Fatigue and Exhaustion Top the Perimenopause Symptom List in a Large Survey

In a large survey of period-app users, fatigue and exhaustion were the most commonly reported symptoms.^[1]

A 2026 study co-authored by Mayo Clinic and Flo Health researchers surveyed 17,494 women in 158 countries about perimenopause. Among the 12,681 respondents aged 35 and over, the most common symptoms were fatigue (83%), physical and mental exhaustion (83%), irritability (80%), depressive mood (77%), and sleep problems (76%).^[1]

Hot flashes were the symptom respondents most often recognized as a sign of perimenopause (71%). That measures awareness, not experience. In this survey, fatigue and exhaustion were each reported by 83% of respondents aged 35 and over.^[1]

One caveat matters. Everyone in this survey used a period-tracking app, and the symptoms are self-reported. It shows what app users notice, not what every woman experiences.^[1]

What to track for two weeks

Write down, once a day:

• Energy on a 1–5 scale, morning and afternoon
• Hours slept and whether you woke during the night
• Mood, including irritability and anxiety
• Your cycle: date of last period and any changes in length or flow
• Anything that made the day harder

Bring the log to your clinician. Ask about sleep and mood, not just hot flashes.

If it doesn’t lift

If fatigue lasts, talk to your clinician. Ask them to check the factors linked to fatigue in a Swiss population study of adults aged 45 to 86: sleep problems, depression, and anemia.^[2] Tell them about each symptom on your log.

References

[1] Hedges MS, Hewings-Martin Y, Karam J, Castaneda R, Cunningham AC, Xu Y, Zhaunova L, Faubion SS, Shufelt CL. Global perspectives on perimenopause: a digital survey of knowledge and symptoms using the Flo application. Menopause. 2026;33(7). doi:10.1097/gme.0000000000002730 ↑︎

[2] Galland-Decker C, Marques-Vidal P, Vollenweider P. Prevalence and factors associated with fatigue in the Lausanne middle-aged population. BMJ Open. 2019;9(8). doi:10.1136/bmjopen-2018-027070 (Swiss adults aged 45–86; not a perimenopause sample.) ↑︎

Kurt Greiner

Kurt is a digital strategist and IT professional blending emerging technology with practical application, exploring how individuals can leverage modern tools to navigate the second half of life with purpose.