Do you wake up tired… and stay that way all day?
Do you feel like you’re dragging yourself through work, errands, and family life—even if you got a “full night” of sleep?
You’re not alone—and you’re not crazy.
At Antigravity Wellness, we hear it all the time:
“I used to be so energetic. Now I need coffee to function, naps to survive, and I still feel like I’m barely holding it together.”
The truth is, fatigue is one of the most common and misunderstood symptoms of perimenopause [1]. And unfortunately, many women are told to just “push through it” or “get used to it.”
But here’s what we want you to know:
👀 Fatigue in midlife is common, but it is NOT normal.
Let’s break down the hidden reasons you may be feeling wiped out—and what you can do to get your energy (and life) back.
1. Blood Sugar Roller Coasters
Women in perimenopause often become more sensitive to blood sugar fluctuations, especially as estrogen, which has a stabilizing effect on glucose metabolism, begins to decline [2].
Symptoms of blood sugar crashes:
- Afternoon energy dips
- Feeling shaky or irritable between meals
- Intense cravings for sugar or caffeine
👉 Quick Fix: Start your day with protein + fat + fiber (think eggs + avocado + greens) instead of just coffee and toast. This helps stabilize energy from the moment you wake up.
2. Cortisol Chaos
Cortisol is your body’s primary stress hormone—and during perimenopause, your ability to buffer stress decreases as estrogen levels drop [3].
You might be experiencing:
- “Tired but wired” at night
- Second wind after 9 p.m.
- Feeling anxious for no reason
Chronically elevated or dysregulated cortisol is associated with fatigue, poor sleep, and cognitive fog [4].
👉 What Helps: Strength training (not overtraining), stress-reducing practices like mindfulness, and adaptogenic support such as ashwagandha or rhodiola (if appropriate) may help regulate cortisol rhythms [5].
3. Poor Sleep Quality
Hormonal shifts in perimenopause disrupt circadian rhythms and contribute to sleep disturbances, including insomnia and frequent night awakenings [6].
Up to 60% of women in perimenopause report poor sleep [7], which leads to:
- Daytime sleepiness
- Brain fog
- Increased risk for anxiety and depression
👉 Support Tips: Improve sleep hygiene, use supplements like magnesium glycinate (proven to improve sleep quality) [8], and consider bioidentical hormone therapy when appropriate under medical guidance.
4. Thyroid Dysfunction
Thyroid hormone plays a key role in energy production, and thyroid dysfunction is more common in perimenopausal women, especially those with autoimmune conditions like Hashimoto’s [9].
Even when TSH is “normal,” low levels of free T3 or the presence of thyroid antibodies can indicate dysfunction not captured by standard labs [10].
Common symptoms:
- Fatigue
- Cold intolerance
- Weight gain
- Dry skin and constipation
👉 What to Ask For: A full thyroid panel: TSH, Free T3, Free T4, TPO antibodies, and Tg antibodies.
5. Nutrient Deficiencies
As women age, several key nutrient deficiencies become more prevalent, especially if menstruation is heavy, digestion is compromised, or dietary intake is inadequate.
Common deficiencies linked to fatigue:
- Iron/ferritin [11]
- Vitamin B12 [12]
- Vitamin D [13]
- Magnesium [14]
👉 Your Move: Ask your provider to check these labs, and work with a functional medicine provider to correct deficiencies safely and effectively.
You’re Not Lazy. You’re Not Crazy.
If you’ve been told “everything looks normal” but you know something’s off, listen to that inner voice.
Your body isn’t broken—it’s speaking to you.
And the good news? There’s so much we can do to help you feel better. With the right testing, guidance, and support, you can reclaim your spark—and your life.
Ready to Start Feeling Like You Again?
🔍 Want to dig deeper? Book your Brief Initial Consult Call and let’s look under the hood to see what’s really going on.
💛 You don’t have to stay stuck in survival mode.
Let’s help you rise.
— Dr. Nicole Smith, DNP, FNP-C, ONP-C
Founder, Antigravity Wellness
References
- Santoro, N. (2016). Perimenopause: From Research to Practice. Journal of Women’s Health, 25(4), 332–339.
- Godsland, I. F. (2005). Oestrogens and insulin secretion. Diabetologia, 48(11), 2213–2220.
- Vamvakopoulos, N. C., & Chrousos, G. P. (1993). Hormonal regulation of human corticotropin-releasing hormone gene expression: implications for the stress response and immune/inflammatory reaction. Endocrine Reviews, 14(4), 443–458.
- McEwen, B. S. (2006). Sleep deprivation as a neurobiologic and physiologic stressor: Allostasis and allostatic load. Metabolism, 55, S20–S23.
- Lopresti, A. L., & Drummond, P. D. (2017). Efficacy of ashwagandha in reducing stress and anxiety: A systematic review. Journal of Clinical Medicine, 6(12), 80.
- Kravitz, H. M., et al. (2003). Sleep difficulty in women at midlife: A community survey of sleep and the menopausal transition. Menopause, 10(1), 19–28.
- Polo-Kantola, P. (2011). Sleep problems in midlife and beyond. Maturitas, 68(3), 224–232.
- Abbasi, B., et al. (2012). The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. Journal of Research in Medical Sciences, 17(12), 1161–1169.
- Hollowell, J. G., et al. (2002). Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). The Journal of Clinical Endocrinology & Metabolism, 87(2), 489–499.
- Gietka-Czernel, M. (2017). Thyroid diseases in postmenopausal women. Przeglad Menopauzalny = Menopause Review, 16(2), 33–36.
- Tolkien, Z., et al. (2015). Iron supplementation for fatigue in non-anaemic women: a systematic review and meta-analysis. BMJ Open, 5(11), e006961.
- O’Leary, F., & Samman, S. (2010). Vitamin B12 in health and disease. Nutrients, 2(3), 299–316.
- Holick, M. F. (2007). Vitamin D deficiency. New England Journal of Medicine, 357(3), 266–281.
- Nielsen, F. H. (2010). Magnesium, inflammation, and obesity in chronic disease. Nutrition Reviews, 68(6), 333–340.
