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Why Are You So Tired All the Time? Sleep, Stress, Menopause...or Something Else?
Updated: Sep 17
If you’re getting what seems like enough sleep most nights but still feel drained, foggy or unlike yourself, it may be time to look beyond stress and menopause.
Have you ever had one of those stretches where you’re technically functioning, but you just don’t feel like yourself?
You’re tired. Your brain feels foggy. Concentrating takes more effort. You want to lie down, not necessarily because you need to sleep, but because doing absolutely nothing sounds glorious.
And maybe the weirdest part is that you actually had a decent night’s sleep.
In midlife, it’s easy to explain fatigue away:
It’s menopause.
I’m stressed.
I’m not getting enough quality sleep.
I’m getting older.
Sometimes one of those things absolutely is the explanation.
But not always.
After more than 20 years in fitness, health and wellness, I’ve learned something important:
When you consistently don’t feel like yourself, don’t get so attached to one explanation that you stop asking questions.
Feeling tired all the time is a symptom, not a diagnosis
Fatigue and brain fog can come from poor sleep, chronic stress, menopause, nutritional deficiencies, medications and medical conditions. Several of these can produce similar symptoms.
For women in midlife, menopause can become the convenient bucket we throw everything into. A 2024 position statement from the European Menopause and Andropause Society highlighted that menopause and thyroid disorders can present with overlapping symptoms, creating diagnostic challenges.
That doesn’t mean your thyroid is causing your fatigue.
It means we shouldn’t automatically assume menopause is causing it either.
Being exhausted can affect what you want to eat too. Research on sleep deprivation suggests that when we’re tired, highly rewarding, energy-dense foods can become more appealing. That can mean things like sweets, chips, pastries and other highly processed foods suddenly sound a lot more exciting than the salmon and broccoli you planned.
So if your cravings feel louder when you’re exhausted, it may not simply be a lack of willpower.
Low iron isn’t only a period problem
A 2025 review in the Canadian Medical Association Journal highlighted that iron deficiency can cause fatigue, brain fog and reduced cognitive function even without anemia. Your hemoglobin can still be normal while your iron stores are low.
During perimenopause, low iron may be easier to suspect. A 2025 study of more than 2,300 midlife women linked heavy or prolonged menstrual bleeding during the menopause transition with greater fatigue.
But what about after menopause?
I think many of us naturally assume:
“Well, I don’t menstruate anymore, so low iron probably isn’t my problem.”
A good friend of mine in her late 50s thought exactly that. She’d been tired for a long time and hadn’t had a period in years, so iron wasn’t high on her list of suspects.
After a lot of investigating with her healthcare providers, she discovered her iron was so low she needed an iron infusion.
Menopause removes one common source of iron loss, but iron deficiency can still happen. If it does, it’s worth having your healthcare provider investigate why rather than simply treating it yourself.
Please don’t read this and run out to buy iron supplements.
I’m not a doctor, and this article is not medical advice.
The message is simple: if you consistently feel lousy, tell your healthcare provider.
I’ve learned not to marry one explanation
My own body has taught me this lesson more than once.
I’ve had bloodwork show that my iron was low. I followed my doctor’s recommendations, my levels improved and I felt like myself again.
I’ve also dealt with low vitamin D.
Living in Canada, I knew vitamin D mattered, but I used to get more casual about my supplement in summer.
Sunshine! Problem solved!
Except apparently my body had not signed that agreement.
Health Canada recommends that adults 51 and older take a daily supplement containing 400 IU of vitamin D throughout the year. Individual needs can vary, so I follow the advice of my own healthcare professionals.
Then, about a year and a half ago, I went through another period of fatigue.
My bloodwork looked fine in the areas we’d been watching, but my blood glucose had crept higher than normal for me. I wasn’t diabetic or prediabetic, but my doctor wanted me to watch it.
I changed a few things about how I ate, mostly the order in which I ate my food and pairing carbohydrates with protein or fat rather than regularly eating them on their own.
Later, my glucose was back within my usual range and I felt dramatically better. It was a huge game changer for my energy, and I stopped feeling like I needed a nap every day at 3 p.m.
Can I prove the slightly higher glucose caused my fatigue?
No.
My body is not a clinical trial.
What mattered was that I kept paying attention.
More recently, brain fog and low energy showed up again. I blamed stress, and there had been a LOT going on.
But as things settled, I still didn’t feel right.
So I got curious again.
It had been a while since I’d had bloodwork done, and vitamin D came back onto the radar.
I’d become inconsistent with my supplement again without realizing how inconsistent.
Same woman. Similar symptoms. Different possible explanations.
That’s why I’m no longer willing to automatically say:
It’s stress.
It’s menopause.
I didn’t sleep well.
I’m just getting older.
Maybe.
But I’m going to stay curious.
My “I Don’t Feel Like Myself” checklist
I’m making this list for myself. Feel free to screenshot it, print it or stick it on your fridge beside that grocery list you’ve been ignoring since Tuesday.
When I consistently feel off, I’ll ask:
How am I sleeping?
Am I getting enough quality sleep? Am I waking too frequently?
How stressed or overloaded am I?
Has life genuinely been unusually demanding? If the stress has eased, have my symptoms eased too?
Am I eating and hydrating enough?
Am I drinking enough water and regularly eating nourishing meals with adequate protein and a variety of foods?
If supporting steadier blood sugar is something I’m paying attention to, am I generally pairing carbohydrates with protein or fat and, for most meals, eating vegetables, protein and fat before the more carbohydrate-rich part of my meal?
What is happening hormonally?
Have my menopause symptoms changed, or am I experiencing something new?
Have my medications or supplements changed?
Did I start something new, stop something or become inconsistent with something my healthcare provider recommended?
Have I been sick recently?
How long has this been going on?
A few exhausted days after a ridiculous week are different from weeks of unexplained fatigue and brain fog.
Is it time to talk to my healthcare provider?
Depending on your symptoms, history and risk factors, your healthcare provider may decide that iron and anemia, thyroid function, B12 or folate, blood glucose or A1C (a measure of your average blood sugar over the previous few months), vitamin D, medication side effects or something else are worth investigating.
Persistent symptoms are a reason to have a conversation.
I’m also going to keep a simple record of when I last discussed these things with my doctor and what was tested.
Because “I’m pretty sure we checked that recently” is not a particularly sophisticated health-record system.
Chase the feeling
This is a weight-loss and healthy-habits blog, but here’s what I really want for you:
I want you to feel good.
Of course I want you to be strong, move your body, nourish yourself well and reach a weight where you feel healthy and comfortable.
But you can look fantastic and still feel like crap.
And who gives a fuck how toned our arms or abs are if we don’t have enough energy to enjoy our lives?
I want you to have energy to walk, travel, lift weights, dance, laugh with your friends and say yes to things because your body feels capable of doing them.
And yes, when you have more energy, the habits that support a healthy weight often become easier.
But even if feeling better didn’t change the number on the scale by a single pound, feeling better would still be worth pursuing.
So when your body keeps telling you something feels off, listen.
Don’t panic. Don’t try to diagnose every symptom yourself with ChatGPT, Claude, Gemini or Dr. Google. And don’t start swallowing every supplement mentioned in an Instagram Reel.
Get curious. Keep track. Have the conversation.
Chase how you want your life to feel first.
When you have more energy and feel good, taking care of your body becomes easier.
Those louder cravings for highly rewarding foods may settle down too. The cookies, chips and pastries don’t necessarily disappear from your life, but they may stop feeling quite so magnetic when you’re not running on empty.
That can make it easier to naturally eat a little less overall, creating the small calorie deficit needed for fat loss without having to obsessively count every calorie.
And looking healthy and fit can become a lovely side effect, rather than the whole damn point.
Is something making healthy habits harder than they need to be?
Low energy may be one piece of the puzzle. Stress, your environment, rigid expectations and the way you respond when things don’t go perfectly can make sustainable weight loss harder too.
Take my free five-minute quiz, What’s Actually Blocking Your Weight Loss?, to discover the roadblock that may be getting in the way of losing weight without dieting.
Prefer to talk it through with me?
Keep reading
If the stress and overload part of this article sounded a little too familiar, read Stuck in Go-Go-Go Mode? This Might Be Why Weight Loss Feels So Hard next. It explains how living in constant go-mode can make healthy habits and sustainable weight loss feel so much harder.
