Endocrine and Metabolic Mechanisms Underlying Fatigue in Perimenopausal Women

Fatigue is a common and often debilitating symptom experienced by women during the perimenopausal transition. This phase, marked by significant hormonal and metabolic fluctuations, leads to complex physiological changes that contribute to persistent tiredness and low energy levels. The current paper explores the endocrine and metabolic underpinnings of fatigue in perimenopausal women, focusing on hormonal changes (including estrogen, progesterone, thyroid, and cortisol), insulin resistance, anemia, mitochondrial dysfunction, and sleep disturbances. Also highlights effective clinical interventions and management strategies to alleviate fatigue during this transitional period. A better understanding of these mechanisms is essential for clinical recognition, intervention, and improving women's quality of life during this transitional period.