Why Am I So Tired During My Period?

Why Am I So Tired During My Period?

Periods tend to bring on a slew of unwanted symptoms, outside of the obviously unwelcome bleeding. Lower energy levels are one of them, and when paired with cramps, they can really put a damper on your day. Period (or PMS) fatigue can make you want to crawl back into bed, turn on Netflix and reach for your favorite comfort food – but that’s not necessarily the best plan to help you get through it. Let’s talk about why your energy levels tank during your time of the month, and how you can learn to combat fatigue and power through.

What’s the Deal? 

During the second half of the menstrual cycle, around the time women start experiencing symptoms of PMS, estrogen levels peak and then fall quickly – causing you to feel tired or sluggish. In the last week (during your period), estrogen levels will continue to fall, carrying this unpleasant feeling through the end of your cycle.1

Other culprits could be iron deficiency related to your period, stress, unhealthy eating habits, or the obvious answer, lack of sleep. The CDC recommends more than 7 hours of sleep each night2 – so if you’re getting less than that, more sleep might be the key to a more manageable time of the month.

If your flow feels abnormally heavy, or you have symptoms that just feel like they have to be something more, it’s possible there are other reasons at play too, like uterine fibroids or abnormal uterine bleeding (AUB). These are known causes of heavy menstrual bleeding that could cause some of the symptoms mentioned above. And the fact is, they’re also pretty common. 70% of women have uterine fibroids, and 80% of African American women will develop fibroids by the age of 50.3 However, not all women experience fibroid symptoms, which include stomach and pelvic pain, anemia, frequent urination and other debilitating symptoms that could lead to physical exhaustion, which makes it even more important to talk to your doctor if you feel like you’re experiencing an unusually heavy flow.4  

What Can I Do? 

Your first instinct for dealing with period fatigue may be to close your eyes again, but that might only make the situation worse. Physical activity can actually increase your energy levels and boost your mood. Try taking on a new workout with a friend to help keep your energy up or keep track of your physical activity in a fitness journal. Hormonal birth control can help to regulate these hormones, and while your hormones will still rise and fall, the symptoms may be less noticeable, just be sure to talk to your doctor before taking a hormonal therapy.1 Also, we know sluggishness and cramps can make you crave those salty and sweet treats – but be sure to eat nutritious foods and drink plenty of water during your period. Dehydration is a common contributor to low energy levels, so make sure you are tracking your water intake too.

What if it’s Not That Easy? 

Extreme fatigue, pain, or heavy bleeding during your period that causes you to stay home and skip out on daily activities could indicate something more serious. If you’re experiencing extremely low energy levels in addition to other symptoms, like heavy or prolonged bleeding, symptomatic uterine fibroids or AUB could be the underlying conditions causing these symptoms and that low-energy feeling. 

Luckily, there are some treatment options to consider with your doctor if some of the more holistic recommendations haven’t worked for you and the symptoms of your period are affecting your quality of life. For example, medical procedures such as, intra-uterine tissue removal procedures and laparoscopic radiofrequency ablation, both of which require little to no incisions, are treatment options for women experiencing the disruptive symptoms of fibroids. Furthermore, there are other safe and effective options for women who are finished having children. For more information and to learn more, check out the resources listed below: 

Laparoscopic Radiofrequency Ablation (Lap-RFA)

Lap-RFA is a minimally invasive procedure that delivers heat directly into a fibroid in order to destroy its tissue and relieve symptoms. It addresses fibroids in most locations and may provide relief from heavy periods and bloating symptoms.5 The procedure recovery time varies but is most frequently between 4-5 days.6

Intra-uterine Tissue Removal

An intra-uterine tissue removal procedure is a uterine sparing procedure that removes fibroids, polyps and other intrauterine tissue. The typically outpatient procedure is minimally invasive and is administered through the body’s natural openings (i.e. through the vagina).7 

Endometrial Ablation

Endometrial ablation is a one-time, five-minute procedure that can safely and effectively reduce or eliminate heavy menstrual bleeding. The minimally invasive procedure removes the uterine lining and is appropriate for women who are finished with childbearing and desire relief from heavy bleeding.8 

Talk to an OBGYN in your area about your symptoms of abnormal uterine bleeding and potential treatment options that might be right for you.


  1. Physical activity and your menstrual cycle. Office on Women’s Health. U.S. Department of Health & Human Services. https://www.womenshealth.gov/getting-active/physical-activity-menstrual-cycle.
  2. “How Much Sleep Do I Need?” Sleep and Sleep Disorders. Centers for Disease Control and Prevention. https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html.
  3. Baird DD, Dunson DB, Hill MV, Cousins D, Schechtman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003; 188:100—107.
  4. Mayo Clinic—Uterine Fibroids—www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288
  5. Acessa ProVu Instructions for Use, ProVu Users Guide PL-01-0040
  6. SG Chudnoff, et al. Outpatient Procedure for the Treatment and Relief of Symptomatic Uterine Myomas. Obstetrics and Gynecology, 2013;121(5):1075-82.
  7. McIlwaine P, McElhinney B, Karthigasu KA, Hart R, A Prospective Study of the Use of the MyoSure Resectoscope to Manage Endometrial Polyps in an Outpatient Setting. The Australian and New Zealand Journal of Obstetrics and Gynaecology. October 2015.
  8. NovaSure Instructions for Use.