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Feeling Exhausted During Your Period? Here's Why—And What To Do, According To Doctors
Even if you're not relying on a trusty cycle tracker, everyone has their sure-fire signs that their period is about to begin. Maybe you get a breakout or start to feel more sensitive. Me? I start to feel fatigue.
I'm not alone; 71 percent of women report feeling tired during their period, according to a study in the American Journal of Obstetrics and Gynecology—and that only makes up one part of fatigue.
Feeling fatigue during your period actually isn't all that surprising if you think about it; your body is doing a lot of work. 'The energy required for menstruation—uterine contractions and shedding of the uterine lining—can contribute to fatigue,' says Kelly Culwell, MD, an ob-gyn and nationally renowned women's health expert. Plus, the very hormones that are changing in your body might cause increased exhaustion, as might those other symptoms you're feeling like cramping, headaches, or difficulty sleeping.
Understanding the causes of your period fatigue and related symptoms can be helpful—especially if your low energy is interfering with your everyday life. And if your fatigue persists month after month, it could be worth a visit to your provider. Ahead, medical experts define the causes and symptoms of period fatigue, what to do about it, and when to see a doctor.
Meet the experts: Kristin Markell, MD, is an ob-gyn based in Springdale, Arkansas. Kelly Culwell, MD, is an ob-gyn and former medical officer for the World Health Organization (WHO).
Don't underestimate how tiring simply getting a period can be. All those symptoms you have to deal with month to month like cramps, headaches, or even just bleeding can all contribute to overall fatigue, says Dr. Culwell.
What to do about it: Start by treating your period symptoms. That means using over-the-counter meds for pain management for cramps. Plus, although you may not feel super motivated to work out, staying active may actually help boost energy levels (and help you find relief) during your period, says Dr. Culwell. Regular exercise has been associated with a reduction in physical and psychological symptoms of PMS, per a review done by researchers at Ohio State University. 'Although it may sound counterintuitive, trying to get exercise and some time outside each day can help improve mood and sleep, both of which can help improve symptoms of fatigue,' she says.
Fatigue during your period could also simply be due to the normal hormone changes that occur throughout a cycle, Dr. Culwell says. 'The drop in the hormones estrogen and progesterone just before menstruation can lead to decreased energy and depressed mood,' she says.
So, for some people, fatigue is a period symptom.
What to do about it: Do what you can to support your hormone health, including getting a good night's rest, eating a healthy, varied diet, and staying active—even though it can be hard to do so when you're getting your period. 'It's almost like a loop where you're less active and so you are actually more fatigued, but then you don't want to be more active because you're fatigued,' Dr. Culwell says. But you don't have to do a full 60-minute HIIT workout. Going for a leisurely walk should do the trick. If you notice that any efforts you may take aren't improving your fatigue, it may be time to seek additional support from a doctor who can advise on next steps.
It's completely normal to have a light period on some days and a heavy one on others. That said, people who consistently have a heavy flow may experience low energy and fatigue more often, says Kristin Markell, MD, an ob-gyn. That's because heavy bleeding means losing more iron. Fatigue and iron deficiency are more common for women who experience heavy bleeding, per a study published in Haemophilia.
Though it's not necessarily always a cause for concern, heavy bleeding might be a sign of something more serious, Dr. Markell says. If you notice common symptoms of anemia like lethargy, weakness, chest pain, changes in your skin complexion, trouble regulating your temperature, or an irregular heartbeat, you might want to speak with your doctor, Dr. Markell says.
What to do about it: If low iron is behind your period fatigue, the first step is talking to your doctor, who can order blood work to get to the bottom of your levels. While some level of iron loss is normal during menstruation, if you are losing a lot of blood—and experiencing symptoms like fatigue—you should get it checked out. After that point, you might be recommended dietary tweaks, an iron supplement, or an iron infusion to get you back to a good place.
'Lack of sleep—either due to other menstrual symptoms or hormonal changes—can also cause fatigue,' says Dr. Culwell. And, you guessed it: your period can totally mess with your sleep. The menstrual cycle can cause changes in your circadian rhythm, interrupt your sleep cycle and even give you bad dreams, according to a study in Sleep Medicine Research. One reason why? Your basal body temperature changes at different points in your cycle, affecting how well you catch those Zzzs, per a study in Physiological Reports.
What to do about it: Getting proper rest may seem like an obvious way to combat period fatigue, but quality sleep isn't always possible for everyone—especially if your fatigue is consistent and lasts days on end. Small habit changes can help, though, like taking a power nap during your lunch or pulling back on high-intensity workouts while on your period. You can also go to your doctor to talk about other options, like cognitive behavioral therapy or medications.
There are a few more serious conditions that might result in increased fatigue during your period—but it wouldn't be the only symptom you experience, says Dr. Culwell. Endometriosis and fibroids are two conditions that can cause fatigue because they cause pain and heavy bleeding.
It's also common for women to experience thyroid conditions, particularly hypothyroidism, which can impact fatigue too.
What to do about it: If you experience heavy bleeding—as in, you go through a pad or tampon or pad in just an hour for multiple hours—go see your doctor. They can evaluate you for a number of conditions.
When To See A Doctor
Period fatigue isn't always a sign of something serious, but if your efforts to treat it with things like diet changes or pain management don't provide relief, it may be time to see a doctor.
Consistently experiencing extreme exhaustion and very heavy bleeding may be signs of anemia, and both Dr. Markell and Dr. Culwell recommend that you see a doctor if you suspect this might be the case. 'If you have heavy menstrual bleeding or fatigue plus other symptoms like weakness, lightheadedness, headaches, or decreased exercise tolerance, you should see a healthcare provider to be evaluated for anemia,' Dr. Culwell says.
The mental impact of period fatigue is worth noting, too. If you have extreme fatigue and worry you may have PMDD, tracking your symptoms can help since diagnosis requires a very specific set to be present, says Dr. Markell. Symptoms may include increased sensitivity to rejection, feeling tense or on edge, diminished interest in your usual activities, feeling overwhelmed or out of control, and sleeping too much (or not enough), among others. If you're concerned and noticing several of these symptoms, make an appointment with your doc for an evaluation.
'If fatigue symptoms are consistently affecting your quality of life and significantly changing your day to day activities, a visit with your healthcare provider is a good idea,' Dr. Markell says.
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