We Asked Doctors Why PMS Can Make You Feel Like A Zombie

by Gina M. Florio and JR Thorpe
Originally Published: 
A woman takes a nap on a couch under a yellow blanket. If PMS or your period make you unusually tire...
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Ever feel like you could sleep for weeks on end when your period is around the corner? You're not the only one. Tiredness and fatigue are some of the most common PMS symptoms that plague menstruating people today. And the fun certainly doesn't stop with PMS. A third of women deal with disturbed sleep patterns when they're menstruating, according to the National Sleep Foundation. If this sounds familiar, you know how annoying it can be to battle fatigue when you've got a million and one things to do.

Feeling tired when you're menstruating "is in general a really, really common complaint," Dr. Alyssa Dweck, M.D., assistant clinical professor OBGYN at Mt. Sinai School of Medicine, and author of V is for Vagina, tells Bustle. Dr. Dweck attributes the fatigue to a number of factors. For starters, people on their periods experience hormonal fluctuations which cause the estrogen and progesterone in our bodies to plummet. Mix that up with water retention, bloating, disturbed sleep patterns, and you've got a recipe for fatigue.

A long or heavy period can also make you exhausted. "Periods lasting longer than seven days are considered abnormal bleeding and can make you feel depleted, tired and even dizzy," Dr. Sherry Ross M.D., an OB/GYN, tells Bustle. Heavy bleeding that creates big blood clots can also cause tiredness, she says, as the body loses a lot of iron in a short space of time.

You don't have to take it all lying down, though (although lying down just might be the answer sometimes). There are many different things you can do to ward off the lethargy, and none of them are complicated. Of course, if you go through all the steps and still find that you're feeling extremely fatigued most of the time, there might be an underlying issue you have yet to address, like anemia or a thyroid irregularity.

Here are eight things to do if PMS and menstruation make you unusually tired.

1. Track Your Menstrual Cycle With A Free App To Make Sure You're Tired *Because* Of Your Period

"Women who have had periods for years and years [still sometimes] don’t recognize what’s going on," Dr. Dweck tells Bustle. She says half the battle is knowing when you're due to menstruate, so you can properly prepare for the symptoms that affect your daily life the most. There are tons of apps at your fingertips that will help you keep track of your cycle. That way, you know what to expect.

2. Keep An Eye On What You're Eating Right Before & During Your Period

During the luteal phase, or the week before your period, you might be particularly craving comfort food, since PMS is so uncomfortable. Often, these foods can cause sugar levels to spike, and in turn, make your insulin levels rise — leading to a hard crash later in the afternoon or evening.

"Diet manipulation is a really good way to manage period fatigue," Dr. Dweck says. She recommends eating small, frequent meals throughout the day, and munch on plenty of protein. A little chunk of dark chocolate when you're menstruating will never steer you wrong. While there's a lot of value in choosing comfort food — it's right in the name! — these adjustments will keep your energy up and help you sleep better.

3. Make Some Changes In Your Sleep Routine If PMS Is Making You Tired

It might sound like a tall order, but you really should be shooting for eight hours a night when you're on your period. Your body is going through a lot, so you need all the rest you can get. Dr. Dweck says that the quality of your sleep matters. Try to get yourself under the covers at the same time every night and avoid caffeine in the last half of the day.

Most importantly, try to get the electronics out of your bed right before you snooze. Light-emitting devices can mess with your internal circadian clock and wreck your REM cycle. All that Netflix can make you wake up feeling cloudy-headed and moody.

4. Amp Up Your Exercise Routine During The Week Leading Up To Your Period

Exercise is known to be helpful for symptoms related to the menstrual cycle, like severe menstrual cramps and low mood. It also gives you some much needed energy when you're feeling sleepy. Dr. Dweck says you should make time to move when you're menstruating. You don't have to go so hard that you completely wipe yourself out — even the simplest of workouts or a short run will get the job done, increasing energy levels and then helping you sleep at night.

5. Know Your Limits When It Comes To Drinking On Your Period

When it comes to menstruation and booze, Dr. Dweck says, "it's kind of an individual variation." Some people find it very relaxing to have a glass of wine at the end of the day, while others feel off with any alcohol in their system. No matter how you feel about a glass of red, though, try not to overdo it with the drinks. Dr. Dweck says that alcohol is dehydrating, so drink plenty of water along with it.

There aren't that many studies out there on what alcohol does for the body during menstruation, but the few reliable ones have shown that booze isn't known increase your period pain. It does, however, increase estrogen and testosterone in your system, which could lead to certain cycle irregularities, including how you sleep at night. So keep that in mind next time you reach for a cocktail.

6. Try Acupuncture For Period Fatigue

People who experience serious PMS are sometimes recommended regular sessions of acupuncture. Dr. Dweck says she would "absolutely consider [acupuncture] to be complementary," and that she's seen it help many of her patients before. Studies have shown that acupuncture can successfully treat insomnia, and it's a therapy known to make you feel more energetic.

7. Apply Heat To Relax & Wind Down

When you're on your period and exhausted, a great way to prepare yourself for deep sleep is by adding some warmth to your evening. Dr. Dweck suggests you take a warm bath and grab a hot water bottle. It will help your menstrual cramps and overall discomfort. Too much heat can make you more wakeful, though, so be aware that your hot water bottle could keep you up at night.

8. Speak To Your Doctor To See If There's Something More Serious Going On

If you've done everything on your checklist and you're still exhausted, it's time to chat with your doctor. "Some women are so fatigued because they have an underlying problem," Dr. Dweck says. It could be an irregularity with your thyroid, a gland that controls your metabolism, which can cause fatigue, irritability, depressive symptoms, and weight gain.

You might be dealing with anemia, a blood disease that affects 3.5 million Americans, which is linked to women who have super heavy flows. Dr. Dweck even lists Lyme disease as a possibility, which would show up alongside joint pain and a rash. Heavy bleeding with a lot of clotting may also cause you discomfort, so it's a good idea to see a doctor to help, Dr. Ross says.

Whatever the case may be, if your instinct is telling you to see a doctor about your ruthless fatigue, do it. You don't want to go through every period so tired you can't even get the smallest tasks done, and you definitely don't have to.


Dr. Sherry Ross M.D., OB/GYN

Dr. Alyssa Dweck M.D., OB/GYN

Studies cited:

Cao, H., Pan, X., Li, H., & Liu, J. (2009). Acupuncture for treatment of insomnia: a systematic review of randomized controlled trials. Journal of alternative and complementary medicine (New York, N.Y.), 15(11), 1171–1186.

Daley A. (2009). The role of exercise in the treatment of menstrual disorders: the evidence. The British journal of general practice : the journal of the Royal College of General Practitioners, 59(561), 241–242.

Okamoto-Mizuno, K., & Mizuno, K. (2012). Effects of thermal environment on sleep and circadian rhythm. Journal of physiological anthropology, 31(1), 14.

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