A common complaint among women in perimenopause is an overwhelming sense of fatigue and exhaustion, often described as crashing fatigue. Many women tend to chalk it up, however, as the result of sleepless nights associated with night sweats and insomnia.
While it is certainly true that insomnia and sleepless nights are a contributing factor to crashing fatigue in perimenopause, it is adrenal fatigue, an often overlooked factor in exhaustion during perimenopause which could very well be the bigger culprit.
The Basic Function of Adrenal Glands
The adrenal glands are two walnut sized endocrine organs located just above the kidneys. Comprised of the inner-medulla and the outer-cortex, the adrenals work in tandem and play a key role in our body’s response to stress by releasing three hormones: adrenaline (norepinephrine), cortisol and DHEA.
Adrenaline and the “Fight or Flight” Response
Commonly known as the “fight or flight” hormone, adrenaline is released by the inner-medulla gland when there is a perceived threat or danger. To prepare us for either a “fight or flight” response, our body releases quick shots of adrenaline. The adrenaline increases our heart rate, causes blood to rush to our organs and large muscle groups, dilates our pupils, sharpens our mental alertness and increases our tolerance for pain.
The fight or flight response is engaged many times throughout our day by simple actions such as, swerving to avoid a potential fender bender or from the anxiety one may feel by getting pulled over by a traffic cop. Ordinary, day to day to day encounters at a stressful job can also engage the fight or flight response as well.
Cortisol and Chronic Stress
When we are under prolonged periods of chronic stress it is the outer-cortex of the adrenal glands that comes to the body’s rescue by releasing cortisol.
Cortisol’s main function is to metabolize fats and proteins into sugars to create and maintain energy. Cortisol also helps the body adapt to chronic stress by increasing energy levels, stabilizing emotions and acting as an anti-inflammatory and pain reliever, among other things.
As with everything, however, too much of a good thing has its downside. If cortisol levels become too high over a long period of time it can cause a loss of bone density, muscle atrophy, thinning of the skin, kidney damage, blood sugar problems, weight gain and an increased susceptibility to illness.
DHEA – The Great Equalizer
DHEA is an androgen released by both the adrenal glands and the ovaries. Like adrenaline and cortisol, DHEA also improves the body’s ability to recover from and cope with stress and trauma. But, it also helps to neutralize some of the damaging effects of high levels of cortisol in the body, namely, the tendency of cortisol to suppress the immune system. As a result, DHEA is useful in helping the body resist sickness and disease.
Estrogen Dominance and Adrenal Fatigue
When women are in perimenopause and experiencing fluctuating progesterone levels, estrogen dominance often occurs. In addition to the many symptoms of perimenopause that excess estrogen causes, it also causes high levels of cortisol-binding globulins in the blood stream. The binding actions of the globulins inhibit free movement of cortisol throughout the body, rendering it useless.
So, while a woman may have adequate levels of cortisol in her system, the body is unable to efficiently use it which results in a reduced ability to manage and cope with stress. Even though the adrenal glands are providing necessary stores of adrenaline, DHEA and cortisol, it is rendered ineffective by effects of excess estrogen.
Over time, the adrenal glands become fatigued and exhausted, unable to produce the necessary levels of adrenaline, cortisol and DHEA. Factor in chronic insomnia, mood swings, night sweats and hot flashes and you have the recipe for the relentless, debilitating, crashing fatigue that women complain about during perimenopause.
How to Relieve Adrenal Fatigue
One of the first and most obvious helps to relieve your body of adrenal fatigue is to rest. Western cultures are the most sleep-deprived cultures in the world and chronic exhaustion associated with adrenal fatigue is a by-product of our poor sleep habits.
Eight to ten hours sleep per day is necessary to help your body recover from adrenal fatigue. A healthy diet rich in low-glycemic index foods is also an excellent remedy for adrenal fatigue as they help stabilize blood sugar.
Vitamin C (3,000 to 6,000 units) is recommended as a supplement along with B-complex vitamins, zinc and magnesium for at least three months. Moderate exercise and exposure to sunlight is also helpful in restoring healthy, adrenal function.
Sources:
Northrup, Dr. Christine. The Wisdom of Menopause. New York: Bantam, 2006. 121-126.
Hotze, Dr. Steven F. Hormones, Health & Happiness: A Natural Medical Formula for Rediscovering Youth with Bioidentical Hormones. Houston, TX. 2005. 133-145.
“Adrenal Fatigue and Women”. November 6, 2006. Dr. Hotze.com. January 18, 2011. http://drhotzeblog.netymology.com/2006/11/06/adrenal-fatigue-and-women-2/
What are the 35 Symptoms of Menopause?” January 3, 2011. Associated Content. January 18, 2011. http://www.associatedcontent.com/article/6161452/what_are_the_35_symptoms_of_menopause.html?cat=5
Perimenopause Hot Flashes: Cool the Heat with Soy. June 10, 2010. Associated Content. January 18, 2011. http://www.associatedcontent.com/article/5443600/perimenopause_hot_flashes_cool_the.html?cat=5
Screaming to be Heard: Your Brain, Hormones and those Moody Blues”. The Perimenopause Blog.com. January 19, 2011. http://www.theperimenopauseblog.com/?p=2301
