SYMPTOM · PERIMENOPAUSE
Chronic fatigue
Tiredness that won't lift, even after a good night's sleep, a sense of exhaustion that settles in: fatigue is one of the most common symptoms of perimenopause, and it is often underestimated.
Why it happens
Sleep problems, night sweats and hormonal fluctuations add up and take their toll on your energy levels. The drop in oestrogen also has a direct effect on how your cells produce energy, which explains tiredness that persists even when you are sleeping enough.
What tends to make fatigue worse
- Sleep problems and night sweats.
- Chronic stress and mental load.
- Irregular eating patterns.
- A sedentary lifestyle, which can keep the feeling of tiredness going.
In the moment
- Take a proper break instead of pushing through the tiredness.
- Step outside into daylight for a few minutes: it helps restore your energy.
- Keep hydrated: dehydration increases the feeling of tiredness.
Day to day
- Make regular sleep your top priority.
- Move regularly, even gently: it supports your energy in the long run.
- Notice the times of day when your energy is lowest and adjust your pace.
Tiredness that isn't getting better?
A healthcare professional can check that nothing else is behind this tiredness and support you in getting your energy back.
For information only. This does not replace a personalised medical assessment.
If several of these symptoms ring true, it's no coincidence.
Menopause isn't just about hot flushes. Symptoms can begin years before your last period and affect sleep, mood, energy, memory, weight and intimate health.
Click on a symptom to find out more.
Brain fog
You search for words, reread the same sentence twice, lose the thread mid-conversation. Nothing to worry about: your brain is simply running slower, with less glucose to fuel it as oestrogen levels fall.
Sleep problems
Asleep in ten minutes yesterday, wide awake at 3 a.m. today, for no reason. Progesterone, which helped you switch off at night, is in shorter supply, and deep sleep takes the hit straight away.
Anxiety
Stress that spikes over an email, a meeting, running ten minutes late. Oestrogen affects serotonin: when it yo-yos, everything feels heavier to carry than before.
Joint pain
Knees that creak as you stand up, hands that feel stiff in the morning. Cartilage loses its best anti-inflammatory ally as oestrogen falls, and you feel as if you are rusting up all over.
Hot flushes
A wave of heat rising from the chest to the face, lasting one to five minutes. Deprived of oestrogen, the thermoregulatory neurons in the hypothalamus narrow the thermal neutral zone: a few tenths of a degree are enough.
Palpitations
Your heart suddenly races, with no effort and no reason. Oestrogen also influences the nervous system that sets your heart rhythm. Alarming in the moment, rarely serious.
Mood swings
You laugh, and thirty seconds later you could cry or tell everyone where to go. Hormones rise and fall faster than before, and your mood follows, without warning.
Weight gain
Your tummy rounds out even though nothing on your plate has changed. Oestrogen redirects fat storage towards the abdomen, and your metabolism runs a little slower than before.
Low libido
Desire takes longer to arrive, or barely arrives at all. Oestrogen and testosterone fall, and sensitivity with them. The desire is still there; it just takes longer to get going.
Vaginal dryness
A feeling of dryness, sometimes a little discomfort day to day. Tissues lose their natural moisture as oestrogen falls. It is a common symptom, and still too rarely talked about.
Irregular periods
One cycle shorter, another dragging on, a month skipped altogether. Ovulation becomes less regular as the ovaries slow down. It is often the very first sign of perimenopause.
Night sweats
Waking up drenched in the middle of the night, sheets to change, sleep cut short. It is the same hot flush as during the day, night-time edition, and it wakes you just as surely.
Pain during sex
Discomfort, sometimes real pain, during or after sex. Tissues thin as oestrogen falls, and what never used to be a problem can become sensitive.
Dry skin
Skin that feels tight, marks more easily and seems to have lost some of its bounce. Collagen declines with oestrogen, by up to 30% in the first few years after menopause.
Hair loss
More hair in your brush, a parting that seems to be widening. Oestrogen used to extend its growth phase. Without it, the cycle shortens and each strand gets finer.