Menopause fatigue: why you feel exhausted and how to get your energy back
By the Mush n Go editorial team - 10 November 2026
By the Mush n Go editorial teamNovember 202613 min read
Energy and menopause
Menopause fatigue is one of the most common symptoms, often starting in perimenopause. It usually comes from broken nights, hormonal changes and mood, but iron deficiency or a thyroid problem should be ruled out. Sleep, physical activity and diet remain the first levers. Here is how to untangle the causes and get your energy back.
Brainstoorm
Lion's Mane, Cordyceps and Chaga at 1,000 mg each, maca, chicory, 20 mg of caffeine. With 6 mg of vitamin B5: pantothenic acid contributes to the reduction of tiredness and fatigue.
Discover Brainstoorm →
Anti-Stress
Ashwagandha, Reishi, holy basil, schisandra and 2 mg of vitamin B6. Vitamin B6 contributes to the reduction of tiredness and fatigue and to normal psychological function.
Discover Anti-Stress →A different kind of tiredness
Menopause fatigue: exhausted for no obvious reason.
It doesn't feel like the tiredness after a busy week. Many women describe it as a battery that no longer recharges: waking up as weary as when they went to bed, an energy slump that hits at 4pm, the urge to cancel everything in the evening. It can appear well before the last period, during perimenopause, at an age when menopause isn't yet on your mind.
Perimenopause starts on average around 45-47 and lasts several years; menopause is confirmed after 12 months without a period, at 51 on average in France. Fatigue is among the most frequently reported symptoms throughout this whole period, alongside hot flushes, sleep problems and mood changes.
Physical fatigue
Heavy legs, needing to sit down, slower recovery after exercise or a day on your feet.
Mental fatigue
A head full of cotton wool, concentration that gives out, words that slip away. This is menopause brain fog.
Emotional fatigue
Less patience, irritability, feeling overwhelmed by things that were easy yesterday.
Morning fatigue
The sign of a night that no longer restores you, often because of awakenings you don't remember.
If your tiredness has lasted several weeks and doesn't go away with rest, our article on persistent fatigue sets out the warning signs and what happens during a consultation, at any age.
Where the fatigue comes from
Perimenopause fatigue: five causes to untangle.
Menopause fatigue rarely has a single cause. Most often several factors add up, and taking them one at a time is how you find where to start.
| Cause | How it tires you | What points to it |
|---|---|---|
| Broken nights | Waking at 3 or 4am, sweats, lighter sleep: the night no longer restores you | Tired from the moment you wake, worse after bad nights |
| Hormones | Fluctuations in oestrogen and progesterone affect sleep, mood and temperature regulation | Irregular cycles, symptoms that vary from month to month |
| Mood | The risk of depressive symptoms rises during the transition, and low mood is tiring | Loss of interest, sadness, anxiety, early waking |
| Iron | Periods often become heavier in perimenopause and drain iron stores | Long or frequent periods, breathlessness, pallor |
| Lifestyle | Less activity, loss of muscle mass, mental load, coffee to keep going, alcohol to unwind | Fatigue that improves on active days or on holiday |
Thyroid problems, diabetes, sleep apnoea and some medicines also cause fatigue at this age. They are simple to screen for: see the section on tests below.
Chronic stress plays its part too. If you recognise yourself in a constant state of tension, our article on high cortisol explains what we really know about the stress hormone.
Hot flushes and fatigue
Hot flushes and extreme fatigue: the link runs through the night.
Women who have a lot of hot flushes are often also the most tired. The most direct link is sleep: flushes and night sweats wake you or make the night lighter, sometimes without you remembering it in the morning. The next day, the body pays for a fragmented night.
Let's be clear: our products do not act on hot flushes, and we don't claim they do. If they wake you and wear you out, the right door is your GP, your gynaecologist or your midwife: hormone therapy (HRT) remains the most studied option, and non-hormonal treatments exist. What you can do from tonight is protect your nights.
- A bedroom at around 18 °C, light layered bedding and cotton or linen nightwear.
- A trigger diary: alcohol, spicy food, hot drinks in the evening, an overheated room. Everyone has their own.
- A fixed wake-up time, even after a bad night, so the next one is better.
- A short nap, 20 minutes at most and before 3pm, rather than a long nap that shifts your night.
Everything about night-time waking, night sweats and cognitive behavioural therapy for insomnia is covered in our article on menopause insomnia.
What the studies say
Menopause fatigue: four useful studies.
Four pieces of research that help explain the fatigue of this period and what makes it recede, with their limits. Full references are at the bottom of the page.
Cohen et al., 2006 · United States
460 women aged 36 to 45 with no history of depression were followed for several years. Those entering perimenopause were about twice as likely to develop significant depressive symptoms as those who were not yet there. Menopause fatigue can have a mood component that should not be ignored.
Vaucher et al., 2012 · Switzerland
198 tired women aged 18 to 53, still menstruating, with low ferritin but no anaemia, were given iron or a placebo for 12 weeks. Fatigue fell by 47.7% with iron, against 28.8% with placebo. Iron only helps if you are short of it: get it measured before you take it.
Sternfeld et al., 2014 · United States
In the MsFLASH trial, 248 sedentary women in peri- or post-menopause followed 12 weeks of aerobic exercise or kept their usual activity level. Exercise did not change the number of hot flushes, but it slightly improved sleep, insomnia and mood.
Puetz et al., 2006 · United States
This meta-analysis of 70 trials and more than 6,800 participants concluded that regular physical activity increases feelings of energy and reduces fatigue, in healthy people as well as in people with illness. The effect is moderate but consistent.
These studies point the same way: menopause fatigue is not inevitable, but it is treated through its cause (sleep, mood, iron) and through movement, even when you don't feel like it.
The tests to ask for
A blood test before any supplement course.
Before trying supplements at random, ask your doctor for a simple blood test. It will show whether a specific, easily corrected cause lies behind your fatigue. This is all the more useful in perimenopause, when periods change.
Full blood count and ferritin
To look for anaemia and iron deficiency, common when periods become heavy. Ferritin reflects your stores.
TSH
To screen for a thyroid problem, which becomes more common in women with age and whose signs resemble those of menopause.
Blood sugar and others
Depending on your situation, your doctor may add blood glucose, vitamin B12, vitamin D or liver function tests. This is not routine.
Hormone tests, on the other hand, are rarely useful to explain fatigue: in perimenopause, hormones vary from one day to the next, and a single blood test says little. Menopause is diagnosed on age and periods.
When to see a doctor
Some kinds of fatigue should not wait.
Menopause fatigue is common and usually harmless. Some signs, however, should prompt you to see a doctor quickly, rather than putting the fatigue down to age.
See your doctor if:
- The fatigue has lasted more than a month, is getting worse, or stops you working or looking after yourself.
- It comes with unexplained weight loss, fever, heavy night sweats with fever, or swollen glands.
- Your periods are very heavy, with clots, or you bleed after 12 months without a period.
- You get breathless on exertion, with palpitations.
- You feel lasting sadness, a loss of interest, or dark thoughts. If you have suicidal thoughts, call 116 123, free, 24 hours a day.
- You snore loudly, or fall asleep during the day, especially at the wheel.
If the exhaustion comes mainly from work and comes with cynicism or a loss of meaning, it may be something other than menopause. Our article on the signs of burnout will help you tell the difference.
The two-week plan
Getting your energy back, one day at a time.
Here is a simple two-week plan to start alongside your blood test. There is nothing spectacular about it, but consistency is what makes the difference.
Days 1 to 3: rhythm
Set a wake-up time, weekends included. Get twenty minutes of daylight within the following hour. Note when your energy slumps hit.
Days 4 to 7: coffee and alcohol
Last regular coffee before 2pm, no alcohol three evenings out of four. Note the quality of your nights.
Week 2: movement
Thirty minutes of brisk walking five days out of seven, two strength sessions. The WHO recommends 150 minutes of moderate activity per week.
Week 2: your plate
Protein at every meal to preserve your muscles, pulses and red meat or offal for iron, fruit for vitamin C.
End of week 2: take stock
Your nights, your energy, your mood. If nothing has changed and your blood test is normal, talk to your doctor again.
The afternoon energy slump has its own logic, between digestion, your body clock and your morning coffee. Our article on the 4pm slump explains it.
Vitamins and supplements
Which vitamin for fatigue during menopause?
Several vitamins and minerals carry an official claim on fatigue in Europe. It means an adequate intake contributes to the reduction of tiredness and fatigue, not that adding more gives you extra energy when you're not short of them. Plants and mushrooms, for their part, have no authorised claim on fatigue.
| Nutrient or ingredient | What is authorised or studied | Good to know |
|---|---|---|
| Vitamin B6 | Vitamin B6 contributes to the reduction of tiredness and fatigue, to normal functioning of the nervous system and to normal psychological function | 2 mg in Anti-Stress, 143% of the reference intake |
| Vitamin B5 | Pantothenic acid contributes to the reduction of tiredness and fatigue and to normal mental performance | 6 mg per cup of Brainstoorm, 100% of the reference intake |
| Vitamin C | Vitamin C contributes to the reduction of tiredness and fatigue | 80 mg in Energy, 100% of the reference intake |
| Iron | Useful if a deficiency is proven: in the Vaucher trial, fatigue fell more with iron | Only after a blood test, on medical advice |
| Magnesium | Magnesium contributes to a reduction of tiredness and fatigue | Present in Sleep+, at 60 mg |
| Cordyceps, maca | Traditional uses, a few small trials on fatigue or endurance, often in athletes | Preliminary data, no authorised claim |
Don't take iron “just in case”: too much iron is not harmless. And if you are being treated for your thyroid, always take supplements at a different time from your tablet, as advised by your doctor or pharmacist.
To find out more about the ingredients in our formulas, see our pages on Cordyceps, maca and ashwagandha. To compare what brands specialising in menopause offer, read our menopause supplement comparison.
Our energy routine
Brainstoorm in the morning, Anti-Stress during the day.
Our formulas treat neither hot flushes nor hormones. They are about your head and your days: a morning coffee that doesn't make you jittery, a routine for busy periods. Here is how to fit them into a perimenopause day.
When you get up
A cup of Brainstoorm: Lion's Mane, Cordyceps and Chaga, maca, chicory, 6 mg of vitamin B5 and 20 mg of caffeine, against around 80 mg for an espresso. The taste of coffee, without the spike of three cups.
At breakfast
One capsule of Anti-Stress with a glass of water: ashwagandha, Reishi, holy basil, schisandra and vitamin B6.
Optional, at lunch
One capsule of Energy, caffeine-free: Cordyceps, maca, ginger and 80 mg of vitamin C, which contributes to the reduction of tiredness and fatigue.
Around 2pm
No more caffeine. If the afternoon is hard, a ten-minute walk outside does more than a second coffee.
In the evening
An evening that slows down, a cool bedroom, a regular bedtime. That is where tomorrow's energy is built.
To cover morning, daytime and evening in a single order, our Perimenopause Pack brings together Brainstoorm, Anti-Stress and Sleep+.
Precautions:
- Brainstoorm contains caffeine. It is not recommended for pregnant or breastfeeding women, or in case of thyroid, liver or heart problems.
- Anti-Stress is not recommended for pregnant or breastfeeding women, in case of thyroid, liver or heart problems, or if you take anticoagulant medication: ask your doctor's advice.
- Energy is intended for adults and not recommended for pregnant or breastfeeding women.
- A food supplement should not replace a varied and balanced diet and a healthy lifestyle. Do not exceed the stated daily dose.
Every formula comes with a 60-day money-back guarantee, even on opened boxes. If you'd rather cut down on coffee than replace it, our guide what to replace coffee with sets out the options.
The Perimenopause Pack
Brainstoorm in the morning, Anti-Stress during the day, Sleep+ in the evening: all three products together in a 30-day ritual, cheaper than buying them separately, as a one-off purchase or a subscription.
Discover the Perimenopause Pack →Your questions
Menopause fatigue: your questions.
Why does menopause make you so tired?
Because several causes add up: nights broken by waking and sweats, fluctuating hormones, a more fragile mood and sometimes iron deficiency linked to heavy periods. The stress of this stage of life and a drop in physical activity often add to it.
Is fatigue in perimenopause normal?
It is common, and can appear years before the last period. That doesn't mean you have to accept it and do nothing: a blood test can rule out iron deficiency or a thyroid problem, and sleep can be worked on.
What is the link between hot flushes and extreme fatigue?
Mainly sleep: hot flushes and night sweats wake you or make the night lighter, and fatigue follows the next day. If they wear you out, talk to your doctor, who can offer you a suitable treatment.
Which vitamin should I take for menopause fatigue?
Several have an official claim on fatigue: vitamins B2, B3, B5, B6, B12 and C, as well as magnesium and iron. They help if your intake is insufficient. Iron should only be taken after a ferritin test, on medical advice.
How long does menopause fatigue last?
It often follows the transition period and the difficult nights, which can last several years. It improves when its causes are treated: sleep, iron, mood, physical activity. Fatigue that doesn't lift despite this should be reassessed by your doctor.
What blood test should I have for menopause fatigue?
Most often a full blood count and a ferritin test for iron, a TSH test for the thyroid, and sometimes blood glucose or vitamin B12. Hormone tests are rarely useful in perimenopause, because hormones vary from one day to the next.
Does exercise help with menopause fatigue?
Yes. Regular activity increases feelings of energy and slightly improves sleep and mood in menopausal women, even if it doesn't change the number of hot flushes. Start with thirty minutes of brisk walking, five days a week.
Does coffee help with menopause fatigue?
In the moment, it masks the fatigue. But taken after 2pm, it damages the night and keeps the fatigue cycle going. It is better kept for the morning, or swapped for a less caffeinated drink such as a coffee with 20 mg of caffeine per cup.
Does hormone therapy reduce fatigue?
In women whose fatigue comes from hot flushes and broken nights, it can improve it by reducing those symptoms. It is not prescribed for fatigue alone: the decision is made with your doctor, based on your symptoms and medical history.
Sources
- Assurance Maladie (French national health insurance). Ménopause : définition, symptômes et diagnostic. ameli.fr.
- Cohen L. S. et al. (2006). Risk for new onset of depression during the menopausal transition: the Harvard Study of Moods and Cycles. Archives of General Psychiatry, 63(4), 385-390.
- Vaucher P. et al. (2012). Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial. Canadian Medical Association Journal, 184(11), 1247-1254.
- Sternfeld B. et al. (2014). Efficacy of exercise for menopausal symptoms: a randomized controlled trial. Menopause, 21(4), 330-338.
- Puetz T. W., O'Connor P. J., Dishman R. K. (2006). Effects of chronic exercise on feelings of energy and fatigue: a quantitative synthesis. Psychological Bulletin, 132(6), 866-876.
- Avis N. E. et al. (2015). Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Internal Medicine, 175(4), 531-539.
- CNGOF, GEMVi (2021). Recommandations pour la pratique clinique : prise en charge de la femme ménopausée (clinical practice guidelines on the management of menopausal women).
- World Health Organization (2020). WHO guidelines on physical activity and sedentary behaviour.
- Commission Regulation (EU) No 432/2012 establishing a list of permitted health claims made on foods (vitamins B5, B6 and C, magnesium, iron).
- Laboratoire FGnutra. Technical data sheets “Brainstoorm Café 180 g” (28 January 2026), “Stress V5” (Anti-Stress, 12 May 2026) and “Énergie” (Energy, 1 April 2026).
Keep reading
Further reading.
Menopause fatigue plays out at night as much as during the day. Our other guides in the series, or our coffee Brainstoorm.
Discover our mushroom and adaptogenic plant supplements
Our vegan formulas, made in Toulouse by a French manufacturer.