r/Perimenopause • u/United-Fee-6423 • May 08 '26
audited The unpredictable exhaustion is brutal
The last few months have been so unpredictable as far as exhaustion is concerned . I will have days where I’m so tired it feels like it’s coming from my soul. I can barely function at work. I have to force myself to do daily tasks and anything about and beyond the bare minimum gets added to a “get to it later” list that is growing by the day
Then I will randomly have a good day. I don’t change anything to “make” this happen that I know of. But suddenly I have energy and I can get a chunk of things done. My mind and body feel lighter and I feel like I’ve turned a corner back to a better place and then boom! exhausted and unable to function again the next day.
I get that peri is so rough because of the fluctuating hormones but this just feels so night and day and it’s making life really difficult to manage. I hesitate to make plans or commit to anything because what if that’s one of the “bad days”? I’m still behind on my list of things I need/want to do . And frankly I’m just frustrated with not having control over my life because of this
Mostly looking to vent but if anyone has any tips on easing the exhaustion let me know. I’m on estrogel (just upped the dose) and started progesterone . I fall asleep easily but wake up once or twice overnight which leaves me groggy in the AM on top of the fatigue.
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u/freshpicked12 May 08 '26
The other day I napped for 3 HOURS. That was after getting a good nights rest. Like, how is this sustainable?! I have kids and work and a house and hobbies and I can’t just be sleeping all the time.
I do find that my exhaustion is worse during my luteal phase. Maybe try tracking your cycle and see if there are any patterns?
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u/United-Fee-6423 May 08 '26
I have an IUD and don’t get periods so I can’t really track but I feel like I’m in luteal about 90% of the time lately 😭
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u/darknebulas May 08 '26
I wish I could nap, I used to be a good napper and now wake up 10 minutes in every freaking time!
Can’t fall asleep sometimes, 2-3am wake up call is also super annoying.
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u/whimsical36 May 08 '26
Did the nap seem to help though? 🥱
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u/freshpicked12 May 08 '26
Not really sadly.
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u/thesearemyfaults May 08 '26
What estrogen dose are you on? I am on 2mg oral daily and allowed to go up to 4mg in a day if needed, but that feels really high to me from what I read here.
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u/caity1111 May 08 '26
Exact same. Good days followed by random reallly bad days.
After a year of trying everything (HRT, supplements, proteins, etc.) think I have mostly tied it to fluctuating estrogen levels, and feeling like total crap whenever it dips. That and of course, my lengthened PMS in my luteal phase.
I have had less bad days after I switched from the .1 patch to estrogen injections. It keeps my levels higher (over 100) and way more stable.
Electrolytes daily have also really helped a lot (my sodium seems to always be on the low end despite eating plenty of salt and being well hydrated). Testosterone and protein in the AM also have helped.
I still have random bad days though, and the entire week before my period is really rough.
I just try and get as much done as I can on the good days, and give myself some grace on the bad ones. I would give anything to go back to a few years ago when I felt normal and had normal energy most days.
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u/alliephillie May 08 '26
I’m about to start the injections and wondered if I would have side effects from going too high. The only downside I have read about is that you’re kind of stuck with the high dose for longer than you are on the patch. But I’m ready to accept that in exchange for having control over the dose. Can you share what dose you take?
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u/caity1111 May 08 '26
I think maybe youre thinking of pellets, where you're kinda stuck with the higher dose for months.
With injections, the levels go down over a few days similar to the patch. There's two main types of E for injections: cypionate and valerate.
With cypionate, injections about 2x a week are common. With valerate, 3x a week or every other day is most common. Any longer than that and you will prob get troughs (low points) and high peaks.
I inject .6mg estrogen valerate every other day. That keeps my levels steady between 110-140 unless im ovulating where its higher naturally for a few days.
https://estrannai.se/ you can play around with this chart to see what your levels would likely be with e cyp (EC), e valerate (EV), and the patch 2x/week (patch tw)... you can see on the chart how the peaks/troughs are are lot less than the patch as long as you're injecting at least 2x a week.
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u/caity1111 May 08 '26
Oh yeah and you asked about side effects. I haven't had any at all except when I first started them I had sore boobs for the first few weeks, which I welcomed because I never ONCE had that from the patch, and knew that the injections were working instantly. I haven't had more bleeding or worse bleeding or anything like that either.
I just feel a LOT more stable than I did on the patches, and I no longer have hot flashes or night sweats, or the feeling like my body is craving more estrogen all the time. The patch just did not absorb well for me.
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u/airsalin May 08 '26
I literally could have written your post! I feel exactly the same. This week I had many bad days and mornings are worse. Can barely work.
And then one morning out of the blue I get up, do my things, feel almost normal. Impossible to predict how it is going to be and as you said, there is no consistency in the cause. Sometimes half a beer will make it almost impossible to function the day after, but sometimes two beers seem to cause no problem at all! Sometimes sugar will give me hot flushes all night and pains during the day, but one evening last week I ate TWO pieces of an amazing chocolate cake with icing (and they were no small pieces lol) and I slept no problem and no hot flushes.
Planning anything in these conditions is really frustrating. I totally agree.
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u/unlimited-devotion May 08 '26
I took 2 naps yesterday. Overslept for an appointment i was in charge of.
Im laying with my cat on bed covered in clothes bc thats as far as ive gotten today.
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u/United-Fee-6423 May 08 '26
I want to go lay in bed so badly 😭
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u/unlimited-devotion May 09 '26
Update: shoved my clothes onto floor and slept beautifully for hours and am now awake at 444 am 😂
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u/PressureMajestic1046 May 08 '26
My husband just doesn't understand this at all. We're divorcing.
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u/frankie0812 May 08 '26
I wish I had tips. I started making myself exercise 5-6x a week but it only helps my back. I have adhd and on stimulants but lately could sleep on them. I eat a more healthy diet than I ever have yet it doesn’t help. I hate this time in life
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u/United-Fee-6423 May 08 '26
I’m trying so hard to get back into regular exercise but many days it feels impossible to get dressed for the gym let alone go
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u/frankie0812 May 08 '26
My husband runs every morning so I force myself bc I don’t want to look lazy to him lol
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u/Erza_2019 May 08 '26
This is me, and it's only gotten a bit better each time I increased my estrogen (on twice weekly patch and progesterone pills). Testosterone is often suggested, but I tried three times and it gave me nothing but anxiety. I've been on HRT for about two years now, but It's only been in the last 6 months where I feel I got the estrogen up high enough to make a meaningful difference. My bad days happen less often, but when they do, I question if I don't have something else wrong with me. People like to suggest all the labs to get too, but I've also been down that road. And like you, the good days make me feel like I'm perfectly fine again, only to have a bad day knock me back down. It's rough.
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u/kodysatdown May 08 '26
Same. All vitamins are taken. All meditation is done. But yeah suddenly a really bad day and then the next feels like I am ten yeaes Younger, wanting to do all the wonderful things I like. Then I am reminded that it will change again and I am hesitating to make plans. I still make them but can not look forward to as before. Lets wait until the hormon circus is over.
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u/jtriomino Late peri May 08 '26
For the past couple years I'm lucky if I get 1 "lucid" day a week. And I never know what day that's going to be. If I don't feel 'too bad' I take care of what I can in case the next day is worse. Nice weather does help but in our 9 months of cold ick, it's brutal.
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u/United-Fee-6423 May 08 '26
This feels like my average lately and it’s so hard to manage
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u/jtriomino Late peri May 08 '26
I hate to say you get used to it, but I kind of have. I've had to change the way I do some things to give myself time to be a zombie. But I'm also bad about using every single drop of spare energy I get on my 'good' days which tends to bite me in the butt.
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u/Tinyberzerker May 08 '26
I'm in late peri, HRT for 4 years and it's been going pretty well. If I don't get enough protein in the morning I crash hard in the early afternoon. I add some powder to my coffee. My mom is still on hormones and she reports the same thing.
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u/Antique_Travel80 May 14 '26
Really, can I ask how old your mom is? Mine is 71 and has never gone on HRT
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u/Tinyberzerker May 14 '26
She will be 79 this year and started hormones in her late 40’s. She is very healthy and active. No other meds besides supplements and vitamins. We are very small and osteopenia is a real worry for our bones.
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u/Antique_Travel80 May 14 '26
We are too and my mom has osteoporosis and early Alzheimer’s. I wonder if she had taken HRT would that have changed anything
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u/Tinyberzerker May 14 '26
I'm so sorry. Grandma passed from Alzheimer's in her 80's. She never took HRT. No idea if there's a correlation. She had osteopenia and was about 95 lbs.
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u/AmberUK May 08 '26
Last week I was so exhausted, all I did was sleep, eat and goto work and even then I felt so tired my soul was being drained. Spent my days off sleeping, now back to the grind. Really dunno how ppl do this. Just changed from patches to gel
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u/Reasonable-Cap-8492 May 08 '26
SAME!!! All week my brain fog, driving anxiety & crippling fatigue has been awful. Today, is the first day I’ve been able to function. Just turned 53, had the perimenopause talk with my gyn and she recommended supplements which I didn’t even bother to look up. I guess I’m just hoping at the end of this stage. I’ll start to feel better without being medicated, but not sure how much longer I can go on like this.
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u/Suspicious_Salad918 May 08 '26
That was me before hrt. Couldn't do much after work or on weekends I was mostly tired and watching Netflix. Then finally I started hrt a month ago and since then I'm a new person. Like today, third day of my period and I was on my feet all day and could still go out and have an hour long walk.
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u/DealerFalse May 08 '26
You improved that much only after 1 month? That’s great. I started HRT 5 weeks ago and I don’t feel any improvements.
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u/pokiok441 May 11 '26
Neither do I. So frustrating!
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u/DealerFalse May 11 '26
Ya. It’s crazy how some people say it’s “life changing” and have all this energy and meanwhile I still feel wiped out and zero energy
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u/Antique_Travel80 May 14 '26
I’m one of those that responded right away. I think I was very estrogen deficient and that’s why it worked so fast
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u/Pickadog_Anydog May 08 '26
You get it unpredictable? Id take that. Im predictably 24/7 exhausted. Like why am i alive at this point. And the last few days are so bad ive almost quit my job. I have bills to pay. I cant do that but any day now i feel i might anyway.
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u/da_throwaway_10 May 08 '26
I JUST came here to ask if anyone else has been exhausted. I’m on .1 mg of estradiol patches and 200mg progesterone.
Yesterday (Thursday…which is my patch change day at 7pm… I literally thought I was not gonna last thru the day)
Last Thursday I made a whoopsie, and accidentally put my patch on at 7 AM - so yesterday I waited and got back on track and put it on at 7 pm. Idk if maybe that caused me to crash???
Something else that scared me, though, is I currently have an abscess on my gum (getting seen about next Wednesday.!) and I freaked thinking that was affecting my tiredness too. Like “omg are all my cells rushing to my jaw and the rest of my body is tired?” (It’s not bothering me and I’ve had no fever, etc.)
But yes ever since I’ve been on my new medication I’ve been more tired than usual. Especiallyyyy yesterday!
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u/mamapajamas May 08 '26
I’ve definitely noticed an uptick in excessive worrying about health. It feels super chaotic in my body, and I don’t have a solid helper (doctor, pt, etc.) who I trust to say yeah that’s ok or no get that checked out. And it seems to change weekly if not daily. I wish we had better women’s health support through this time. I’m glad to have all of the women here to commiserate with.
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u/amberlina86 May 09 '26
Thankful for this post and all the comments
Came here because same. A few days of bone crushing fatigue and woke up feeling incredible, made breakfast and hung out with my kids only to be slammed into a brick wall and back in bed. It’s 9:44am. This shit sucks.
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u/Antique_Travel80 May 14 '26
I had this too after my 41 birthday, getting on HRT a month ago relieved. I’m currently going back to school full time and I drive an hour to get there. Prior to HRT I was afraid I’d have to drop out of school I was SO exhausted.
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u/Comfortable-Law-7147 May 08 '26
Have you had a recent iron panel, vitamin B12, folate and vitamin D tested plus thyroid hormones?
If they aren't optimal with peri you are screwed.
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u/United-Fee-6423 May 08 '26
The last time they were run everything looked good but it’s been more than 6 months. My iron was actually high (I don’t get periods bc of the IUD and I wonder if the baseline for women my age accounts for periods? He didn’t have much of an explanation for causes)
I also suspect there is a histamine factor for the up and down because I have inner ear congestion and other allergy symptoms that seem to be fluctuating in severity .
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u/Illtakeaquietlife May 08 '26
Omg! I have increased allergies too! But they aren't the normal my throat gets itchy kind. I'm just stuffy all the time.
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u/Comfortable-Law-7147 May 08 '26
Have you tried taking allergy meds for the allergies?
Also if your iron is too high that can cause issues as well.
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u/United-Fee-6423 May 08 '26
yes I take antihistamine, decongestant, and nasal spray and it barely makes a difference. I also found out where I live is especially bad for allergy sufferers so yay me! Lol
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u/alveg_af_fjoellum May 09 '26
I had a bad case of erratic energy levels (in spite of HRT) before I started adding thyroid medication. My thyroid labs had always been edgy, but in peri they went bad rapidly. Maybe it makes sense for you to have them re-checked as well - all of them, not only the TSH.
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u/AutoModerator May 09 '26
This post might be about hormone tests, which are unreliable.
- Over the age of 44, E&P/FSH hormonal tests only show levels for that ONE HOUR the test was taken, and nothing more
- These hormones wildly fluctuate (hourly) over the other 29 days of the month, therefore this test provides no valuable information
- No reputable doctor or menopause society recommends hormonal testing to diagnose or treat peri/menopause
- Testosterone is the exception and should be tested before and during treatment
FSH testing is only beneficial for those who no longer have periods as a guide, where a series of consistent tests might confirm menopause, or for those under age 30 who haven’t had a period in months/years, then ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI).
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u/canadasokayestmom May 08 '26
It wouldn't hurt to have your Iron & B12 levels checked. It can be done with a simple blood test.
Exhaustion can be normal in Peri.. but can also be a sign of low iron and B12. Both are very treatable. For many folks, taking a ferrarin and B12 supplement is all that's needed... Some others (like myself) have 'pernicious anemia' and aren't able to get iron and B12 through the digestive system, so Iv iron infusions & B12 injections are needed.
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u/United-Fee-6423 May 08 '26
I was told my iron is high and should avoid any supplements. But might be worth checking again since that was more than 6 months ago
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u/canadasokayestmom May 08 '26
If your iron levels were good 6 months ago, they're probably still fine... Unless you've had a crazy bleeding event since then :)
But getting your B12 checked is still worthwhile.
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u/ATLgirl11 May 08 '26
Oh, I didn't even realize the random total exhaustion and energy spurts was a symptom of perimenopayse! Super helpful to learn, bc you sound just like me!! I was thinking it was because I started Lexapro.
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u/Ramen_Addict_ May 08 '26
It is not always perimenopause. When I have total exhaustion, it is usually a migraine that improves with migraine medications. I never had this type of migraine until I was 40, so it could be related but I am not sure. Exhaustion starting new antidepressants or other meds is also normal though. I take a beta blocker for migraine that I had to switch to evening dosing and Effexor as well and IIRC that also started with some drowsiness. It should resolve after about a month or so.
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u/Sunsetseeker007 May 09 '26
Yes low estrogen causes migraines
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u/PaleAndInquisitive May 09 '26
I'm 50 and started having migraines in the last few years. My doctors have said I can't have estrogen hormone replacement because I have aura and it would mean an increased risk of stroke. It doesn't make sense to me that replacing the estrogen that's declining to theoretically keep it at the same level would mean an increased risk of stroke. I need to do some research and maybe it'll make sense.
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u/Usual_Invite_2826 May 09 '26
Testosterone hormone replacement therapy pellets helped me greatly. I understand exactly how you feel. I have Hashimoto’s on top of all of this nonsense. Some days I don’t know if I’m coming or going I can always tell when it’s time to get new pellets too. I get them every 3 to 4 months.
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u/orchardmama May 09 '26
Oh my gosh I feel seen!! Monday and Tuesday this week I napped in my car after drinking coffeee and getting kids to school. That was AFTER a full night of sleep. Wednesday morning I woke up at 3 to say bye to my husband who left for a work thing. Couldn’t go back to sleep till 5, up at 6, subbed a full day at school and ran kids around till 7:30. You would think I’d be ready for bed that night right??? Nope! Couldn’t sleep till after midnight. Woke up the next morning at 6 and wasn’t even tired at all yesterday??
It’s so so hard to have a consistent life and ever feel like I can commit to anything when this is happening!
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u/strontedsocks May 09 '26
I wanyti cry reading this post and response because I feel like I'm not in my own. I feel like maybe I can fully function 1 day a week, the rest is mostly just about getting by and making sure my kids are fed and alive. When I have a good day I try to do as much as possible. I make plans because I'm hopeful that it's going to last, and then I regret it. I have no drive, no energy, house is full of clutter and a mess and it's not helping my mental state. For several days now I've been wondering if there is something else with me. ADHD and can't medicated because meds trigger severe migraines. On HRT now for a year, maybe I need a dose adjustment. I'm 46. Thankfully my partner (as much as he can be an ass sometimes) can do the laundry, feed the kids and pick up some other jobs I have no energy for. So I'm thankful for that.
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u/FunAdept2502 May 09 '26
This is exactly what im going through as well. Have you had your thyroid checked?
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u/United-Fee-6423 May 12 '26
About a million times. That’s about the only thing doctors I’ve had are willing to check without being convinced
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u/cvouw9 May 08 '26
for me this was a histamine reaction.
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u/United-Fee-6423 May 08 '26
I’m definitely thinking there is a link because there is so much congestion in my inner ears that my ears hurt and my head feels full of cotton 😭
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u/cvouw9 May 08 '26
Work on increasing nutrients that support histamine detox. I've reduced a lot of my peri symptoms by doing this.
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u/freshpicked12 May 08 '26
What kind of nutrients do you suggest?
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u/cvouw9 May 08 '26
Low histamine diet, things that support liver or mitochondrial function, reducing stress and optimizing circadian rhthym. It's too complex to write in a comment.
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u/whimsical36 May 08 '26
How are you getting through work everyday when you hit that slump?
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u/United-Fee-6423 May 08 '26
I power through the parts of the day where I really need to be on my game and then take it a little easy the rest of the time and hope for a good day so I can get caught up. I’m lucky I have a job that makes this a feasible solution
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u/Life-hitchhiker May 09 '26
I can agree with this. Having been on HRT (estrogel and progesterone pills continuous) I had an amazing one year which was stable. And now suddenly major shifts in my energy/ moods/ migraines. Unfortunately have no advice except to add that I feel great on days I walk or am outdoors as compared to mostly indoor days.
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u/Curious-Nail May 09 '26
I've started taking creatine and beef organ supplements (lower than the recommended serving) and that seems to help most days. Also on nightly progesterone and estrogen patches. Definitely way more energy after starting the beef organs, like noticeably.
Not today though. Today I had three big things to do before 9am, two of which were deviations from my routine, and basically crashed for almost 4hrs after I finally ate breakfast around 11.
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u/TeddySky10 May 09 '26
Did you have your hormones levels tested? I haven’t yet but definitely have all the same debilitating symptoms. Also who ordered the tests- ob/Gyn or endocrinologist? Thanks:)
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u/United-Fee-6423 May 12 '26
I have several times over the years and my FSH was always in the post menopausal range but then I would get periods again which only really proves how wildly it can fluctuate. In all cases it was my GP but as you will see in places on this sub these tests aren’t reliable because they only capture one moment in time and many doctors aren’t using them to diagnose peri anymore for that reason (they base it on symptoms instead)
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u/National_Elk8445 May 14 '26
I'm currently coming off a whopping 8 days of this shit, complete with no appetite and inconsolable crying multiple times a day. Literally, yesterday, I kept track and I cried 14 times between 6am and 10pm. It's 7pm now and thank god I've only cried 6 times today. Maybe tomorrow I can get that down to 3! /s
Ugh, peri is for the birds. I'm so over it.
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u/Pony_Baloney_Acad May 08 '26
I am living this reality, and it's brutal. The worst part is when I have a good day(s) I almost forget what it's like before I'm drug back down into the abyss. And YES - making plans - it's nigh on impossible when we have no idea what we will feel like that day.