Midlife is a season where so much is happening all at once. Many of us are deep in it with our families, careers, relationships, and all the things that fill our days. We squeeze in travel, date nights, and time with friends, and it can feel like a lot, even on a good day.

Enter midlife fatigue.

So what happens when you hit perimenopause and suddenly you are fatigued, and you’re not sure why? Maybe you wake up in the middle of the night for no reason, which is new for you. Or even when you sleep through the night, you still wake up feeling like you could fall asleep standing in line at Target.

This is incredibly common for women in midlife, and not all of it can be blamed on our busy schedules. Of course, sometimes we do need to slow down and ask ourselves, “Do I actually need to do this thing right now?” But often, fatigue isn’t just about how much you are doing. It’s about what’s happening inside your body.

Spoiler: it’s the hormones.

Estrogen and testosterone play a big role in our energy and mood. When they start to shift, whether they are steadily declining or fluctuating wildly as estrogen does in perimenopause, your body feels it. Those rapid changes can leave you completely drained both physically and emotionally.

This stage of life is really about learning balance. You can still aim high. You can still chase big goals. Gone are the days of being “put out to pasture.” But every yin has its yang, and that means you also need time to unplug, recharge, and decompress.

Your body and mind need recovery, and that looks different for everyone. The key is tuning in to your inner voice and your body when it tells you that you need rest. You are not falling behind by taking a break. In fact, it is the opposite. The time you give yourself to rest and reset is what restores your energy, focus, and vitality for whatever comes next, whether that’s your workout, your career, or your relationships.

And here’s something that is often overlooked: get your testosterone tested.

It naturally declines with age and can be a sneaky reason for low energy, poor focus, and that general “blah” feeling. It’s also worth taking a close look at your sleep. If you are not sleeping well, it’s time to talk to a professional and explore every possible way to improve it. Sleep is not a luxury. It is a foundational part of your health.

Midlife is an exciting and transformative time for women. We are finally coming into our most authentic selves. But to show up as the healthiest, strongest version of you, it’s time to honor your body’s need for balance, because that is where your real power lives.

I’m Dr. Jordens, a board-certified osteopathic physician in Family Medicine and Obesity Medicine, and certified by The Menopause Society.

I founded 1988 to offer something different: personalized, evidence-based care for women in midlife. Care that validates your lived experience, supports your body, and honors your whole self—because women deserve care that meets them where they are.

Dr. Tess Signature

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