Energy Levels

Debilitating Fatigue Before Your Period? Get to the root of the Problem

September 1, 2022

Hi, I’m Angela
I'm a functional medicine practitioner & hormone expert working primarily with women in their 40's and 50's to create lasting health.
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Are you feeling run down before your period? 

If you’re like most women, you probably just chalk it up to being “pre-period,” but what if there’s more to it than that? Fatigue is one of the most common symptoms of premenstrual syndrome (PMS) and can be downright debilitating for some women. 

If you’re dealing with fatigue every month, it’s time to get to the root of the problem and figure out what’s causing it. Several things can contribute to fatigue before your period, so it’s essential to identify the culprits and take steps to address them. Here are a few tips for getting started.

In this blog, I will talk about typical happenings for women in their forties and fifties. If you are a woman in this age group, you may have a regular or irregular cycle.

Fatigue Manifests

You might suffer from debilitating fatigue as you come into a monthly period. This fatigue is so bad that it is hard to get out of bed and get your day going. It can cause you to cancel work and even social events. 

You have to stay home, lie in bed, unable to focus or do anything because you’re too tired. Instead of going out, you may need to let everything calm down first. It’s not a great reality for you since it’s happening every month. 

You need to figure out why these things are happening, especially if you didn’t have the symptoms before. The symptoms can get worse.

Reasons Why Fatigue Gets Worse

As a woman, these symptoms have to do a lot with the changing fluctuating hormone levels. What happens as we’re approaching menopause is, that even when we haven’t transitioned into it yet, our female sex hormones, estrogen, and progesterone are both lowering quite a bit. 

But sometimes, progesterone lowers quicker than estrogen. Progesterone is a bit of a balancer for us as women. It helps to balance many different things, including mood. It also balances the timing of when we get our period so that we don’t get it too early. For example, if you are getting a period every 18 to 21 days, it’s quite likely that your progesterone levels could be out of balance relative to your estrogen. Normally, your cycle should be closer to 28 to 30 days. This is now a clue for you.

There will be increased fatigue during your period or cycle in menopause. It’s because of the imbalance between estrogen and progesterone. 

There must be a way to buffer your condition since you can’t change the hormones that behave around menopause. 

On the contrary, some women don’t get as tired as others meaning the root cause can not be simply the lowering of progesterone. There might be something else going on, which most of the time there is. 

High Functioning Stress 

Stress is the probable cause of these imbalances, indicating you have too much stress. It’s common for women, especially in this age range. 

Like many women, you are busy at home with your partner, family, and with your kids. You may be busy running a household where it’s a big part. Other areas include having intense roles in your job requiring much attention. You may have multiple activities going on outside your job. These activities may involve attending a soccer game for your kid, managing aging parents, and attending social events. 

Simply put, you are busy and causing all the stress in the world. There are also different emotional stressors present. When combining all of these, your progesterone lowers faster than estrogen.

Cortisol Production as a Survival Mechanism

The hormone imbalance can have a causal sequence. The body will keep up with your busyness and stress by producing more cortisol enabling you to continue your lifestyle. 

Your body runs out of steam and gas, thus unable to produce more cortisol at the rate and demand needed. It will utilize some of your sex hormones to continue the production of cortisol. The utilization of sex hormones further causes it to decline.

As you keep up with the engagements in your everyday life, stressors keep coming. As mentioned, you are already in this age range where your hormones like progesterone are declining significantly. 

There are other things that can make you tired, like your monthly period where you can have quite a heavy flow.  This can be part of the reason why you feel so tired. Furthermore, It can lead to low iron and eventual anemia,  which also makes you tired.  

You can see how it can become a cycle. If you don’t understand what’s happening, you have no idea how to deal with those symptoms. It’s not easy to ‘pull the plug’ in your busy everyday life.

You must have some strategies to help your body buffer by managing stress. The continuous production of cortisol affects your female sex hormones, which are already declining to cause more symptoms around fatigue.

Insulin Issues

There’s a need to further investigate beyond the effects of the declining levels of estrogen and progesterone, where estrogen, in particular declines more.

The other effect of it is that it makes you less sensitive to insulin, causing its level to rise. Insulin helps you manage your blood sugar balance. The imbalances in your blood sugar can also cause some of this fatigue. Many women spoke of having debilitating fatigue because of less sugar intake.

Women may claim they have a reasonably healthy lifestyle, but what they eat may contribute to their rising blood sugar levels. Changes are happening in your blood sugar level and estrogen levels. You may not be aware of some changes in your estrogen level lowering, but when blood sugar levels fluctuate, you will notice something. You will feel energetic for a short period, followed by a crash. Then, you will be weak and unable to do other things during the day. Your low energy may cause you to lie down and want to take a nap. 

The changes in blood sugar that happens as our female sex hormones lower. As we get closer to transition into menopause, you shouldn’t have to be this tired. Albeit, it’s not normal to feel so fatigued that you can’t get your everyday life done, just because you’re at a certain point in your cycle.

Lifestyle Related Strategies

Even if you’re getting close to the transition into menopause, there is something you can do. I’ve noticed in my practice, that some women resort to quick-fix solutions. They take supplements, medication, or something that can help them to focus and function.

In reality, the approach doesn’t work, for it’s not how the body is ‘wired.’ We must peel back the layers and understand the root cause of these symptoms of fatigue. I found primary strategies which work and are essential for these problems. They are lifestyle-related strategies.

Deliberate Exercises

Two strategies will help you buffer stress, elevate cortisol, and keep blood sugars more balanced. One is exercise. I don’t mean exercising like crazy to lose weight, for it’s often the goal for women in this age range.

I’m talking about exercising to regulate hormone levels. These simple exercises include a walk, light jog, hike, and short workout at the gym. It doesn’t have to be long, about 15 to 20 minutes once or twice a day. These exercises can have a massive and positive impact on those problems and can help to improve your fatigue.

Some women tell me they’re so exhausted. There is no way to get out the door when they feel this way. I suggest they will try to do exercise at the most optimal time of the cycle. Debilitating fatigue for most women usually happens in the last two weeks of the monthly cycle. 

Most women typically feel a little more energetic when they get to the first half of the cycle, especially as the bleeding starts to wind down. It’s time to interject with the exercise piece and drop off after this half.

It’s a good starting point for you and something to help you regulate blood sugar levels.  You can be specific in doing the exercise too, for instance, doing your walk after eating a meal. It will help control and stabilize your blood sugars. 

Proper Diet

Diet is the other essential thing. It doesn’t mean going on a diet such as a calorie restriction or these types. I’m referring to a healthy whole foods diet evenly distributed with macronutrients such as carbohydrates, fats, and proteins.

I find many women have other struggles, such as weight problems and metabolism issues at this age range. They’re going on extreme food plans involving zero carbohydrates, high protein, or high fat. The results of a food plan backfire on their health over time. Organ systems of your body need carbohydrates and not any kind of carbohydrate, but the right kind. It’s crucial, especially as you get closer to menopause.

You must avoid sugary carbohydrates such as white pieces of bread, white rice, and white sugary foods. These are all baking goods and foodstuffs of these kinds. You need complex carbohydrates such as lots of vegetables because of the impact on stabilizing blood sugars.

Your diet is sometimes one of the root causes of fatigue, and in some ways, it’s related to hormone and blood sugar levels. You must pay more attention to your diet, especially those affecting those levels, as you get into this period of life. When these levels are changing, they impact your body. 

Getting The Balance Back

Fatigue is probably impacting a lot, almost ruining your life. There is a way to get the balance back. You have learned lifestyle tips, and one other thing is proper laboratory testing. The test will reveal what’s happening with your hormones and blood sugars. 

I am a functional medicine practitioner, and I work with women all the time with this concern. I make sure there is proper laboratory testing performed. The results will be the basis for a customized individual plan for you. Its purpose is to help rebalance your sex hormones, cortisol, and blood sugar levels, which often results in an improvement throughout your cycle. 

You won’t have those highs and lows anymore, especially the lows at the back half of your period. And you will be a bit happier, more productive, and more connected in your life. If you’re looking for such results, please feel free to reach out. You can connect with me through my website:

If you want to book a complimentary consultation where we can talk about your health, you can do so. There may potentially be a good fit for us to work together in helping you rebalance your hormones. Reach out to us, and we’re glad to help you! 

If you’re experiencing debilitating fatigue before your period and would like help getting to the bottom of it, we’d be happy to schedule a discovery call with you. During this call, we can discuss your symptoms in more detail and come up with a plan tailored specifically for you.

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DISCLAIMER: The information in this email is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. All content is for general informational purposes only and does not replace a consultation with your own doctor/health professional.

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