Fatigue brought on by the Menopause can be an extreme exhaustion that affects mood, well-being, and your ability to concentrate. It’s extra tough when your employer, (who’s often not on the same fatigue page), is demanding a lot of you.  

Depleting oestrogen levels impact on both your sleep cycle and the quality of your much-needed shut-eye. Oestrogen regulates (limits!) production of the hormone cortisol; so when levels drop, cortisol production increases, causing fatigue and anxiety. Result, you don’t feel refreshed or rested when you wake up and this persists throughout the day. Women who have previously slept soundly may now notice a change in sleep habits. Add stress, insomnia, night sweats, alongside a constant sense of dread and anxiety experienced by some perimenopausal and menopausal women, and it becomes a fairly toxic fatigue cocktail. And the good news is…. Fatigue should pass if you take appropriate action! 

The best ways to deal with menopause fatigue Think about your diet. Take a good look at your lifestyle. How do you deal with stress? The results of this self scrutiny exercise will make up your menopause management road map. 

What to eat to help with fatigue 

Eating a balanced diet, little and often, should help to prevent fatigue. 
Be vitamin B savvy, it converts food into energy, less vitamin B means less energy. 
Eat more: B12, found in dairy, chicken, turkey, eggs, sardines, tuna, cheese, cottage cheese, lamb, milk, and B6, found in spinach, peas, carrots Essential fatty acids. 
Eat more: nuts, seeds, avocados, extra virgin and linseed oils, oily fish, such as mackerel, tuna and sardines Try to add lean sources of protein. 
Eat more: poultry, lean meats and fish Increase your intake of magnesium-rich foods. 
Eat more: cashews, almonds, spinach, avocados, brown rice Nitrate rich foods boost energy levels as they push oxygen around the body. 
Eat: beetroot, radishes, green beans and spinach. Beetroot is also a rich source of iron that can help improve your stamina. Try adding it to a breakfast smoothie. Pass the macaroni cheese! 
Eat more protein foods rich in tryptophan, one of the building blocks of serotonin, a chemical responsible for sustaining a proper sleep cycle. Found in: chicken, eggs, beans, nuts, seeds, salmon, turkey, pork, avocado, bananas, yogurt and cheese. 
Eat proteins with a healthy complex carbohydrate such as wholegrain bread, brown rice and pasta hence comfort foods such as macaroni cheese to get the tryptophan effect. 
We’re not seriously advocating this as a nightly ritual, but we’re just highlighting how tryptophan-rich foods work with carbs to create a feel good sensation. 

When to eat Breakfast like a king (or queen!)
Try to eat phytoestrogen-rich oats in muesli, and porridge or add them to a smoothie. This low GI food will prevent blood sugar dips that can cause low mood, fatigue and irritability. 
Eat smaller meals The little and often rule applies here. You’ll avoid the blood sugar rollercoaster ride, which can add to your fatigue. 
Take to the bottle - drink water to ward off fatigue Keep a bottle of water handy. When your body is dehydrated it needs to work harder - the last thing you’re menopausal-fatigued self needs. Drink water an hour before bed to avoid any night sweats dehydrating your body and impacting on the quality of your sleep.

What to avoid to help with fatigue 

The bad Avoid sugary snacks and drinks. Processed foods, most ready meals, cakes and biscuits and pre-cooked meats are full of sugar, preservatives, salt and other additives that may slow you down. So resist the devil on your shoulder telling you that it won’t do you any harm! You may relate more to Deliciously Stella but it’s time to be more Deliciously Ella. (But chocolate lovers, take heart! Dark chocolate supports the work of neurotransmitters that help to balance mood, enjoy in small quantities.) Cigarettes and alcohol Oasis sang about them but didn’t mention how they contribute to menopause fatigue. Nicotine and alcohol affect the quality of your sleep, giving you an initial rush but can leave you feeling drained and dehydrated, so disrupting your sleep. Not good news we know but cutting back on nicotine and alcohol will have a beneficial impact on other 

Lifestyle & wellbeing to help deal with fatigue 

Fit 30 minutes of exercise into your day Getting a move on, helps with mind and body. Thirty minutes of exercise releases feel-good endorphins, and lowers the stress-inducing hormone cortisol. Drawing up an exercise plan and sticking to it will give you a sense of achievement, hopefully show results and raise self-esteem. 
Dust off the gym membership, 
Try online exercise programmes or yoga sessions. 
Take a fast walk during your lunch break, or on a short regular route, walk rather than relying on public transport. 
Check out lots of free, online walking programmes such as the US site, www.prevention.com to motivate you. 
Go yoga to banish fatigue! Fatigue is exacerbated by anxiety or stress; yoga will help to manage this. Breathing techniques help you to calm down by slowing your heart rate, stabilising and lowering blood pressure, relaxing muscles and increasing blood flow to your brain. Time spent on yoga is time away from your stresses. If you’re a novice, try a beginner’s yoga class or online programme.  

A trick of the mind A daily dose of mindfulness as recommended by the National Institute for Health and Care Excellence (NICE) can help to train your mind to change the way you see things, reducing stress and helping you to sleep. Try the Inscape or Head space Apps for a ‘healthier, happier and more enjoyable life using proven meditation and mindfulness techniques.’ If this isn’t for you, make time each day when you can relax, breath slowly and be still for a few minutes. 

You really do need to sleep to crack fatigue Lack of, or poor quality, sleep may be part of the problem. A US National Sleep Foundation study found that we need between 7 and 9 hours sleep a night. Time to develop good sleep practices to maximise your chances of achieving this. 
Try to eat at least four hours before you go to bed. Avoid screens, for at least 30 minutes before bed to help you wind down. Blue light on screens, including the little one on your phone, suppresses our production of melatonin. Use the ‘night shift’ option, if your phone has one, to see a warmer blue light. Better still leave your phone on the other side of the bedroom door. 
Take a calming bath, while burning a soothing essential oil such as clary sage or vetiver. Why not try a pillow spray we've suggested a few in our blog Love sleep? The best 5 pillow sprays to help you sleep. Sip a relaxing tea containing Valerian, a natural sedative, e.g. Pukka Night Time Tea. Make sure the bedroom is cool, dark and quiet. Ensure that bedding isn’t too heavy. If you’re still struggling to sleep and fatigue is taking its toll, sneak in a cat nap during the day, but no more than 20 minutes and before 3pm. 

Supplements worth trying for fatigue 

Valerian. A 2008 NICE survey (National Institute for Clinical Excellence) found that ‘valerian might improve sleep quality without producing negative side-effects’, although this was based on a small number of participants. 
 is used to reduce sleep disrupting hot flushes and night sweats. Not for you if you have a history of liver problems or breast cancer. 
Sage contains mild Phytoestrogen (plant-based) properties, which may help with the hot flushes and night sweats that can contribute to fatigue. 
B-complex vitamin capsules may help support your nervous system and are involved in your body’s energy production. 
Wild Nutrition have a supplement set - Women's Daily 45+ Set developed to developed to support the body's energy stores, management of the daily demands of life as well as the hormonal, physical and emotional shifts that women experience through menopause. 
A.Vogel’s Menopause Support containing isoflavines and magnesium and Vitabiotics Menopace may help to manage fatigue and underlying anxiety. We’re not sponsored, we’re just sharing. 
The 2015 NICE guidelines emphasise that the different strengths of over-the-counter brands and preparations can impact on the effectiveness of prescription drugs. If you have any underlying health issues, check with your doctor.

Alternative help for fatigue 

Aromatherapy Essential oils* work by stimulating a response in the brain’s cortex. Put 3 to 5 drops on a tissue, add to the bath or hot water to make a vapour, or use an oil burner. 
These oils may help balance your moods: 
Lavender: calming properties may help with sleep and relaxation, soothing the mind and body. Frankincense: promotes relaxation and a sense of peace, satisfaction, and serenity. Good for anxiety Ylang Ylang: helps to reduce tension and stress 
Rose: useful for relaxation. 
*The oils are strong and shouldn’t be applied directly to the skin. 
Acupuncture and traditional Chinese Herbal Medicine (TCM) TCM sees menopause symptoms in terms of Qi (energy), and works to help relieve sleep problems, tiredness and fatigue by stimulating specific acupuncture points to ease sensitivity to pain and stress, encourage relaxation and switch off your over active brain, which may be causing your lack of sleep. Try the Association of Traditional Chinese Medicine or the British Acupuncture Council to find a local practitioner. 
Homeopathy The British Homeopathic association site says ‘Many patients speak enthusiastically of the help they have received from homeopathic treatment for menopausal symptoms as various as hot flushes, profuse sweating, mood swings, irritability and sleep disturbance.’ During a homeopathic consultation, you’ll be asked a range of questions to identify the right remedy to get to the bottom of your fatigue.

When to see your doctor about fatigue 

Your fatigue may be caused by underlying health issues, or reactions to medication, and be unrelated to menopause. Speak to your doctor. 

And then there’s always HRT… 
If you are able to take HRT, it replaces the naturally occurring, now depleting hormones causing your fatigue. When these hormones are topped up many symptoms will disappear including fatigue if fluctuating hormone levels are the cause. The usual caveat here that this is something to be discussed with your doctor. There are pros and cons to taking HRT. 

And we can help 
Your Fbl Team x