Fatigue is a common symptom of menopause experienced by up to 80% of women. The fluctuating hormone levels that occur during menopause, especially decreases in estrogen and progesterone, disrupt sleep cycles and cellular energy levels. This leads to persistent feelings of tiredness and low energy. Alternative approaches like herbal supplements that nourish the endocrine system and support natural hormone production are generally safe and effective ways to treat menopause-related fatigue. Lifestyle changes focusing on diet and sleep quality can also provide relief from fatigue symptoms.

1. Menopause
and Fatigue

2. Index
Page
About Fatigue 2
Causes of Fatigue 3
Fatigue Treatments 6
Alternative Medicine 7
Phytoestrogenic Supplements 7
Hormone-regulating Supplements 8
Medications 9
References 10

3. Menopause and Fatigue
About Fatigue
Fatigue is defined as an ongoing and
persistent feeling of weakness, tiredness and
lowered energy levels. This should be
distinguished from drowsiness, which implies
an actual urge to sleep. Fatigue involves a lack
of energy rather than sleepiness.
Another distinction that must be made is that
between fatigue as a symptom of menopause
and chronic fatigue syndrome, which is a
more serious and complicated disorder.
Chronic fatigue syndrome includes periods of
extreme fatigue that do not improve with bed
rest, may worsen with physical or mental
activity and is often tied to other illnesses.

4. Menopause and Fatigue
Causes of Fatigue
Fatigue is one of the most frequently
experienced symptoms of menopause, with
up to 80% of women reporting this
experience at one time or another.
For women undergoing the menopausal
transition, the most likely cause of fatigue is
the fluctuation of hormones that occurs
naturally during this time. Hormones are
responsible for controlling energy at the
cellular level. Thus, when levels of estrogen
and progesterone decrease, so do energy
levels.
Hormones also play a role in regulating the
sleep cycle. These fluctuations also affect a
woman's ability to get a good night of rest,
leading to fatigue in the morning.

5. Menopause and Fatigue
Other hormones that are involved in this
process include the thyroid and adrenal
hormones, as well as melatonin. They all work
at the cellular level to regulate energy levels,
which means when the hormone levels
naturally decrease during menopause, so do a
woman's energy levels. This is what leads to
the feeling of persistent fatigue.
While most middle aged women experiencing
fatigue as a result of the hormonal changes
that occur naturally during this time period,
there are certain other, less common
conditions such as thyroid disorders or
depression, that are liable to cause fatigue as
well.

6. Menopause and Fatigue
Estrogen increases rapid eye movement
during sleep. This is an important
reconstructive process in the body. Periods of
REM sleep help the brain make sense of the
day's events through dreaming while
refreshing the mind. With the drop of
estrogen that occurs naturally with age, time
spent in restorative REM sleep decreases.
Progesterone by contrast, affects the part of
the brain that causes a woman to feel sleepy
and so as progesterone levels drop, she may
have difficulty falling asleep. This may
manifest as insomnia, which can lead to
fatigue during the daytime. Progesterone
regulates sleep induction. With the steep
drop in progesterone levels that occurs
between ages 35-50, insomnia or other sleep
disturbances are reported as a consequence.

7. Menopause and Fatigue
Fatigue Treatments
Fatigue in the daytime is closely tied to a
woman's sleeping habits. Often during
menopause, when women experience other
common symptoms such as night sweats or
sleeping disorders, the sleep cycle is
interrupted, which can lead to fatigue. In such
cases, the importance of a good night's sleep
cannot be emphasized enough. In addition to
cutting out caffeine and alcohol, it can also be
useful to use the bedroom only for sleeping.
Paying attention to diet is helpful as well.
Eating more alkaline-forming foods such as
figs, beets, leafy greens, almonds, dates and
parsley are beneficial in fighting fatigue, since
these foods have been shown to balance
blood pH levels and boost energy.

8. Menopause and Fatigue
Alternative Medicine
In the case of herbal supplements, there are
two types of herbs that can be used for
treating fatigue: phytoestrogenic and
hormone-regulating herbal supplements.
Phytoestrogenic supplements
These supplements (such as black cohosh)
contain plant compounds called
phytoestrogens, which resemble estrogen and
function like it. Phytoestrogens found in these
herbs can help treat an estrogen deficiency.
However, from introducing external hormones
into the system, the body may become
incapable of producing its own hormones at
proper levels, which ultimately results in a
decrease in hormone levels.

9. Menopause and Fatigue
Hormone-regulating Supplements
These supplements (such as Macafem) do not
contain phytoestrogens or any hormones.
Rather, they work by supporting the
endocrine system with ample nutrients, which
promotes the body's natural hormone
production. This balances not only estrogen,
but also other vital hormones like
progesterone. Thus, supplements that nourish
the endocrine system are considered to be a
safe and effective way to treat fatigue, since
the body produces hormones naturally.
A combination of approaches are often the
best way of treating fatigue, especially a blend
of lifestyle changes and herbal supplements.
However, in rare cases, fatigue may be
difficult to treat naturally or involve
complications.

10. Menopause and Fatigue
Medications
This treatment tier entails the highest risk and
frequently the greatest costs as well. The
most-used medication in North America for
addressing menopausal fatigue is HRT. While
this form of treatment is fast and easy, it
poses the risk of dangerous side effects,
including an increased likelihood of getting
certain cancers.

11. Menopause and Fatigue
References
• Hutchinson, Susan M.D. "The Stages of a
Woman's Life: Menstruation, Pregnancy,
Nursing, Perimenopause, Menopause".
November 2007.
• Love, Susan M.D. Menopause and Hormone
Book. New York: Three Rivers Press, 2003