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Fatigue Isn't An Inevitable Part Of Menopause — Here's What You Can Do

Kyrin Dunston, M.D.
Board Certified OBGYN
By Kyrin Dunston, M.D.
Board Certified OBGYN
Dr. Dunston is a board certified OBGYN and functional medicine specialist.
Image by Fly View Productions / Istock

If you find yourself constantly reaching for coffee, feeling too tired to follow through on plans, you're not alone. And while low energy can be spurred by a long list of things, fatigue and menopause often go hand in hand

Statistics show that 85.3% of postmenopausal women and 46.5% of perimenopausal women experience symptoms of both physical and mental exhaustion1.Being tired all the time seems like an inevitable part of the transition. But just because 90% of your friends would rather stay home on the couch and watch a movie doesn't mean fatigue during menopause is unavoidable.

What is fatigue? 

To understand fatigue, you've got to understand how your body creates energy in the first place. 

Your cells contain millions of tiny powerhouses called mitochondria. The mitochondria produce ATP (or adenosine triphosphate), a molecule that gives us energy. 

If the mitochondria are the economy, ATP is the dollar bill. In the financial economy, you work to earn dollar bills. In the body, your mitochondria work to create the ATP that energizes your life. 

The mitochondria make this precious resource and your body "spends" ATP molecules to bat an eyelash, walk across the room, think a thought, or digest your food.

If you are fatigued, that means your mitochondria are not functioning up to par and you are depleted in ATP. Just like when your finances are running low, it means that enough work hasn't been performed and you do not have enough dollar bills to pay your bills. 

Mitochondria in menopause.

Our sex hormones aren't only used for reproduction. You have more receptors for these hormones in your central nervous system and brain than anywhere else. Sex hormones are vital for healthy neurotransmitter levels, which are a key factor in how you feel. 

The majority of women become estrogen, progesterone, and often testosterone deficient during menopause. In addition, many women suffer from undiagnosed stress hormone cortisol imbalances. Both sex and stress hormone imbalances contribute to fatigue during menopause

During perimenopause, progesterone declines while estrogen tends to increase throughout the day. The ovaries often make a high amount of estrogen in the early stages of perimenopause due to poor ovarian reserve. Our eggs get older and the ovaries do not function as well. 

The further into perimenopause you get, the lower your estrogen levels are until you enter menopause. Once you are in menopause, production is at an all-time low. 

Some studies suggest that high estrogen levels encourage the body to hold on to fat2. Women with high estrogen levels during their reproductive years often have a higher concentration of fat and weigh more. This fat storage ensures that women have enough fat to support a baby throughout pregnancy and breastfeeding. The fat is stored in the hips and thighs as subcutaneous fat (a thin layer beneath the skin).

During menopause, lower estrogen levels cause fat to be stored in the belly area. This visceral fat can contribute to diabetes, heart disease, and insulin resistance, among other health problems. 

Mitochondria rely on healthy fats to function properly. A 2010 study on the way mitochondria process fat suggests that twice as many mitochondria are needed to process visceral fat versus subcutaneous fat3. That means your mitochondria are working twice as hard to produce energy. No wonder most people feel run down when estrogen levels drop! 

The 4 main reasons your mitochondria are struggling. 

During perimenopause, I've found that energy issues can be caused by a combination of hormonal and energetic imbalances, toxicity, and nutritional deficiency. I advise my patients to address all four of these factors to treat the root cause of fatigue. 


Hormone imbalance 

Your energy relies on hormones. Hormones are the signalers and metabolic regulators that tell your mitochondria how to function efficiently. If your body is not making enough ATP, it could be because of a hormonal-signaling problem. During menopause, hormone fluctuations interfere with the signals to the mitochondria. 

The hormones in your body are the communicators telling your mitochondria how much energy they need to make. During menopause, when your hormones are suffering, the signals and communication are effectively shut down and ATP production decreases. Cortisol imbalances aggravate the situation. 

Hormone balance starts with a healthy diet. Try to eat a low-sugar, whole-food diet to help support healthy hormone balance.


Toxicity and inflammation

Another reason your mitochondria might be struggling to make enough ATP is excess toxicity. Toxicity interferes with ATP production and causes inflammation throughout the body, which your body has to spend more energy to correct, using up precious resources. 

In this day and age, we are exposed to toxins constantly, from pesticides and colorants in the food you eat to contaminants in the water you drink. There are harmful chemicals in our toiletries and home care products, pollutants in the air you breathe, not to mention more serious problems like chronic viruses and stomach bugs. 

Picture what would happen if you dumped a barrel of oil in the mailroom at the post office. The mail would be ruined, the mail carriers would be panicking, and none of the mail would get sent out. The same thing happens in our body when we are exposed to or ingest toxins from our food, drink, and environment. They interfere with normal processes and prevent our mitochondria from functioning. 

Here are some actions to take to help mitigate toxins from getting inside: 

  • Eating organic and locally raised produce can help weed out any toxins from your diet. Stick to the outside of the grocery store, and stay away from processed foods with lots of unpronounceable ingredients. 
  • Filter your water to eliminate any potential toxins. 
  • Finally, eliminate environmental toxins. Opt for natural products free from parabens, phthalates, sodium lauryl sulfate, artificial scents, colors, and preservatives. 

Nutritional deficiencies 

Nutrients are the resources that are needed to run the machinery of your body. Your body requires a lot of nutrients to create ATP, but a majority of Americans are nutrient deficient. Without nutrients, the body doesn't make enough ATP, and fatigue is the result. 

The reason so many Americans are nutrient-deficient is a combination of modern farming practices and overprocessed food. The soil in which our food is grown is nutrient-deficient, and the food we eat does not have the nutrient density it had years ago. 

Your body needs plenty of resources to do its job well. Healthy sugars, fats, vitamins, and minerals are the resources your mitochondria need to make ATP. Unfortunately, these days you cannot eat enough food to meet your body's nutrient needs. The sheer volume of food you would have to consume is staggering. Do you really want to eat 10 heads of broccoli each day? (Probably not.)

In my experience, nutritional supplementation is the only way to combat nutrient deficiencies. 

Unfortunately, although very popular and inexpensive, a one-a-day tablet is usually not enough. Look for high-quality multivitamin supplements to ensure that your mitochondria have all the nutrients they need to make ATP.


Energetic imbalance 

Science has proved that we are energetic beings with an electromagnetic frequency. Whatever you want to call these frequencies—meridians, chakras, prana, chi—your body has an energetic framework on which your physical health relies. 

Ancient medicine traditions have acknowledged the connection between the physical and energetic bodies for years. Acupuncture is a time-honored medical practice that treats this energy system and is recognized for many applications by mainstream medicine. 

Mitochondria are the powerhouses and electrical resources of our body. So if your electromagnetic frequencies are running low, that means some blockages are preventing your body from creating ATP. 

You need to focus on the intangibles to address energetic imbalances including your mental, emotional, and spiritual health. Practices like meditation, grounding, and other mind-body techniques are a great place to start. 

You can also eliminate electromagnetic frequencies from your home by turning off your Wi-Fi at night and sleeping with your cellphone in a different room. These can disrupt your own frequencies and rhythms. 

Bottom line.

Although fatigue may seem common when you hit menopause, the truth is that once you address the causes of the fatigue, there is no reason you cannot have the same energy at 50 or 80 as you did at 20.

If you find yourself dragging lately, I challenge you to start to address these issues to see how good your energy can be. Once you understand why your body is struggling, you can empower yourself to support your mitochondria and heal your body as you age. 

You deserve to enjoy this time of life. 

Kyrin Dunston, M.D. author page.
Kyrin Dunston, M.D.
Board Certified OBGYN

Kyrin Dunston, M.D., FACOG, is a Board Certified OB/GYN with Fellowship training in Anti-Aging, Metabolic and Functional Medicine. She specializes in bioidentical hormones, gut restoration and anti-aging medicine.

Leading by example OBGYN Dr. Kyrin Dunston lost a life changing 100 pounds and healed herself from chronic disease using natural treatments. Now, she specializes in helping women heal, lose weight and regain energy at midlife naturally by treating the root cause in her digital clinic.

She hosts the weekly Her Brilliant Health Revolution podcast, the Her Brilliant Health Secrets YouTube channel, and the Stop the Menopause Madness Summit where 53 experts share their top strategies to lose weight, regain energy, balance hormones and moods, feel sexy and confident, look great and master midlife.