Anita's Blog

Feeling Run Down? Understanding Menopause Fatigue and How to Get Your Energy Back

A major symptom that is commonly associated with menopause is fatigue. It is not often thought of as a hallmark symptom of menopause, the way hot flashes and night sweats are, but it is an extremely common complaint of women who are going through this rite of passage. Women will often talk about feeling mentally and physically exhausted in such a way that it takes every last bit of energy to get through the day. Menopausal fatigue can manifest itself as sleepiness, poor memory, inattentiveness, brain fog/mental fuzziness and irritability. It is NOT part of the normal aging process to feel exhausted and tired all the time. There are a number of contributing factors that cause fatigue in menopause. Understanding what causes this physical and mental exhaustion will aid in providing a solution to alleviate this problem.

Causes of Menopausal Fatigue:

There are several hormones that influence our energy and sense of well-being. First on the list is our sex hormones: estrogen, progesterone, and testosterone. As I have discussed in many previous blogs, these hormones are imperative for a number of functions in our bodies. Estrogen and progesterone both affect our moods and the decline in these hormones can result in mood swings or depression. This in turn can result in a sense of constant exhaustion. Progesterone is also involved in regulation of the sleep-wake cycle, inducing a state of calm and has a sedating effect in the body. When progesterone levels decline it is often common to see women start to experience insomnia. Anyone who has ever suffered from insomnia can tell you first-hand how debilitating it is and the negative impact it has on energy levels during the day as well as mental alertness. Estrogen is also involved with maintaining restorative sleep through its activity on REM sleep. If estrogen levels decline, the time spent in REM sleep declines, which leads to a less restorative sleep. Low testosterone can also zap our energy, leaving us feeling physically exhausted in addition to a decline in libido and sexual desire.

As a woman enters menopause it is also very common to begin to see changes with thyroid function and adrenal function. The hormones produced by our thyroid regulate our body’s metabolism, and the hallmark symptom associated with low thyroid function is fatigue.

The adrenal glands also play an important role in menopausal fatigue. These glands are affected by stress, either physical or mental, and this will result in changes in the adrenal gland’s output of hormones. Cortisol is one of the hormones that is produced by the adrenal glands and over a prolonged period of time the output of cortisol will begin to decline, leading to adrenal fatigue. Supporting adrenal function throughout menopause is important to aid in avoiding adrenal fatigue and will help to maintain healthy energy levels.

The neurotransmitters serotonin, norepinephrine and acetylcholine that are produced in the brain are involved in the regulation of cognitive function. Changes to the production of these neurotransmitters can be associated with cognitive decline, resulting in the possibility of experiencing problems with memory, foggy thinking and difficulty concentrating. While estrogen is not directly involved in the production of these hormones, we know that when estrogen levels are low, the production of these neurotransmitters can also be affected, contributing to the cognitive changes that women can experience as they transition through menopause.

So what can you do?

There are a number of proactive steps that you can take to prevent or alleviate menopausal fatigue. First of all determining the cause will help to steer you in the right direction. Having a complete hormone panel run that includes not only the sex hormones but also a thyroid panel and cortisol levels will aid in determining what body systems are at play and will help to ensure that the right treatment approach is being utilized. Once this is determined, addressing the hormonal imbalances via diet, lifestyle, supplementation (botanicals, vitamins, minerals, etc.) or, if necessary, prescribed medication will aid to get you back on track and help to get you feeling energized and more like your old self.

There are a few botanical medicines that I find to be particularly helpful for fatigue associated with menopause. My favourite botanicals for menopausal fatigue are all adaptogenic botanicals. Adaptogens are substances that promote homeostasis in the body and modulates the body’s response to stress. Essentially they improve the body’s ability to adapt to stress. The following are some botanical medicines that I have seen in practice to provide benefit to patients.

Ashwaganda: This is a fantastic botanical medicine that has been used for centuries in ayurvedic medicine. This plant has been shown to contain several medicinal chemicals but in particular the withanolides provide the most therapeutic properties when it comes to restoring energy levels.

Holy Basil: Another botanical that is used in ayurvedic medicine, Holy basil has been valued for centuries because of its benefits for the mind, body and spirit. Holy basil has been studied for it’s antioxidant properties and use in cancer as well as for a number of other health benefits but the most compelling research is with regards to stress. It has been shown to aid in stress relief and promote relaxation. I have seen this to be beneficial in patients who suffer from anxiety as well, providing a sense of calm in the body.

Siberian ginseng: This botanical medicine has been studied mainly in Russia and has been shown to improve immune function, increase mental alertness and improve physical performance.

Rhodiola: This is one of my favourite botanical medicines to use to improve energy levels and decrease mental and physical fatigue. Rhodiola is used in traditional Chinese medicine to enhance strength and endurance and has been used with Russian astronauts to improve their ability to cope with the psychological strains of space travel. Olympic athletes also use this for improving performance and endurance.

If you are suffering from fatigue associated with menopause, there are a number of solutions to aid in restoring your energy levels. Discussing this with your health provider is the first step to help get you on your path to restoring health.

-Dr. Lara Armstrong, N.D.

Lara Armstrong, is a licensed naturopathic doctor who currently practices in Ancaster and Hamilton, ON. She received her training in Naturopathic Medicine from the Canadian College of Naturopathic Medicine (CCNM), graduating in 2004, and started her private practice, Armstrong health in 2005, where she runs a general family practice. In 2007 she started the menopause clinic at Monarch Laser and Wellness in Hamilton. This clinic offers naturopathic treatment for menopause and issues surrounding hormonal imbalance and is run in conjunction with a medical doctor, bringing a very unique and refreshing approach to health care. Dr. Armstrong is very passionate about helping women going through menopause, providing them with education and has been involved in several speaking engagements discussing this topic. Dr. Armstrong has been the recipient of the Diamond Award for “Best Naturopath” in the Hamilton’s Readers Choice for the last 5years.

In addition to seeing patients, Dr. Armstrong, is part of a mentoring program with the Michael G. DeGroote School of Medicine and will have medical students shadowing appointments from time to time.

Outside of clinical practice, Lara enjoys the practice of yoga and the health benefits that this provides. She is the mother of 3yr old Jasmine and loves spending time with her and continuing to learn from her.

Lara is a member of the OAND, CAND and APND.

Visit Lara’s site at:

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