How to beat menopause fatigue: causes, treatments, and exercises
Learn about causes and treatment options for menopause fatigue, including exercises for relief, recommended by physical therapists.
El índice
There’s tired — and then there’s menopause tired. Menopause fatigue persists even after rest because, let’s face it — menopause sleep can be less than restful. Menopause symptoms can sap your energy, mess with your focus, and get in the way of daily activities.
If you’re dragging from menopause fatigue, you’re definitely not alone. In one study of 300 women, 46.5% of perimenopausal women and 85.3% of post-menopausal women reported symptoms of physical and mental exhaustion. But common doesn’t mean you just have to deal. There are steps you can take to feel less tired.
Read on to learn how menopause can cause fatigue, what it feels like, and the best ways to boost energy and manage symptoms with lifestyle strategies and exercises from our Hinge Health physical therapists.
Toca el alivio del dolor. En cualquier momento y en cualquier lugar con nuestra aplicación.
Revisado por nuestros expertos clínicos y médicos
Bijal Toprani, PT, DPT
Renee Bullis, PT, DPT
Causes of menopause fatigue
Shifting hormones likely play a role. Perimenopause — or the time leading up to menopause — usually begins in the mid-to-late 40s and lasts an average of four years. (Menopause officially means that it’s been a year since your last period.) During this transition, your body stops producing as much estrogen and progesterone. Changes in these and other hormone levels affect how your body regulates energy levels, which can lead to fatigue.
Sleep problems that occur during the menopause transition factor in as well. “Fluctuations in hormones change sleep patterns and reduce sleep quality,” explains Renee Bullis, PT, DPT, a physical therapist at Hinge Health. Low levels of progesterone can make it hard to fall and stay asleep. Low estrogen can lead to hot flashes and night sweats, which can disrupt your sleep and contribute to daytime fatigue.
Other causes of menopause-related fatigue may include:
Mood changes. Low estrogen levels can impact the production of serotonin, a brain chemical linked to mood and energy, says Dr. Bullis. Depression and anxiety — more common in menopause — are strongly linked to fatigue.
Sleep disorders. Sleep apnea is a sleep disorder that causes breathing to repeatedly stop and start during sleep. It can lead to daytime sleepiness and fatigue, plus other health problems. Postmenopausal women are more likely to develop sleep apnea.
Joint pain. Estrogen affects your musculoskeletal system. It helps improve muscle mass, keeps joint tissue healthy, and plays a role in preventing inflammation. When estrogen levels dip, cartilage and other joint tissues lose some of their protection and inflammation can occur more easily. “Increased joint pain and stiffness during menopause can impact sleep and mood, contributing to fatigue,” says Dr. Bullis.
Other medical conditions that become more common after menopause, such as heart disease and poor blood sugar control, can contribute to fatigue. Talk to your healthcare provider to determine the factors that are affecting your fatigue.
Symptoms of menopause fatigue
With menopause-related fatigue, you may feel worn out and exhausted, even after rest. You may find activities more challenging, like carrying grocery bags or walking up a flight of stairs, or need to take more breaks during everyday tasks.
Fatigue can affect you mentally as well. Signs of mental fatigue include:
Forgetfulness or memory problems
Trouble focusing or concentrating
Irritability or moodiness
Feeling stressed
Treatments for menopause fatigue
Exercise
Exercise helps manage and improve menopause-related fatigue, says Dr. Bullis. Physical activity causes changes in your body that increase energy levels. Plus, exercise helps boost endorphins — brain chemicals that improve mood and reduce pain, which may help decrease fatigue. Regular exercise can also help improve other symptoms of menopause that contribute to fatigue:
Promotes better sleep
Improves mood and focus
Decreases joint pain and stiffness
Eases stress
Improves bone density and protects heart health
May help manage hot flashes and night sweats
Counteracts menopause-related changes in metabolism
Exercise helps ease menopause-related fatigue, but doing too much too often may contribute to symptoms instead of alleviating them, says Dr. Bullis. Your movement sweet spot is the “Goldilocks point” of exercise — not too much, not too little, but just right. “Exercising in this zone will help you feel stronger, sleep better, and improve your pain,” she says.
You can exercise on your own to ease menopause fatigue, but working with a physical therapist (PT) can be helpful, too. A PT can do a full assessment and help tailor a comprehensive treatment plan to help manage conditions or symptoms of menopause that contribute to fatigue.
A PT may recommend low-impact exercises and stretches to help prevent stiffness and tightness, as well as exercises to reduce tension and strengthen your core, pelvic floor, low, mid-, and upper back muscles. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.
Lifestyle changes
It may take some trial and error to find the right combination of approaches to managing menopause fatigue. Some approaches that can help:
Protect your sleep. Keep a consistent sleep schedule, create a cool, restful environment, avoid screens before bed, and limit daytime naps to 20 minutes.
Eat a balanced diet. Whole foods like fruits, veggies, lean proteins, and healthy fats lower inflammation and boost energy. Avoid too much sugar or alcohol, which can disrupt sleep and worsen anxiety. Stay hydrated for better focus and energy.
Plan your day. Schedule demanding tasks when you’re most alert and save easier ones for when your energy dips.
Go outside. “Sunshine and vitamin D play a role in fatigue and quality sleep,” says Dr. Bullis. “There’s some evidence that shows light exposure within an hour of waking can help with sleep quality, which can reduce fatigue.”
Reduce stress. Try deep breathing, meditation, yoga, or a short walk to help calm your mind and body. A bonus: Mind-body relaxation techniques have also been shown to help relieve the severity and frequency of hot flashes during perimenopause and menopause.
Practice self-care. Set boundaries, ask for help, delegate tasks, and lean on your support network.
Sleep treatments
Consider sleep medications or supplements if fatigue is due to poor sleep and other menopause symptoms. They’re not a replacement for other sleep hygiene and lifestyle changes, but they can be part of your treatment. Discuss the risks and benefits of medications and supplements with your healthcare provider.
Menopause hormone therapy (MHT) improves sleep, especially for those with hot flashes, by reducing night sweats and improving sleep quality. Effectiveness varies by hormone type and delivery method.
Antidepressants can address insomnia, particularly if linked to depression, and may also reduce menopause symptoms like hot flashes. They may be an alternative for those who can’t use MHT.
Prescription sleep medications like zolpidem (Ambien) and eszopiclone (Lunesta) help with falling and staying asleep by slowing brain activity. While effective short-term, they can cause side effects like drowsiness, memory issues, increased fall risk, and dependence.
Sleep supplements like melatonin may help but aren’t well-regulated. Use only with provider guidance to ensure safety and proper dosing.
Exercises for menopause fatigue
Want expert care? Check if you're covered for our free program →- Diaphragmatic Breathing
- Scapular Clocks
- Bird Dog
- Squats
- Open Book Rotations
- Cat and Cow
Physical therapy (PT) is for more than just recovering from surgery or injury. It’s one of the top treatments for joint and muscle pain. It helps build strength, improve mobility, and reduce pain. And it doesn't always need to be in person.
Hinge Health members can conveniently access customized plans or chat with their care team at home or on the go — and experience an average 68% reduction in pain* within the first 12 weeks of their program. Learn more*.
The above exercises are recommended by Hinge Health physical therapists to help you improve energy and reduce menopause fatigue.
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
PT tip: Start small and make exercise fun
“Exercise can be a really helpful tool in managing fatigue, but it can be hard to get moving when you feel tired,” says Dr. Bullis. “So start small. Carve out just five or 10 minutes a day to do something active that you enjoy.” Maybe turn on your favorite music or podcast and take a short, brisk walk — just long enough to get your heart rate up, she suggests. “Building good exercise habits pays dividends in the long run, and a single session of exercise can improve your mood, fatigue, and energy.”
How Hinge Health can help you
If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
¿Busca alivio del dolor? Verifique si su empleador o plan de salud cubre nuestro programa
References
Chiu, H.-H., Tsao, L.-I., Liu, C.-Y., Lu, Y.-Y., Shih, W.-M., & Wang, P.-H. (2021). The Perimenopausal Fatigue Self-Management Scale Is Suitable for Evaluating Perimenopausal Taiwanese Women’s Vulnerability to Fatigue Syndrome. Healthcare, 9(3), 336. doi:10.3390/healthcare9030336
Cintron, D., Lipford, M., Larrea-Mantilla, L., Spencer-Bonilla, G., Lloyd, R., Gionfriddo, M. R., Gunjal, S., Farrell, A. M., Miller, V. M., & Murad, M. H. (2017). Efficacy of menopausal hormone therapy on sleep quality: systematic review and meta-analysis. Endocrine, 55(3), 702–711. doi:10.1007/s12020-016-1072-9
Krüger, M., Obst, A., Ittermann, T., Bernhardt, O., Ivanovska, T., Zygmunt, … & Daboul, A. (2023). Menopause Is Associated with Obstructive Sleep Apnea in a Population-Based Sample from Mecklenburg–Western Pomerania, Germany. Journal of Clinical Medicine, 12(6), 2101. doi:10.3390/jcm12062101
Li, C., Wang, L., Sun, X., & Yang, X. (2019). Analysis of the long-term beneficial effects of menopausal hormone therapy on sleep quality and menopausal symptoms. Experimental and therapeutic medicine, 18(5), 3905–3912. doi:10.3892/etm.2019.8058
Lu, C., Liu, P., Zhou, Y., Meng, F., Qiao, T., Yang, X., Li, X., Xue, Q., Xu, H., Liu, Y., Han, Y., & Zhang, Y. (2020). Musculoskeletal Pain during the Menopausal Transition: A Systematic Review and Meta-Analysis. Neural Plasticity, 2020, 1–10. doi:10.1155/2020/8842110
Menopause | Office on Women’s Health. (2024). Office on Women’s Health. https://womenshealth.gov/menopause
Menopause-Why do I feel fatigued? (n.d.). https://www.nhsemployers.org/system/files/2022-03/Fatigue%20%26%20Menopause%20Leaflet.pdf
Mohamed, D. M., Hussien, A., El, H., & Awad, D. (2023). Effect of Pilates exercises on fatigue in post-menopausal women. Bulletin of Faculty of Physical Therapy, 28(1). doi:10.1186/s43161-023-00140-z
Money, A., MacKenzie, A., Norman, G., Eost-Telling, C., Harris, D., McDermott, J., & Todd, C. (2024). The impact of physical activity and exercise interventions on symptoms for women experiencing menopause: overview of reviews. BMC Women S Health, 24(1). doi:10.1186/s12905-024-03243-4
National Institute on Aging. (2021, September 30). What is menopause? National Institute on Aging. https://www.nia.nih.gov/health/menopause/what-menopause
Sys, J., Van Cleynenbreugel, S., Deschodt, M., Van der Linden, L., & Tournoy, J. (2020). Efficacy and safety of non-benzodiazepine and non-Z-drug hypnotic medication for insomnia in older people: a systematic literature review. European journal of clinical pharmacology, 76(3), 363–381. doi:10.1007/s00228-019-02812-z
Taylor-Swanson, L., Wong, A. E., Pincus, D., Butner, J. E., Hahn-Holbrook, J., Koithan, M., … & Woods, N. F. (2018). The dynamics of stress and fatigue across menopause: attractors, coupling, and resilience. Menopause (New York, N.Y.), 25(4), 380–390. doi:10.1097/GME.0000000000001025