Perimenopause - extreme fatigue

Posted by soph77 @soph77, Oct 16, 2023

Hi everyone,
I am 46 and although my cycle is still regular, I am having some issues that I think may be related to perimenopause. I had an episode this weekend where my body and muscles were so tired and weak that I felt like I would just collapse (I didn't - I could still function but it just felt that way). I was so freaked out that I think I also had an anxiety attack. I ended up going to ER but they found nothing wrong.
Last week I spoke briefly to my doctor about perimenopause. One of the things that came up was possible sleep disturbances which of course leads to tiredness. But this seemed extreme to me. Wondering if anyone has experienced extreme fatigue. I have a follow up appointment with my doctor and I will bring this up.
Thank you

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annewoodmayo | @annewoodmayo | Oct 17, 2023

Hi Soph77,

Extreme fatigue can be caused by a lot of things. Some are simple and some are complicated. Your doctor will probably start with ruling out the simple ones, like diet, sleep, stress level and activity level. Before your appointment, you may want to think carefully about these factors.

Is there a specific reason that you think this is connected to perimenopause? If you have a specific reason, be sure to tell the doctor, but there are a lot of other possibilities, too, and the doctor may want to pursue them first.

This is just a suggestion. Before you go to the doctor, think really carefully about what exactly happened before and during the episode before the ER visit. Write it all down. Tell the doctor. Let the doctor figure it out, and give you some initial suggestions. If the doc suggests stuff that you have already done, you might want to be really clear and insistent that you did it already so that is no longer a possibility.

Since you went to the ER about it, you must feel that it is really unusual for you. Try to make this clear to your doctor, but the doc may still offer simple first steps anyway, which may make you feel "brushed off." But it is where the doctor needs to start, so that he can rule out some factors.

So, I suggest that you follow all of the initial instructions (no matter how stupid they may seem), keep a written log to show the doc that you have followed the initial instructions. If they don't work, then the doc should come up with some additional steps. Maybe they will work and you will feel better.

It is important to work with the doctors when you have a symptom that can have a lot of causes, like fatigue.

Hopefully the doc will order up some blood work that can help clarify the cause.

Sorry this got so long and sounds so bossy. Best of luck!