How Adrenal Fatigue Mimics Perimenopause

Midlife exhaustion is often dismissed as “just hormones”, yet for many women, it’s the quiet hum of adrenal fatigue that’s stealing their spark.

When chronic stress keeps cortisol switched on, the adrenal glands lose their natural rhythm, leaving the body depleted and reactive. Add in fluctuating oestrogen during perimenopause, and the result is a perfect storm; energy crashes, mood dips, and nights that stretch too long.

Dr Fiona Kerr, neurophysiologist at the University of Adelaide, explains that our brains rely on rhythmic rest cycles, not relentless stimulation, to regulate focus and energy. Yet women in midlife often push through exhaustion, juggling work, caregiving, and invisible mental load, fuelled by caffeine and willpower instead of recovery. Over time, this “push through” culture can make hormonal transitions feel like burnout in disguise.

As the ovaries slow their hormone production, the adrenal glands are designed to take on some of the workload. But when they’ve been under pressure for years, they simply can’t keep up. This overlap creates a cluster of symptoms that can be hard to separate:

• Persistent fatigue despite rest

• Anxiety, mood swings, and irritability

• Brain fog or forgetfulness

• Night sweats, poor sleep, and weight changes

It’s the sensation many women describe as “wired but tired” where the body feels on high alert, yet utterly drained. Rebuilding energy doesn’t require radical change; it begins with rhythm. Small, consistent micro-rituals help signal to your nervous system that it’s safe to rest again:

• Eat within two hours of waking to anchor cortisol levels.

• Step outside for natural light to reset your circadian rhythm.

• Pause between transitions, take two deep breaths before each new task.

Simple moments like sipping herbal tea slowly, lighting a candle before bed, or journaling for five minutes are not indulgences, they are recalibration cues. These small pauses remind your body that safety, not survival, is the goal. Reclaiming energy in midlife isn’t about doing more it’s about remembering how to be again.

Science Snapshot

ABC Catalyst (2018) The Mindfulness Experiment. Available at: https://www.openground.com.au

Alevia Medical Weight Loss Centre (2023) Protein and Menopause: Your Medical Guide to Supporting Weight Loss During Hormonal Changes. Available at: https://www.alevia.com.au

Dr Garrett, A. (2024) What You Need to Know About Adrenal Fatigue in Perimenopause. Available at: https://www.drannagarrett.com

Eir Women (2023) Feeling Wired But Tired? It Could Be Your Adrenals. Available at: https://www.eirwomen.com.au/blogs/news/feeling-wired-but-tired-it-could-be-your-adrenals

Jean Hailes for Women’s Health (2023) Cortisol and Menopause. Available at: https://www.jeanhailes.org.au

Kerr, F. (2019) The Neurophysiology of Rest and Focus. University of Adelaide. Available at: https://researchnow-admin.flinders.edu.au/ws/files/29318158/Kerr_Neurophysiology_P2019.pdf

Uluna (2023) Micro-Rituals: The Power of Small Practices for Big Energy Shifts. Available at: https://www.uluna.com.au/blogs/journal/micro-rituals

Wilson, S. (2020) This One Wild and Precious Life. Available at: https://www.sarahwilson.com