"I am always tired, but I cannot afford to take a break." For many women who have reached 40 years of age, being consistently tired becomes an unwritten aspect of their daily routine. They feel tired when waking up, struggle through meetings at work, do their chores, answer emails late into the night, and meet deadlines. Everything appears to be alright from the outside. But internally, they may be running on empty.
Social media has given this experience a name: "high-functioning exhaustion". Unlike burnout, which can make it difficult to continue with everyday responsibilities, this form of exhaustion can be harder to recognise because women continue to work, care for their families and remain productive despite feeling depleted. Experts, however, say persistent exhaustion should not always be dismissed as the result of a busy lifestyle. For women approaching their 40s, hormonal changes associated with perimenopause may contribute to symptoms such as poor sleep, brain fog, mood changes and fatigue.
It's not always just your to-do list
Long work hours, constant notifications, and the need to juggle several tasks can make exhaustion feel routine. Irregular sleeping habits, late-night screen use, and being always reachable can all contribute to even less time to rest. But persistent fatigue accompanied by memory lapses, difficulty concentrating, anxiety, mood changes or unexplained weight gain may warrant closer attention.
"Many women assume they are simply overwhelmed because of work or family responsibilities," says Dr Bimalpreet Mohan, Director, Chief Radiologist and Women's Health Specialist at Capital Health Clinic in Hauz Khas, New Delhi. "While lifestyle certainly contributes, hormonal changes during perimenopause can make the brain and body respond differently to stress. Women often describe feeling mentally slower, emotionally overwhelmed and physically exhausted even when they haven't changed their routine."
Why your brain suddenly feels 'full'
Brain fog is one of the symptoms women may experience during perimenopause. It can involve difficulty concentrating, forgetting small details, struggling to multitask or finding it harder to remain focused during the day. Poor sleep can make these difficulties more noticeable and may affect productivity and confidence.
"Hormonal fluctuations during perimenopause can disrupt sleep long before hot flashes become obvious," explains Dr Mohan. "Many women wake up repeatedly during the night or don't feel refreshed despite sleeping for several hours. That sleep deprivation affects memory, concentration and emotional resilience the following day."
When stress shows up on the weighing scale
Some women also notice changes in their weight despite maintaining similar eating and activity patterns. Changes in fat distribution, particularly around the abdomen, can occur during midlife. Chronic stress and hormonal changes may both play a role, while poor sleep and reduced physical activity can further affect weight management.
"It's important not to dismiss sudden weight gain as simply ageing or lack of discipline," says Dr Shobha Gupta, Medical Director, Gynaecologist and IVF Specialist at Mother's Lap IVF Centre in Pitampura, New Delhi. "Perimenopause brings metabolic and hormonal changes that affect how the body stores fat. Combined with poor sleep, stress and reduced physical activity, it becomes much harder to maintain a healthy weight."
The invisible symptoms women often ignore
Perimenopause is not limited to irregular periods or hot flashes. Women may also experience anxiety, irritability, reduced motivation, joint aches, low energy, poor sleep and changes in confidence. Because these symptoms can develop gradually, they may easily be attributed to work pressure, family responsibilities or lifestyle.
"Women often think they're simply falling behind because they're juggling too many responsibilities," says Dr Gupta. "In reality, hormonal changes during perimenopause can quietly affect sleep, mood and emotional resilience. Recognising these signs early can help women seek the right support instead of silently struggling."
How to break the cycle
There is no single quick fix for persistent exhaustion. It is recommended that one should focus on their daily routines, such as having a regular sleeping pattern, avoiding too much screen time before bed, taking movement breaks, eating meals with lots of protein, stress management and routine health checks.
At the same time, persistent symptoms should not automatically be attributed to perimenopause. "Brain fog, fatigue or irregular periods are not always caused by perimenopause. Thyroid disorders, anaemia, vitamin deficiencies and other health conditions can present in similar ways," says Dr Mohan. "A proper medical evaluation helps identify the real cause and ensures that conditions requiring treatment aren't missed."
What should women remember?
Being constantly exhausted should not become a measure of success. A woman may continue meeting deadlines and managing responsibilities while still experiencing symptoms that deserve attention. "High-functioning exhaustion need not be normalised, particularly for women approaching 40 years. If you have fatigue, brain fog, disturbed sleep, or anxiety for a few weeks, do not assume that is due to stress. Pay attention to your body, visit a doctor and focus on the prevention of health issues. Self-care is not about indulgence but health and wellbeing," concludes Dr Mohan.
In light of the current open discussions regarding mid-life health concerns amongst women, acknowledging the issue of chronic fatigue as one that deserves attention might help women get the required assistance.
Disclaimer: The information provided here is based on religious beliefs and popular traditions. There is no scientific evidence to support it. India TV does not vouch for the accuracy of any of the information.
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