During your menstrual cycle, your hormone levels fluctuate considerably. Two weeks before your menstruation, estrogen production decreases. It reaches its lowest point just before your menstruation. Your level of progesterone also decreases drastically in the week prior to menstruation. You may feel tired and apathetic due to low hormone levels. In the meantime, your body is working hard to regain its balance, leaving you with less energy for your normal daily life.

The quality of your sleep may be adversely affected around menstruation.1 Retrospective surveys and studies, including subjective reports using diaries, found that women across a wide age range (18–50 years) report more sleep disturbances during the premenstrual week and during the first few days of menstruation than at other times

Fatigue from heavy bleeding and anemia

Fatigue can also arise due to severe or prolonged menstruation. If you lose a lot of blood, you can experience iron deficiency or anemia. 30% of women of reproductive age worldwide are anemic. 2 Iron deficiency anemia is the most common type of anemia worldwide. Excessive menstrual bleeding is the most usual cause of iron deficiency anemia.3 Your body needs iron to make hemoglobin. Hemoglobin carries oxygen to the red blood cells. Without adequate iron, your body can't produce enough hemoglobin for your red blood cells.4 As well as fatigue, other symptoms of anemia can include: feeling weak and lacking in energy, pale or yellowish skin, irregular heartbeat, shortness of breath, dizziness or lightheadedness, chest pain, cold hands and feet and headache. 4 If you think you may be anemic, ask your physician to check for you.

Fatigued and tired? Take good care of yourself

Fatigue can have a significant impact on your daily life and your mood. You can do a lot to help yourself by making some changes to your lifestyle. Take particularly good care of your body. Rest regularly, make sure you get plenty of exercise and eat healthy foods.

Because of the monthly blood loss, women need more iron than men.2 The following foods are rich in iron: spinach, broccoli, lentils, cauliflower, beets, Chinese cabbage, sesame seeds, cashew nuts and dark chocolate.

Drink plenty of water, at least one and a half litres per day. Your body needs water for nearly every process and function. If you don’t drink enough water, you'll tire more rapidly.

Do some exercise. Particularly when you're feeling tired or apathetic. Exercising increases the bloodflow to your muscles. It will also help you rest and sleep well, which is important for restoring your energy.

Stay away from sugars and processed foods. When you're tired, they offer an immediate boost but numerous studies show that processed and sugary foods cause extreme fluctuations in your blood sugar levels.5,6 Energy levels can crash after a sugar high. If you're tired, opt for healthy fats instead. Eat a handful of raw nuts or half an avocado instead of sugary carbohydrates.

Reduce stress. Stress burns energy and leaves you exhausted. Can't make changes to your busy schedule? Then make sure you build in restorative activities, doing something positive for yourself as often as you can. Participate in a sport you enjoy, meditate, do yoga or practice mindfulness techniques which can help you deal with stress.


1. Baker,F.C.and Driver,H.S. Circadian rhythms, sleep, and the menstrual cycle. Sleep Med. Vol 8, 613-622 (2007)
2. WHO | Intermittent iron and folic acid supplementation in adult women and adolescent girls. at http://www.who.int/elena/titles/iron_women/en/
3. BJ, C. & Y, G. Anemia and menstrual blood loss. Obstet. Gynecol. Surv. 35, (1980).
4. Symptoms and causes - Anemia - Mayo Clinic. at http://www.mayoclinic.org/diseases-conditions/anemia/symptoms-causes/dxc-20183157
5. O’Keefe, J. H., Gheewala, N. M. & O’Keefe, J. O. Dietary Strategies for Improving Post-Prandial Glucose, Lipids, Inflammation, and Cardiovascular Health. J. Am. Coll. Cardiol. 51, 249–255 (2008).
6. Westman, E. C. et al. Low-carbohydrate nutrition and metabolism 1 – 3. Am. J. Clin. Nutr. 86, 276–284 (2007).

Tip: Nutri-Gyn MenstruComfort helps you to maintain a comfortable menstruation.