Why Am I So Tired on My Period?

Evidence suggests this is an extremely common issue. In fact, some surveys estimate up to 71% of people who menstruate deal with sleep disruptions before and during their periods. Research also shows that PMS is one of the main causes of sleep problems, like insomnia and repeatedly waking up in the middle of the night, in women who get periods. Needless to say, the more disturbed your rest is, the more sluggish you’re going to feel, Dr. Eblen says.

Other health issues can make matters worse.

While being a little more tired than usual is to be expected, it’s not normal to feel super zapped around your period. Excessive sleepiness—i.e. you feel it affecting your ability to work, exercise, do your chores, or even sleep at night—could be connected to another health issue.

Anemia

Bleeding, particularly if it’s *a lot* of red, can worsen (or even trigger) symptoms of anemia, a condition that inherently causes fatigue and weakness, says Dr. Pal. What exactly counts as heavy menstrual bleeding? The American College of Obstetricians and Gynecologists defines it as a period that lasts longer than a week or causes you to soak through a pad or tampon every hour for several hours.

But, as Dr. Whitmore points out, a lot of people don’t use pads and most of us aren’t out here measuring how many milliliters of blood we’re losing every day. Her advice? If you think you’re bleeding more than you used to or are going through multiple Diva Cups, tampons, or period underwear each day, go get evaluated by a healthcare professional. Even if you aren’t sure, it doesn’t hurt—and, hey, can even help—to ask if the amount of blood you’re losing is normal.

Premenstrual exacerbation

If you have a chronic condition—like anxiety, depression, or fibromyalgia—and feel like it intensifies around the start of your menstrual cycle, you could be dealing with premenstrual exacerbation, or PME. This describes the phenomenon when a chronic illness (either mental or physical) tends to get worse in the second half of the menstrual cycle, as you creep closer to your period.

If you struggle with depression, for example, feelings of worthlessness and lethargy may skyrocket during this time, or fear and worry may surge if you have an anxiety disorder. These conditions are often already tiring to deal with—and fluctuating hormones can make that fatigue even worse, says Dr. Pal. PME isn’t a diagnosable condition yet and a lot more research is needed to understand why it happens or how prevalent it is, but some suggests certain people are more sensitive to hormonal changes for some reason, causing them to feel extra crummy during menstruation.

Premenstrual dysphoric disorder (PMDD)

Feeling drained and lethargic also goes hand-in-hand with PMDD, a severe form of PMS that affects roughly 5 to 8% of people who menstruate. Most people experience some discomfort during their period, but PMDD—and the exhaustion it can ignite—can upend your quality of life and daily activities. With PMDD, You may tire easily or feel lethargic and perpetually zapped during that time of the month. Or, perhaps, you suddenly have insomnia, causing you to feel worn out during the day. “There is a spectrum of how much PMDD symptoms can impact people,” Dr. Whitmore says. But increased fatigue, to some extent, is a common one.

Thyroid abnormalities

Your thyroid—a small gland that sits in the front of your neck and controls your digestion, breathing, heart rate, and mood—can impact your menstrual cycle, too. For example, if you have hypothyroidism, the thyroid doesn’t produce enough hormones, which can affect how the pituitary gland communicates with the ovaries. As a result, your estrogen and progesterone levels may abnormally ebb and flow, which can certainly cause you to feel drained, especially during your period, Dr. Whitmore says.

Reproductive health conditions

There are also multiple reproductive health conditions that can be incredibly painful and cause higher-than-usual bleeding, which can make you feel spent.