Why Am I So Tired? The Real Reason Perimenopause Zaps Your Energy

by Allison Palmer

If you often find yourself dragging through the day, reaching for another cup of coffee and wondering why you feel like you’ve run a marathon when all you did was answer emails, you’re not alone. Up to 85 percent of women report fatigue during perimenopause, according to Johns Hopkins Medicine, making it one of the most common and frustrating symptoms of this hormonal transition.

This isn’t just about “getting older” or needing more sleep. The exhaustion you are feeling has real, physiological roots. Understanding those roots is the first step toward getting your energy back.

The Hormone Connection: Why Your Body Feels Like It’s Running on Empty

Fatigue during perimenopause is not in your head, it’s in your hormones.

Hormonal changes can disrupt the body’s energy regulation, leading to persistent fatigue, according to research by Dr. Mary Jane Minkin, clinical professor at Yale School of Medicine. During perimenopause, estrogen and progesterone levels do not simply drop; they fluctuate unpredictably, which can throw your body’s energy systems out of balance.

Estrogen plays a crucial role in how your body produces and uses energy. When levels swing up and down, your metabolism can struggle to keep up. As progesterone’s calming effects decline, you lose one of your body’s natural relaxation signals. The result is often a spike in cortisol, your main stress hormone, which can leave you feeling wired and exhausted at the same time.

The Sleep Saboteur: When Night Sweats Steal Your Rest

Sleep disturbance is one of the most commonly reported symptoms of perimenopause, according to the Sleep Foundation, and it’s a major energy thief.

Night sweats can jolt you awake multiple times a night, preventing you from reaching the deep, restorative stage of sleep your body needs. Even if you’re in bed for eight hours, you might only be getting five or six hours of quality rest.

However, sweating isn’t the only concern. Anxiety often increases during perimenopause, making it harder to fall asleep. Hormonal shifts can also disrupt your circadian rhythm, leaving you wide awake at 3 a.m. and groggy when your alarm goes off.

The Hidden Energy Drainers: Nutrients Your Body Might Be Missing

Fatigue can also signal that your body is running low on essential nutrients.

Iron, magnesium and B vitamins all play critical roles in energy production. If you’re dealing with heavy or irregular periods, you could be losing more iron than usual. Low iron means less oxygen gets to your cells, which directly translates to fatigue.

Magnesium helps your body convert food into energy and supports healthy sleep. B vitamins are essential for cellular energy production. When these nutrients run low, your energy tends to tank.

Supplements like MegaFood Blood Builder can help address iron deficiency, while HelloHealth Magnesium Glycinate drops offers targeted magnesium support. Always check with your doctor about testing your nutrient levels before starting any new supplement.

Lifestyle Factors That Make Fatigue Worse

Sometimes, the common ways you might try to cope with fatigue can actually make it worse.

Stress overload compounds the hormonal chaos already happening in your body. When you are constantly in fight-or-flight mode, your cortisol levels stay elevated, draining your energy reserves over time.

Overtraining — pushing through intense workouts when your body needs more rest — can backfire during perimenopause. Your recovery time may be longer now, and ignoring that can leave you even more exhausted.

Blood sugar swings are another culprit. Skipping meals or loading up on refined carbs and sugar can cause your blood glucose to spike and crash, sending your energy levels on a roller coaster.

Evidence-Based Solutions That Actually Work

If all this information has you feeling more worried than reassured, the good news is there are proven strategies to reclaim your energy.

Sleep hygiene is essential. Create a nighttime routine that signals to your body it’s time to wind down. Keep your bedroom cool, avoid screens an hour before bed and stick to consistent sleep and wake times, even on weekends if possible.

Nutrition matters. Focus on balanced meals with protein, healthy fats and complex carbohydrates to keep blood sugar stable. Don’t skip breakfast if you can help it and consider smaller, more frequent meals if you find yourself experiencing energy crashes.

Strategic supplementation can help fill nutritional gaps. Beyond magnesium and iron, some women find adaptogens such as ashwagandha helpful for energy support, though it is important to discuss any supplements with your healthcare provider first.

Hormone replacement therapy (HRT) is worth discussing with your doctor. According to Columbia University Irving Medical Center, for many women, the benefits of HRT significantly outweigh the risks — replacing declining hormones can greatly improve energy levels, sleep quality and overall quality of life.

Your 7-Day Energy Reset

Ready to take action? Here is a simple plan to start stabilizing your energy:

Days 1-2: Establish a consistent bedtime and wake time. No negotiating.
Days 3-4: Add a 10-minute wind-down routine before bed, such as stretching, reading or meditation.
Days 5-6: Audit your meals. Are you eating protein at breakfast? Are you balancing blood sugar throughout the day?
Day 7: Check in with yourself. Notice patterns. What helped? What didn’t?

Track your energy levels each day on a scale of 1 to 10, along with sleep quality and any symptoms. Patterns will emerge that can guide your next steps.

The Bottom Line: You Don’t Have to Accept Exhaustion as Your New Normal

Perimenopause fatigue is real, common and rooted in measurable hormonal and physiological changes. But it’s not something you just have to live with.

By understanding the true causes — from hormone fluctuations to sleep disruption to nutrient depletion — you can take targeted action. Whether that means improving your sleep hygiene, addressing nutritional gaps, managing stress or exploring HRT with your doctor, there are evidence-based solutions that work.

Your energy matters, and getting it back is absolutely possible.