Are you just plain exhausted throughout your day even when you get a good night’s sleep? Do you feel constantly stressed out? Out of control? Losing your swagger, confidence and motivation? Are headaches slowing you down? It’s tough to find joy in life when everything you do throughout your day has begun to feel like a “chore”. Patterns of feeling constantly stressed out with no energy leave many women feeling depressed and wondering “is this really what life is all about?”.

At Wine, Women and Hormones®, we have talked with literally thousands of women who have simply lost their “Joie de vivre” and cannot seem to break the cycle of constant exhaustion and lack of energy. Let’s be clear: there is a big difference between “being tired” and existing in a state of “chronic fatigue”. We all get tired. Sometimes a rough night of not sleeping due to a stressful incident at home or work can cause us to not sleep and leave us feeling tired and lethargic during the day. Moreover, a woman can suffer from “constant fatigue” even if she sleeps well at night!However, when a woman is consistently overwhelmed with a sense of fatigue that causes exhaustion from the moment she wakes up in the morning day after day, there’s a bigger problem to address.

The good news is relief is on the way as patterns of constantly feeling stressed and exhausted (even with proper rest) can be a sign of internal imbalances that often can be corrected with proper testing of hormonal, adrenal and thyroid systems.


Testosterone is important in women as it influences an overall sense of well-being and energy level. When testosterone is balanced it boosts self-confidence, energy and motivation. It increases a woman’s ability to build muscle. Testosterone strengthens libido and the ability to climax.

Hmmm…better morale, strength and sex? It’s no surprise testosterone is a big part of managing stress and mitigating chronic fatigue.


Lowered levels of progesterone may decrease sex drive while increasing anxiety and depression. The result: an overall less optimistic outlook on life resulting in more stress and chronic fatigue.

Got headaches? It’s tough to be on your game and enjoying life when I bad headache persists. Imbalanced progesterone levels might be the culprit. Headaches can occur when progesterone levels fluctuate and hit extreme lows. “Hormonal headaches” are unpredictable and may come on suddenly. Women who have previously never experienced ongoing headaches may start suffering on a regular basis during perimenopause when progesterone levels become most unpredictable.


“I’m just so stressed out!” Let’s face it. It’s crazy out there. Most of us are wishing there were more hours in the day to get all we want to get done. These stressed out feelings activate the “fight or flight response” which is physiologically a huge plus if being chased by a tiger, but not so great when it becomes our daily way of life.

Constant stress can to high cortisol levels, adrenal fatigue and complete exhaustion! Adrenal fatigue (aka adrenal imbalance, adrenal dysfunction, “adrenal exhaustion,” or “adrenal burnout”) occurs when the adrenal glands are putting out the wrong levels of stress hormones—either too much or too little—in relation to the amount that’s actually required. This disparity can really mess with your sleep.

Your sleep patterns can help assess your adrenal function.

Overactive adrenal symptoms:
• Trouble winding down while trying to fall asleep
• Trouble staying asleep; wake frequently

Balanced adrenal symptoms:
• Relaxed and pleasantly tired at bedtime
• Sleep throughout the night or if sleep is interrupted you easily fall back to sleep
• Wake up in the morning refreshed

With Overactive adrenal symptoms you may sleep, but you will not feel refreshed and more than likely have difficulty getting out of bed in the morning

Adrenal fatigue disturbs a woman’s natural ability to adapt to ongoing stress, forcing her to burn through reserves to respond to life’s inevitable ups and downs. A good healthy aging physician can create a customized plan of hormonal balance and proper nutrition which can help greatly reduce stress and adrenal fatigue.

Thyroid: Maybe it is your thyroid…

Another possible underlying cause of chronic fatigue is thyroid imbalance. Thyroid related fatigue can result from unsatisfying sleep, where you may actually sleep through the night, but still wake up feeling lethargic and exhausted. Hypothyroidism (low/underactive thyroid levels) is one of the most under diagnosed of all hormone imbalances. Hypothyroidism can cause ongoing insomnia, fatigue and daytime sleepiness. Hypothyroidism also appears to have a high correlation to sleep apnea. Hyperthyroidism (high/overactive thyroid) results in the thyroid being extremely active, over-producing hormones and causing problems like rapid pulse, insomnia and restless sleep.

Due to the increased hormone levels, the body seems to have difficulty relaxing enough to fall asleep. Some people may even experience increased heart rate leading to feelings of anxiety throughout the night and increased movement causing the person to wake once asleep.It’s important to visit a specialized healthy aging physician to assess thyroid. He or she must run a whole thyroid panel and not simply TSH to accurately access thyroid function.With just TSH levels, often the patient is deemed “normal level” when they are actually struggling with low thyroid.