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Tired, but trying to "push through?"

Sarah asks: 49, perimenopause. I used to be able to push through anything but this fatigue is unbearable.

My reply: I'm so glad you asked this question because ❶ it means you're asking for help (too many try to solve fatigue and exhaustion on their own!) and ❷ talking about fatigue is the perfect follow-up to our “Sleep is the Best Medicine” conversation from last week!


The work that I do at Menopause Chicks involves unpacking a lot of misconceptions--including some societal misconceptions about “feeling tired.” Let's start there. Especially because you used the phrase “PUSH THROUGH.” 


Feeling fatigued is not a badge of honour!



  • You are not tired all the time “because you are a woman.”

  • You are not tired all the time “because you are getting to that age.”

  • You are not tired all the time “because of menopause.”

I'm happy you reached out so you can learn the possible reasons behind your fatigue/exhaustion, and then get to work on a plan that will be right for you! 


(Too often, women try to “push through” their fatigue and as we are about to find out, that can mean missing or overlooking important health conditions.)


1️⃣ Iron Deficiency: Iron deficiency anemia is one of the most common nutritional deficiencies in women, causing things like fatigue, brain fog, cold intolerance, hair loss, and sometimes, not having enough energy to even climb a flight of stairs! Important for you to note is this: anemia is diagnosed when ferritin (measurement of iron stores in our blood) falls below 25. But fatigue is experienced when ferritin levels are 50 or below. My doctor says 90% of her patients are iron deficient. It is particularly common in women who still have a period and those who eat primarily a vegetarian diet. I assume you still have a period, so please check your most recent blood work, or request a ferritin test (simple blood test your doctor requisitions) and choose a quality iron supplement (one that does not cause stomach upset or constipation.) Note: a physician is required to requisition the ferritin test; a physician is not required to supplement iron.


2️⃣ Thyroid: Conversations about perimenopause, menopause, and postmenopause can get so focused on some areas (hot flashes, for example) that thyroid health is overlooked. I'm working hard to change that! Look at any list of common experiences associated with thyroid conditions and you will see fatigue and exhaustion on the list. Along with your fatigue, if you are also experiencing cold hands & feet, inability of lose weight, dry skin, hair and nails, poor concentration, constipation or muscle aches, be sure to investigate thyroid with your primary care provider. 


3️⃣ You're carrying the weight of the world at home, with your children, with your aging parents, at work, in your community. I don't know what to say except now is an excellent time to get curious about stress (cortisol) levels, to practice putting your own name at the top of the to-do list (I know this is easier said than done but YOUR HEALTH is WORTH IT!) I realize you have already started to do that by posting this question today! I want to remind all of us reading along: there is no “trophy” for pushing through fatigue; sometimes fatigue is a “tap on the shoulder” from our body--alerting us that something even more serious requires our attention. What if there could be a trophy (i.e. your current & long-term health!) for investigating and asking for the support you need!


4️⃣ Do you have insomnia? Are you experiencing difficulty falling asleep? Staying asleep? Waking too early?…and then having your quality of life (i.e. productivity at work, relationship conflct, mood swings) diminished the following day? Answering yes to any of these four questions qualifies as a definition of insomnia. Explain to your health care provider just how important your sleep health and energy levels are in order for you to function, and ask for support.


Please circle back and let me know what you learn after investigating iron, thyroid health & insomnia.



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