Does midlife have you dragging? Here are some simple ways to fight fatigue and boost your energy.
Menopause signals the end of a woman’s menstrual period and fertility, and it causes a host of other changes in the body. Common symptom that many women experience include low energy due to changing hormone levels, vasomotor symptoms like night sweats, and sleep disruptions like frequent urination.
While there are lifestyle changes you can make to boost your energy, it’s important to speak with a healthcare provider if fatigue significantly interferes with your life. “Women should seek medical evaluation when fatigue becomes a frequent symptom that is disrupting their performance at work or their ability to carry out or enjoy usual daily activities,” says Jane Limmer, MD, assistant professor and director of the medical student program in ob-gyn at the University of Colorado’s Anschutz Medical Campus in Aurora, Colorado. “Fatigue is a common complaint, and there are many conditions that should be ruled out before attributing it to menopause.” These include:
Anemia
Depression
Diabetes
Hypothyroidism
Heart conditions
Sleep apnea
Medication side effects
Hormonal changes, hot flashes, frequent urination at night, and night sweats can make sleep a challenge. In fact, between 40 and 56 percent of women experience sleep difficulties during menopause.
Creating a healthy, consistent routine may help you wind down at night and feel more rested in the morning. To get a better night’s sleep, try these tips:
Aim to go to bed and wake up at the same time every day, even on weekends.
Avoid drinking caffeinated beverages, such as coffee, tea, and kombucha, before bed.
Take a warm shower or bath close to bedtime.
Make sure your room isn’t too warm or too chilly. For optimal sleep, health experts suggest a bedroom temperature between 65 and 68 degrees F.
Avoid using smartphones, computers, or watching TV while in bed.
Read before bed.
Listen to soothing music before bed.
Limit late-afternoon or evening naps.
Avoid exercising at least two hours before bedtime.
Cognitive behavioral therapy for insomnia (CBT-I) may also be beneficial. This is a type of therapy that involves reframing negative thoughts that may be contributing to sleep issues. Research suggests that CBT-I can improve sleep quality and reduce the severity of insomnia in women in menopause.
If you regularly feel tired after a full night’s sleep, you may want to speak with a healthcare provider about obstructive sleep apnea (OSA), a sleep disorder that causes breathing to stop and start. Women in menopause have a higher risk of this condition during menopause. “If you are experiencing OSA from hormonal changes or weight gain, discuss appropriate evaluation and treatment options, such as hormone replacement therapy, weight management strategies, breathing machines, oral devices, or exercise therapy for your mouth and facial muscles, with your doctor,” says Staness Jonekos, Los Angeles-based coauthor of The Menopause Makeover and founder and CEO of Eat Like a Woman Inc. “OSA is a risk factor for cardiovascular disease and may also cause depressive symptoms.”
Try setting a consistent sleep schedule with a relaxing bedtime routine, and if you still feel fatigued, don’t hesitate to seek professional help for more serious sleep issues.
Exercise may be the last thing you want to do when you’re tired. But “it produces those feel-good hormones and gives you the energy you’re looking for when you’re not feeling good,” Jonekos says.
Regular aerobic exercise, such as walking, swimming, tennis, or cycling, can help boost your overall mood and energy levels and promote longer, higher-quality sleep. Research involving premenopausal women found that walking with long strides three or more days per week improved insomnia, irritability, and fatigue. In addition, premenopausal women doing 30 minutes of aerobic exercise over a period of six months noted significant improvements in their sleep.
Try to aim for 150 minutes of moderate-intensity aerobic exercise weekly for the most benefits, Jonekos says. This is in line with the National Institutes of Health’s physical activity recommendations.
When building any exercise routine, start slowly and build up your intensity gradually, and get plenty of rest between workouts. Also be sure to stay hydrated by drinking water throughout the day. Dehydration is a possible cause of fatigue.
It may seem counterintuitive, but regular exercise can really help improve your energy levels.
Diet choices during menopause can help you manage symptoms and maintain your overall health. In particular, eating foods that are high in melatonin and tryptophan may help you avoid the fatigue that sleep issues can cause.
Melatonin is a sleep-inducing hormone. It helps tell your body it’s time to wind down and prepare for rest. Tryptophan is an amino acid that produces melatonin. Research shows that consuming foods with tryptophan can help increase and improve sleep time. In addition, people who reduced their intake of tryptophan experienced worse sleep.
The foods providing the most melatonin include:
Eggs
Fish
Nuts
Cherries
Strawberries
Good food sources of tryptophan include:
Fish
Shellfish
Algae, including spirulina
Eggs
Soy
Sesame seeds
Sunflower seeds
Pumpkin seeds
Cheeses
Yeast
To promote better sleep, consider reducing your intake of high-fat, spicy foods, too. High-fat foods may reduce how much your brain responds to a sleep-inducing hormone called orexin, while spicy foods contribute to hot flashes and heartburn, both of which cause uncomfortable symptoms that can disrupt sleep.
Consider adding high-tryptophan and high-melatonin foods, such as seafood, eggs, and soy, to your diet for better sleep. You may also want to cut down on your intake of spicy, fatty, or sugary menu items to help prevent uncomfortable symptoms that can keep you up.
“Eating smaller meals more frequently can provide energy throughout the day,” Jonekos says. And it can help you avoid the slump that comes from eating a large, carbohydrate-rich meal. Instead, try to eat a healthy meal or snack every three to four hours.
Eating at the same time each day is also important for maintaining energy levels. Doing so can help keep your circadian rhythm on track, promoting better sleep. Your circadian rhythm is the body’s clock that tells your brain when to be alert and when to ready itself for sleep. To keep it on track and help avoid any sleep disruption, try to stop eating at least two hours before bedtime.
Try to eat a small nutritious meal or snack every three to four hours to maintain energy levels throughout the day and avoid a post-meal slump.
Caffeine, typically found in chocolate, coffee, and tea, excites your nervous system and may contribute to alertness and focus. However, drinking caffeine too close to bedtime can make falling and staying asleep difficult. If you’re not used to caffeine, avoid drinking it after 2 p.m. because it may overstimulate you too close to bedtime. If you like the taste of tea or coffee, switch to decaf after a certain point in the day.
Alcohol is a diuretic, meaning it makes you need to urinate more often. It can also relax the throat muscles, which can increase your risk of sleep-related breathing issues and OSA.
Caffeine and alcohol can both cause night sweats, so limiting both may support better, more comfortable sleep.
If you regularly drink coffee or tea, aim to stop by 2 p.m. each day to avoid overstimulation that can interfere with sleep.
“Nicotine is a stimulant, so use of nicotine close to bedtime may affect sleep quality and thereby lead to more fatigue,” Limmer says.
Smoking is linked to poor sleep in general. Research involving 15,000 people found that tobacco use negatively affects sleep quality and duration. This effect is also more pronounced in females than males.
Other research found that women in menopause who smoked 21 to 30 years experienced more intense symptoms than those who smoked for less than 10 years.
If you smoke, consider taking steps to quit smoking. Nicotine replacement therapy, smoking cessation apps, and free counseling helplines can all support you on the journey. You can also speak with your healthcare provider for advice.
Whether you like to read, go on long walks, dance, work in the garden, or meditate, take the time to indulge in your favorite activities. “You’re entitled to pamper yourself and take time for yourself,” Jonekos says. “As a result, you will be more energetic.”
In particular, relaxation techniques like meditation, deep breathing, and massage can help you build resilience and overcome fatigue caused by stress. Research found that mindfulness-based stress-reduction techniques improved fatigue scores for women with menopause also living with anxiety.
In addition, mind-body exercises like yoga, tai chi, Pilates, and qigong reduce fatigue in peri- and postmenopausal women. These exercises also improve sleep quality and positively affect depression and anxiety, two common causes of fatigue.
Try making time for yourself to do activities you enjoy, engaging in mind-body movements, or practicing different stress-relief techniques to reduce stress and improve your energy levels.
Black cohosh and valerian root are two ancient herbal remedies used to manage menopause symptoms. While these herbal remedies have some anecdotal support, there is limited research on their overall effectiveness. Be sure to talk with your doctor before using herbs in teas or supplements because they can interfere with some medications.
Black cohosh may have benefits for relieving menopausal symptoms like fatigue, depression, and pain. While it’s often included in supplements and other menopause products to treat hot flashes, research doesn’t consistently show that it has this particular effect.
Some studies suggest valerian root may help people fall asleep faster and achieve higher-quality sleep. However, more research is needed here, too.
While soy foods and extracts are sometimes touted as herbal remedies for improving energy levels for women in menopause, health experts generally advise against these products. In fact, the North American Menopause Society does not recommend eating or using soy or soy extracts to relieve vasomotor symptoms in menopause.
Talk with your doctor before using herbal remedies like black cohosh, valerian root, or soy products for menopause. While anecdotal reports suggest these remedies may be beneficial for improving menopause symptoms that can interfere with sleep, the scientific evidence is limited. Some may also interfere with medications.
Menopause can lead to changes in how you urinate, largely due to lower estrogen levels causing the gradual loss of muscle mass in the bladder and urethra. This may mean you’re waking up several times a night to urinate, a very common symptom known as nocturia. These interruptions, along with night sweats, can interfere with your ability to sleep through the night, which can mean you feel more tired during the day.
Using vaginal estrogen therapy, available in a cream, tablet, or ring, may help you manage nocturia.
You can also make lifestyle changes to reduce how much you need to go to the bathroom at night. Aim to:
Reduce caffeine intake
Manage your weight (having excess weight can put pressure on your bladder)
Strengthen your pelvic floor muscles with Kegel exercises
Another possible cause of urinary issues during menopause is pelvic organ prolapse, which occurs when organs near the pelvis drop into the vagina. The stress of childbirth can cause pelvic organ prolapse. It can also damage the pelvic floor muscles, making you feel as if you need to urinate more frequently and causing stress incontinence.
A doctor can insert a pessary, a type of medical device, to hold the bladder in place and prevent leakage. Surgery might also be an option to support the prolapsed organ inside the pelvis. Be sure to speak with your doctor if urinary issues are interfering with your sleep.
Nighttime urges to pee, or nocturia, can disrupt your sleep during menopause, which can affect how energized you are during the day.
Certain prescription drugs can help you manage hormonal shifts and their effects on the body. HRT involves using various combinations of progesterone and estrogen either as capsules, creams, injections, sprays, patches, gels, or vaginal rings.
Hormone replacement therapy (HRT) is the most effective treatment for night sweats and hot flashes, reducing them by 85 percent. This may significantly improve quality of life and sleep. However, it’s important to speak with your healthcare provider about HRT’s risks and benefits.
Doctors generally advise that women with a history of breast cancer avoid taking HRT, as it could increase the risk of cancer recurrence. If HRT isn’t right for you, other medication options are available, including selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs). SSRIs and SNRIs are antidepressant medications. “If women are fatigued because of worsening depression, which is common in midlife, then proper treatment of that depression can improve their symptoms,” Limmer says.
But while some medications can improve fatigue, taking a holistic approach to your lifestyle is more helpful for menopause than any one medication or supplement, Limmer says. “For all patients, we recommend a healthy diet with limited caffeine and alcohol consumption, regular exercise, and adherence to sleep hygiene techniques.”
Speak with your doctor about the right medications for fatigue and other menopause symptoms that may interfere with sleep. HRT is an effective option for reducing symptoms like night sweats, but it’s not for everyone.
Lifestyle measures like eating a balanced diet, getting regular exercise, limiting or avoiding alcohol, caffeine, and nicotine consumption, and practicing good sleep hygiene habits can help you rest better and maintain energy during the day.
Managing menopause-related health issues linked to poor sleep and low energy, such as anxiety, depression, and urinary problems, can support reduced fatigue during the day.
Hormone replacement therapy (HRT) is the most effective treatment for vasomotor symptoms that interrupt sleep, such as hot flashes and night sweats. But be sure to speak with a doctor to determine if it’s right for you.
