Hormonal Causes of Crashing Fatigue in Women

Some hormonal changes can cause fatigue in the female body. These include those related to the menstrual cycle and the menopause trajectory. If you’re experiencing fatigue for one of these reasons, focusing on the lifestyle factors noted above that can combat fatigue can help.

Menopause fatigue

Menopause is a term for when you’ve reached an absence of a period for a full year. After this milestone, a person is in postmenopause. Leading up to menopause is the transition known as perimenopause, which can span more than a decade.

During perimenopause , your hormones can be erratic, eventually leading to a decline in estrogen, progesterone, and testosterone. All these hormones, and others that are shifting, impact your energy levels , and the sometimes dramatic fluctuations that occur during perimenopause can lead to sudden crashing fatigue.

The menopause transition can also disrupt lifestyle factors, leading to tanking energy. “In a nutshell, we see increased fatigue in menopausal women due to the increase in insomnia associated with this life transition,” Alsibai says. “As women approach menopause, their changing hormones and increased hot flashes and night sweats all lead to more and more sleep disturbances throughout the night.”

If you are struggling with your energy levels during the menopause transition, talk to a knowledgeable clinician who can help you address your symptoms, whether through hormone replacement therapy (HRT) or another option.

Premenstrual fatigue

If your period is on the way, you might naturally feel some fatigue. During the luteal phase of the menstrual cycle, which spans the two weeks leading up to your period, fatigue is common. Researchers attribute this fatigue to changes in progesterone levels.

During this phase of the menstrual cycle, your progesterone level peaks and then plummets, almost like the climb and fall of a roller-coaster. Both high and low levels of progesterone have been linked to fatigue.

Experiencing some fatigue or energy changes prior to and during your period is normal. For example, you may notice that you have more oomph for your workouts during ovulation, and then leading up to your period or during your bleed, you may experience a change in your performance. This is common. However, if you’re frequently experiencing extreme fatigue or other symptoms before your period, talk to a knowledgeable clinician.

Endometriosis, PCOS, and PMDD

Some medical conditions have a complex interplay with reproductive hormones. These include polycystic ovary syndrome (PCOS) , endometriosis , and premenstrual dysphoric disorder (PMDD) . These conditions can also lead to fatigue through various mechanisms.

If you have one of these conditions or aren’t sure, talk to a knowledgeable clinician who can help with appropriate treatment options.

Adrenal fatigue

Adrenal fatigue is a myth , not a medical term. Instead, some people may experience adrenal insufficiency.

“Adrenal insufficiency is an official diagnosis referring to the inability of the adrenal gland to produce adequate levels of cortisol,” Alsibai says. “It can be diagnosed through blood work. ‘Adrenal fatigue’ on the other hand is a relatively new term people use to describe feeling burnout. It cannot be diagnosed.”

Hypothyroidism and hyperthyroidism

Thyroid disease affects more people assigned female at birth than those assigned male. Fatigue is a common symptom of both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid). Several factors can affect the thyroid gland, including pregnancy and the menopause transition. If necessary, a clinician can order tests to determine how well your thyroid is functioning.