Exhaustion during perimenopause

Perimenopause can present with night sweats or hot flushes that interrupt sleep, while irregular or heavy periods may leave you feeling depleted. Anxiety, low mood, pain and changes in routine can add to daytime tiredness. Fatigue may also reflect anaemia, thyroid disease, infection, sleep apnoea, medication effects or another health problem. The symptom’s duration and effect on concentration, driving and daily tasks are useful clues.

Keep a short diary of sleep, awakenings, flushes, bleeding, mood, caffeine, alcohol and medicines. Choose gentle activity and regular meals, and make the bedroom cool and quiet if heat disrupts rest. Pace demanding tasks and accept practical help while you seek advice. Book a clinician review when exhaustion lasts, is worsening or limits normal activities; bring the diary and describe your sleep quality rather than only the hours in bed.

Seek prompt care for exhaustion with heavy bleeding, faintness, breathlessness, chest pain, racing heartbeat, severe weakness or new neurological symptoms. Arrange an appointment for unexplained tiredness, persistent low mood, loud snoring with pauses in breathing or sleepiness that makes driving unsafe. A clinician can review symptoms and medicines and check for treatable causes.

Ask whether sleep disruption, bleeding or mood symptoms could explain your fatigue, whether you need checks for anaemia or thyroid problems, and which treatment or sleep-support options are appropriate for you.