Exploring Symptoms – 1. why do you feel lethargic and how can you ease this symptom

New Year…it doesn’t mean NEW YOU, but why not start getting to KNOW ‘YOU’ better. It’s time to start exploring the nitty gritty and understanding symptoms, what is normal and what causes different menstrual related symptoms. Over the course of the next couple of months Optimal Period will be focussing on different symptoms, doing a deep dive into causes and advice on prevention and management. Following comments on my previous post ‘Tired or premenstrual symptoms‘, lethargy is the first symptom Optimal Period will explore and share with you.

First, it is important for me to share that everyone’s experience of symptoms will be unique and even for 1 person this may change across different cycles due to the effect of external factors such as stress, nutrition and sleep. Second, the reason I am talking about symptoms and management is to help improve your menstrual health. Menstrual health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity, in relation to the menstrual cycle (Hennegan et al., 2021). This research describes menstrual health requires access to accurate, timely and age appropriate info about the menstrual cycle as well as related to self-care. I don’t feel I am achieving this, so I wanted to start this journey to help us all achieve good menstrual health. Let’s not work around our cycles and adjust what we do, take control and manage the symptoms!

What do I mean by symptoms?

During the menstrual cycle women experience cyclical changes in psychological and physical symptoms (Halbriech, 2003). Symptoms can also be behavioural or emotional. They are something a person experiences/feels which cannot be seen. Relating the menstrual cycle symptoms may include:

  • Irritability
  • Stomach cramps
  • Depression
  • Tiredness/lethargic
  • Tense/nervous
  • Breast tenderness
  • Bloated
  • Nausea
  • Headache
  • Clumsy
  • Sleep disturbance
  • Low motivation
  • Mood swings
  • Emotional

To make things even more complicated, there are many causes of menstrual related symptoms:

  • Neuroendocrine
  • Variation in estrogen levels
  • Insufficient progesterone
  • Decline in hormone levels
  • Inflammatory response


Lethargy or tiredness prior to your period can be common and it can have a negative effect on work/school performance along with being physically active, training and competing in sport. It’s a real thing so give yourself a break.

Before your period, oestrogen and progesterone levels decrease super rapidly which can make you feel wiped out. These sex hormones also interact with a neurotransmitter – serotonin, which plays several roles in your body (happiness, mood, regular body temp and hunger), one of which includes decreasing energy levels and affecting sleep. Another reason for lethargy or feelings of fatigue is linked to inflammation as progesterone decreases – with this type of fatigue you feel a bit like you are getting ill, maybe a sore throat. A final cause of this symptom can be linked to stress, the reduction in progesterone can affect your HPA axis and worsen symptoms of adrenal fatigue – feelings of agitation or stress commonly accompany this (Briden, 2017).

What can I do?

It’s time to start taking action. Start by tracking your symptoms, you need to work out what is causing you to feel lethargic – is it lack of sleep, stress or linked to your menstrual cycle and if so are you feeling ill alongside this or agitated to help work out the underlying cause.

It is now important to address the cause, if its lack of sleep try and tackle this (as best you can given your situation). Sleep hygiene, banking sleep and naps are some suggestions.

For other causes focus on:

  • Stay hydrated, 6-8 glasses of water a day
  • Regular balanced meals, preventing sugar food cravings and crashing! Reduce inflammation by having as many portions of fruit and veg a day to increase antioxidant intake. Here are some ideas to help achieve this. Wholegrains are also associated with reduced inflammation and also contain fibre to help with bloating and bowel symptoms.
  • Move, sometimes 10mins of movement or light exercise such as yoga can shift that lethargic feeling.
  • Rest, take plenty of time for yourself, read a book, have a bath – give yourself permission to stop.

Stay posted for Symptom 2 – Period Pain!


Hennegan J., Winkler IT., Bobel C., Keiser D., Hampton J., Larsson G., Chandar-Mouli V., Plesons M. & Mahon T. Menstrual health: a definition for policy, practice and research. Sexual and Reproductive Health Matters, 2021, 29(1), 1-8.

Halbreich U. The etiology, biology and evolving pathology of premenstrual syndromes. Psychoneuroendocrinology 2003; 28(3), 55–99.

Briden L. Period Repair Manual, 2017; 219.

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Dr Natalie Brown

Hey! I am Natalie, a research associate exploring all things menstrual cycle and sport related, whether that is Olympic performance or factors affecting participation in physical activity. When I am not talking about the menstrual cycle, I love climbing and being active outside. I have a background in physiology and research related to hormonal responses in athletes (male and female), combined with my own personal experience in sport, I am passionate to share information on the menstrual cycle with you.

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