If you’re tired all the time — and not the kind of tired that a decent night’s sleep sorts out — it might be more than just a busy life or poor rest.
A constant, bone-deep exhaustion is one of the most common symptoms women experience during the run-up to menopause. It’s called perimenopause fatigue, and if it’s something you’ve been feeling, you’re not on your own.
This isn’t about feeling a bit run down. It’s that creeping heaviness that makes simple things feel like hard work. Some days, you might feel like you’re wading through mud. Others, like your brain just isn’t firing properly. It can show up gradually or knock you sideways out of nowhere. And unfortunately, it’s often brushed off by GPs or labelled as being “just a bit stressed.”
Let’s break down what’s really behind this kind of fatigue — and more importantly, what you can do about it.
Perimenopause Fatigue: Why It’s So Draining
Your hormones are shifting during perimenopause — sometimes gradually, sometimes in unpredictable spikes and crashes.
The ones most involved in your energy levels are oestrogen, progesterone, cortisol, and even testosterone. When these hormones fall out of balance, your body and brain can struggle to keep up.
Oestrogen plays a part in mood and sleep regulation. Progesterone helps calm your nervous system and promotes deep rest. If those drop — and they usually do in this stage — it gets harder to feel rested or alert. You might start waking at 3 a.m., unable to get back to sleep. Or you might be sleeping longer but still waking up exhausted.
Your stress response can also get pushed into overdrive. Cortisol, your main stress hormone, can become elevated in response to low oestrogen, keeping your body stuck in a fight-or-flight mode. This leaves you feeling wired and tired at the same time.
And low testosterone — yes, women have it too — can make you feel flat, foggy, and physically weaker than usual.
And Let’s Not Forget the Perimenopause Bloating…
If you’re also feeling constantly bloated during this time, it’s no coincidence.
Perimenopause bloating is another side effect of hormonal fluctuations, especially changes in oestrogen and progesterone. These hormones help regulate fluid balance and digestion, so when they’re not working properly, you might notice uncomfortable swelling around your midsection or sluggish digestion.
This type of bloating can add to the perimenopause fatigue. Your body is using more energy just to digest food or manage inflammation — and you’re left feeling drained.
Why You Need a Proper Perimenopause Blood Test
You might already suspect your hormones are the problem, but getting answers through your GP can be frustrating. Many women are told they’re “too young” for menopause testing or are sent away with vague advice to “wait and see.”
At BioID Health, we do things differently. Our perimenopause blood test doesn’t rely on guesswork or rough age estimates. It’s a detailed look at what your hormones are actually doing.
We check:
This gives us a much clearer picture of what’s driving your perimenopause fatigue — and what needs to be rebalanced.
You won’t be left trying to figure it out alone, either. Once your results are in, a doctor will talk you through them and build a treatment plan based on your actual levels — not a one-size-fits-all approach.
How Bioidentical HRT Can Help With Perimenopause Fatigue
If your blood test shows that your hormones are out of balance, there are options.
The NHS can offer hormone replacement therapy, but what they provide is usually a standard dose using synthetic hormones or ones derived from animal sources. That can work for some people, but not for everyone.
At BioID, we use bioidentical HRT — which means the hormones are structurally identical to the ones your body naturally makes. They’re typically made from compounds found in plants (like Mexican yam) and are carefully adjusted to match your needs.
Here’s why that matters:
Instead of being handed a generic prescription, you get a treatment designed around your biology.
Why Going Private To Treat Your Perimenopause Fatigue Might Be the Better Option
Let’s be honest — most GPs are doing their best under pressure. But with tight appointment times and limited testing options, it’s not always possible to get the help you need. You might be told your symptoms are “normal for your age” or offered antidepressants when the real issue is hormonal.
At BioID, we listen. We test properly. We treat what’s really going on.
You won’t need to chase referrals or fight to be taken seriously. From the moment you complete your symptom checker, everything is handled for you — including at-home blood tests, remote consultations, and home delivery of medication if treatment is needed.
How It Works
1
Complete our Symptom Checker This helps us understand what you’re experiencing before any testing.
2
Perimenopause Blood TestWe arrange for you to visit a local, qualified phlebotomist. Alternatively, you can have the blood draw completed in your own home.
3
Doctor Review and Consultation Your results are reviewed by a specialist who explains what’s going on.
4
Tailored Bioidentical HRTIf treatment is recommended for your perimenopause fatigue, your hormones will be prescribed based on your exact needs.
5
Ongoing MonitoringYou’ll have regular follow-ups to check your progress and adjust if needed.
Perimenopause Fatigue Doesn’t Have To Be The Norm
Perimenopause can be relentless. But just because you’re not in full menopause yet doesn’t mean you should be left to struggle through. If perimenopause fatigue is making it harder to cope with everyday life, it’s time to get answers — and support that actually works.
We’re here to help you figure out what your body is missing — and get it back on track.
Ready to take the first step? Book your perimenopause blood test or request a callback to speak with someone who understands.
