What is the link between menopause and chronic fatigue syndrome, and how can I treat it?

Doctor's Answers 2

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Dr Michelle Chia

General Practitioner

I am sorry to hear that these symptoms have been so troubling for you and affecting your quality of life.

Chronic fatigue syndrome is usually diagnosed when no other medical conditions or causes can be found for a person's symptoms of excessive tiredness/fatigue. This sounds like it may be consistent with the symptoms you are going through.

Very often, chronic fatigue syndrome can affect a person's quality of life and day to day activities, which becomes very frustrating for the affected person.

To address your question with regards to the link between menopause and chronic fatigue syndrome, the relation between the 2 conditions has actually not been extensively studied as of yet.

However, studies have shown that the majority of women affected by chronic fatigue syndrome are in their late 40s to 50s, which also correspond to women in their peri-menopausal or menopausal years.

In addition, menopause itself can lead to symptoms of fatigue, tiredness, mood swings or lower energy levels due to the lower level of female hormones in the body. As such, having menopaused may in turn be an additional factor for the symptoms you are experiencing as well.

Hope this addresses your concerns and hope you feel better soon.

Regards,

Dr Michelle Chia

Menopause, also known as the change of life, is when a woman’s periods stop. When a woman has not had a period for 12 months, she is considered to have been through menopause. Menopause is diagnosed primarily by its symptoms and usually occurs between the ages of 45 and 55, with an average age of 51. As estrogen production declines, women often develop irregular periods, hot flashes, night sweats, mood swings and fatigue. These symptoms usually develop three to five years before a woman's last period — a time referred to as perimenopause.

In the months or years leading up to menopause (perimenopause), a woman may experience these signs and symptoms:

  • Irregular periods,
  • Vaginal dryness,
  • Hot flashes,
  • Chills,
  • Night sweats,
  • Sleep problems,
  • Mood changes,
  • Weight gain and slowed metabolism,
  • Thinning hair and dry skin,
  • Loss of breast fullness.

Some of the symptoms of chronic fatigue syndrome and menopause overlap: joint pain, headaches, lack of energy, depression and anxiety are present in both conditions.

Fatigue may be due to hot flashes, which interfere with sleep. Antidepressants related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs) may decrease menopausal hot flashes. A low-dose antidepressant for management of hot flashes may be useful for women who cannot take estrogen for health reasons or for women who need an antidepressant for a mood disorder. Gabapentin is approved to treat seizures, but it has also been shown to help reduce nighttime hot flashes.

The main way to manage crashing fatigue is through lifestyle changes.

First, one of the most important practice is sticking to a regular and healthy sleep pattern. During the few hours leading up to when a person goes to sleep, try not to eat heavy meals, drink caffeine, or be exposed to blue light from electronics, which interferes with melatonin secretion and our circadian rhythm. Establish a nighttime routine oftentimes helps to set the mood for sleep. Take a warm shower or a bath can be part of the routine; so can listening to soothing music, or reading short passages from a book that we have read before.

Another important tip is to partake in regular exercises at least 30 minutes a day, five days a week. To overcome fatigue, the best way is to find time to exercise regularly. Exercise is one of the best solutions for fatigue. Moderate to high-intensity exercise is associated with higher energy levels. Exercise can improve hot flashes, weight, mood, chronic pain and improve our quality of life

Third, consider practising progressive muscle relaxation, deep breathing, mindfulness exercises or meditation. To practice mindfulness, one can sit in a quiet place and close his eyes. Slowly breathe in and out, clearing his mind while focusing on his breath.

Fourth, to deal with hot flashes and night sweats from menopause, one can keep her bedroom cool. If a woman finds herself waking up every night because of night sweats, she may want to try to prepare her sleep environment before going to bed. Switching on the air con and adjusting the temperature would be good steps.

Fifth, foods to increase are those that contain phyto oestrogens: tempeh, miso, soy beans, chick peas, lentils, red clover, and linseeds. These are suitable supplements for chronic fatigue. These will cause a natural balance of hormones in the body. One may also increase the intake of foods high in essential fatty acids such as tuna, herring, anchovies, trout, nuts and seeds. These foods lubricate the joints, vagina, and skin and help lower inflammation.

Sixth, it is important to step back and reassess our priorities. Oftentimes we are overcommitted and would rush to perform our chores and fulfil our obligations, without realising that all the rushing and having a packed schedule make us feel so overwhelmed and fatigued. It will be good to learn to say no. We need to learn to say no more often. We need to be compassionate toward ourselves so that we can take good care of our physical and mental well being.

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