Period Fatigue: Causes, Management and Treatment

By Terez Malka, MD
Medically reviewed checkmarkMedically reviewed
April 7, 2022

Many of the most common symptoms related to a monthly period are well-known: abdominal pain, cramping, bloating, and tender breasts.

In addition, you may find yourself developing a strong craving for sweets, overindulging in unhealthy foods, or crying for no reason.

Shortly before or during menstruation, you may also experience intense tiredness.

Period fatigue is a common symptom of premenstrual syndrome (PMS) that is usually caused by the hormonal changes that occur around the time of your period.

Learning your menstrual cycle in more detail can help you prepare for and manage your symptoms. 

In this article, I’ll talk about what causes period fatigue, its symptoms, and offer some tips for managing it.

I’ll also outline some treatments that can help. Finally, I’ll tell you when to talk to your doctor.

What Causes Period Fatigue?

Period fatigue is typically caused by the hormonal changes that occur around the time you menstruate.

The ovaries produce estrogen and progesterone. During the first half of your menstrual cycle, your estrogen levels increase, and then lower during the second half.

When they decline, so do levels of serotonin, a brain chemical that is related to alertness and mood.

This decline can result in a low mood and decreased energy levels. 

Other possible causes of period fatigue include:

  • Disturbed sleep: Period pains and fluctuations in mood can disrupt your sleep. You may experience insomnia the night before your period. As a result, you can feel exhausted the next day. 
  • Heavy bleeding: Heavy bleeding can lower your iron levels and cause iron deficiency anemia, resulting in weakness and fatigue. The reduction in iron levels makes it difficult for the body to produce the hemoglobin that red blood cells need to transport oxygen to the body’s cells.
  • Food cravings: Food cravings during your period could lead you to overeat, and subsequently feel tired. 

Is it normal?

Yes. Since your body is experiencing hormonal changes, it is normal for this to affect your mood and energy levels. Track your menstrual cycle using an app where you can log your symptoms at various times.

This will help you predict and prepare for the symptoms of PMS you may experience.

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Premenstrual syndrome (PMS) affects more than three in four people who experience periods in a lifetime.

Most people will experience mild symptoms including:

In some cases, these symptoms can be severe.

This is known as premenstrual dysphoric disorder (PMDD).

Tips for Managing Fatigue

Fatigue can be frustrating when you live a busy life, especially if it’s brought on by circumstances beyond your control.

If you regularly suffer from fatigue caused by fluctuating hormone levels, consider the following tips to help manage your symptoms.


Regular exercise can reduce the intensity of most premenstrual symptoms, including period fatigue.

A 2014 study tested the effects of aerobic exercise on 30 young women with PMS symptoms.

All participants received daily vitamin B6 and calcium supplements, and some performed aerobic exercise three times a week for 3 months.

Those who exercised regularly experienced less period fatigue than those who only took the vitamins.

The exercisers also showed improvements in blood health.

Bedtime routines

Create a regular sleep schedule and stick to it. Try to get at least eight hours of sleep a night when you are menstruating.

Going to bed at the same time each night and waking up around the same time each morning can help regulate the hormones that induce sleep.

Adjust the room temperature

Your body temperature can increase by about 0.5°C before your period. This can affect your sleep and lead you to become fatigued the next day.

Lower the room temperature slightly to improve sleep quality.

Relaxation techniques 

It’s not uncommon for people to experience increased stress or anxiety when they have their period.

Consider the following relaxation techniques to help manage your stress:

  • Massage
  • Taking a warm bath
  • Mindfulness meditation
  • Breathing exercises
  • Yoga 

Stay hydrated

Dehydration can worsen period fatigue, so drink plenty of water.

You may want to consider drinking water with electrolytes while on your period.

Eat balanced meals

Eat small, regular meals throughout the day.

This consistency can help prevent energy crashes and fatigue caused by your hormonal fluctuations.

Treatment Options

Several over-the-counter and prescription medications can help with PMS symptoms. 

Birth control pills

If you struggle with severe PMS, your healthcare provider may prescribe birth control pills to help regulate your hormone levels.

Your doctor may advise you to take the pills back to back and skip your period to help prevent fluctuations in hormone levels. 


Certain studies have found that herbal medicines such as ginkgo biloba may improve symptoms of PMS and PMDD—though larger, high-quality studies are needed.

You may want to take iron supplements to avoid iron deficiency anemia, especially if you have heavy periods. Vitamin D, omega-3, and B-complex vitamins may also help with energy levels and mood.

Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help alleviate abdominal pain, cramps, and inflammation.

If you experience cramps at bedtime that keep you awake, take an NSAID to help you sleep.

A heating pad can also help alleviate cramps.


In some cases, a healthcare provider may prescribe you a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI) to help treat symptoms of PMS.

SSRIs your provider may prescribe include fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft).

These medications can help if you struggle with depression related to your hormones, and can also improve other symptoms such as anxiety, fatigue, and mood swings.

You may feel more rested when taking antidepressants.

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When to See a Medical Provider

See your healthcare provider if your fatigue does not respond to at-home treatment, especially if your period is causing sleep problems that then interfere with your daily life.

Talk to your doctor or primary care provider if your PMS symptoms are unmanageable and affect your ability to carry out daily activities.

They will be able to determine the right treatment plan for you. 

How K Health Can Help

Did you know you can access online urgent care with K Health?

Check your symptoms, explore conditions and treatments, and if needed, text with a healthcare provider in minutes. 

K Health’s AI-powered app is based on 20 years of clinical data.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.

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