and choose:

  • Apple slices with almond butter (peanut butter works in a pinch)
  • Pre-cut vegetables, hummus or baba ganoush and ½ whole wheat pita
  • ½ cup plain yogurt with blueberries and walnuts
  • Baked chips with guacamole
  • Smoothie made with banana, blueberries, kale, protein powder and coconut water

A note about hydration: fatigue can be directly linked to low fluid status, so drink water whenever you think of it.

3. Be rigid with your pre-sleep routine.

If you have crashing fatigue, it helps to calm your body and mind as you approach bedtime to set yourself up for better sleep. When you can prompt yourself to fall asleep more easily, you will move into deeper sleep (NREM) faster and get more restorative rest.

  • One to three hours before bed, take a hot bath for 30-45 minutes. This stimulates a passive heating effect that enhances and deepens sleep and many women swear by it. Afterwards, finish up your evening routine and prep your body to cool down. This is a key physical change that tells your body to prepare for rest.
  • Get into bed at least one hour earlier than your current bedtime — even if you don’t feel sleepy — but don’t try to doze off right away. Instead, settle down and, if you’re using them, turn off all devices after a few minutes, then switch to reading or listening to quiet music. The objective is to get off your feet and lie down and allow your natural relaxation processes to be triggered. This tells your body it’s time to activate its internal processes that allow your systems to refresh and repair — functions that only get turned on when you’re resting. Some women like to take natural melatonin about an hour before bed when they are first setting this routine.

The midlife transition can be a tough time, especially if you have crashing fatigue. There are effective ways to optimize how you feel in menopause, and they all start with prioritizing your own health and happiness. If crashing fatigue is running your life today, listen to your body and put these steps into action. They can guide you to restore natural sleep patterns, reclaim energy and become more productive.

Soon you’ll l feel like yourself again, and maybe even better.



Crashing Fatigue. [Discussion forum] Available at: https://www.patient.co.uk/forums/discuss/crashing-fatigue-270742. Accessed January 12, 2015.

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Lipovac M, Chedraui P, Gruenhut C, et al. The effect of red clover isoflavone supplementation over vasomotor and menopausal symptoms in postmenopausal women. Gynecol Endocrinol. 2012 Mar;28(3):203-207.

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Shams T, Setia MS, Hemmings R, et al. Efficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysis. Altern Ther Health Med. 2010 Jan-Feb;16(1):36-44.

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Last Updated: April 17, 2024
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