Actionable strategies for perimenopausal fatigue

Actionable strategies for perimenopausal fatigue

Key Takeaways:

• Low progesterone and estrogen in perimenopause can disrupt sleep, trigger anxiety, and interfere with mitochondrial energy production.
• Even without night sweats or hot flashes, estrogen fluctuations can wreck sleep and leave you feeling foggy and fatigued.
• Blood sugar imbalance and insulin resistance become more common during midlife, contributing to fatigue and inflammation.

Feeling constantly exhausted in your 40s or 50s? You’re not alone – and it’s not just part of getting older. In this episode of Menopause Rescue, Dr. Polly Watson teams up with Kate Willis, NP-C of Hormone Wellness MD, to tackle one of the most common (and misunderstood) symptoms of perimenopause: fatigue.

“You’re not alone, and it’s not just in your head.“

As hormone levels like progesterone and estrogen begin to fluctuate, many women experience sleep disruptions, anxiety, brain fog, and a significant drop in energy. But this episode dives much deeper than hormones. Dr. Watson and Kate explore how issues like mitochondrial dysfunction, iron deficiency, insulin resistance, and even stress-related blood sugar spikes can all contribute to feeling chronically tired. They also discuss the importance of functional lab testing, which goes beyond basic hormone levels to include full thyroid panels, ferritin, B12, and organic acids testing. These tests help identify the root causes of fatigue, especially in women who don’t feel better even after starting hormone therapy.

From lifestyle changes to advanced tools like continuous glucose monitors (CGMs) and targeted supplements such as magnesium, CoQ10, and inositol, this episode is full of practical, science-backed advice to restore your energy. If you’re wondering how to get your energy back during perimenopause, this conversation offers hope, clarity, and a real path forward. You don’t have to accept exhaustion as your new normal.

• “Fatigue is one of the top complaints we hear from women in perimenopause – you’re not alone, and it’s not just in your head.” – Kate Willis NP-C
• “I remember putting on that estrogen patch and two days later thinking, ‘She’s back.’ It was like flipping a switch.” – Dr. Polly Watson
• “Listening to women is key – not just checking boxes or writing prescriptions. We have to ask what’s really going on beneath the fatigue.” – Kate Willis NP-C

Resources: https://hormonewellnessmd.com/podcast-resources

Disclaimer: https://hormonewellnessmd.com/podcast#Disclaimer

Dr. Polly Watson is a board certified OBGYN who has additional training in menopausal medicine, sexual medicine and functional medicine.

She looks forward to sharing her knowledge with you to help find a solution to address the imbalance in your system and restore your health.

Kate Willis, NP-C, IFMCP is a virtual nurse practitioner for Hormone Wellness MD. She’s been working in women’s health for 15 years in the field of gynecologic oncology and sexual wellness.

In 2021, Kate received her certification through the Institute for Functional Medicine (IFM), and is thankful for such solid and evidence-based training. She uses it daily in her care for patients as she works to address the root cause of disease and dysfunction in the body. As of 2024, she is also a Menopause Society Certified nurse practitioner who is ready to help with your perimenopause and menopause questions. Click here to become a patient!