3 Real Reasons You’re Always Tired in Perimenopause

If you’re in your 40s and feel like you’re dragging yourself through the day — you’re not alone. That bone-deep fatigue? It’s not in your head. In fact, it’s one of the most common (and frustrating) symptoms women experience during perimenopause.

After 12 years of practicing functional medicine and working with women just like you, I’ve found that fatigue often comes down to three root causes. And the good news? They’re not only fixable — they’re empowering once you understand what’s really going on.

1. Poor Sleep Quality (Yes, Even If You’re “Sleeping”)

You may be spending 7–8 hours in bed, but are you actually getting restorative sleep?

As progesterone declines in perimenopause, your sleep quality can take a major hit. But there’s another silent disruptor: your light environment.

Let me ask you:

• Are you scrolling on your phone first thing in the morning?
• Binge-watching shows or TikTok long after sunset?

This kind of “backwards” light exposure throws off your circadian rhythm, leading to disrupted melatonin and cortisol cycles. That means even if you go to bed early, you might still wake up tired and groggy.

Fix it:

• Step outside and expose your eyes to the sunrise each morning
• Stick to a consistent sleep-wake schedule
• Reduce blue light after sunset with filters or blue light glasses

Doing this helps re-regulate your hormonal rhythms and dramatically improves sleep quality.

2. Adrenal Fatigue (Also Called HPA Axis Dysfunction)

If you’re feeling wired but tired, this one’s for you.

Women in midlife are master multitaskers — juggling kids, aging parents, demanding careers, and endless responsibilities. Over time, this constant stress keeps cortisol levels elevated, which eventually depletes your adrenal reserves.

Here’s why it matters:
When your ovaries reduce estrogen production in menopause, your adrenal glands are supposed to take over. But if they’re already taxed? You’ll feel exhausted, anxious, and emotionally depleted.

✅ Fix it:

• Practice daily nervous system regulation
• Try deep breathing, walking in nature, journaling, or EFT tapping
• Start small — even 5 minutes a day can help

3. Blood Sugar Dysregulation

Declining estrogen levels lead to increased insulin resistance — which means blood sugar spikes, crashes, and energy dips become more common.

Yes, Hormone Replacement Therapy (HRT) can help, but supporting your metabolic health first can make your body more responsive to any therapy you choose.

✅ Fix it:

• Focus on protein-rich meals (especially breakfast)
• Try reverse fasting (early dinner, longer overnight fast)
• Supplement smartly and reduce processed carbs

You’ll feel clearer, lighter, and more balanced — without the blood sugar rollercoaster.

You’re Not Lazy. You’re Not Crazy. You’re Just in Perimenopause.

If you’re tired, moody, and frustrated, know this:
You’re not alone — and you’re definitely not broken.

Your body is changing. And while it might feel like everything is falling apart, you can support your system with simple daily actions.

So take a breath. Make one small change today. And welcome to the Peri-party — where healing, energy, and joy are all still on the table.

➡️ If this post helped you feel seen, share it with a friend who needs to hear this. 💛