Episode 06: Why Perimenopause Fatigue Feels So Different
Perimenopause can leave women feeling tired, bloated, and mentally foggy without a clear reason why.
Energy drops in the middle of the day. Digestion feels slower.
Food that once worked fine now feels heavy.
It’s frustrating, especially when nothing obvious has changed.
Hormones are part of the picture, but they’re not the whole story.
As estrogen and progesterone shift, digestion can change too, which may affect how well the body absorbs certain nutrients.
When nutrients aren’t absorbed efficiently, energy production can feel less steady.
The result is fatigue that sleep doesn’t always fix and brain fog that coffee can’t fully cover up.
What if the issue isn’t a lack of effort, but a change in how the body is processing fuel?
In this episode, host Sara Estes explores what may be happening beneath the surface.
She walks through how shifting hormones can influence digestion and nutrient absorption, and why that matters for steady energy.
When key nutrients like iron and B12 aren’t absorbed as efficiently, the cells that produce energy may not function as smoothly.
Sara breaks down why bioavailability matters, why some nutrient forms are easier to use than others, and why supporting the gut often works better than pushing through fatigue.
Instead of forcing energy, this episode offers a more sustainable way to support how the body processes fuel.
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WIW Ep. 06 - Perimenopause, Bloating, and Brain Fog: It's All Connected
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[00:00:00] if you're in perimenopause, and by about two or three in the afternoon, you just feel off like your energy is tanking, your stomach feels heavy, you've got brain fog. This episode is for you because what's happening isn't random. And it's definitely not because you're doing anything wrong.
[00:00:16] Perimenopause is a whole body transition, not just hormonal. It's digestive, metabolic, and cellular. today I wanna show you something. Most conversations miss energy and digestion don't break separately in the season.
[00:00:29] They break together and once you understand why, everything starts to make a little more sense. Welcome to Wild is Wise. I'm Sara Estes, a former private investigator who ditched the high stress legal life after a major health crisis. I rebuilt my health from the ground up through nutrition and functional medicine
[00:00:51] and now I'm here to uncover the truth about women's wellness and translate it so you can make informed decisions about your health. On this podcast, [00:01:00] we break down women's nutrition and physiology with real research and actionable tips, and here's the core philosophy, what's found in nature is often exactly what our biology is wired to thrive on. We get nerdy with the science, but keep it practical for everyday life. If you're ready to understand what your body actually needs, you're in the right place. As always, this podcast is educational, not medical advice.
[00:01:23] Please talk to your healthcare provider before making any changes.
[00:01:26] Let's jump in.
[00:01:28] We usually think about estrogen and progesterone as hormones that just handle periods and fertility, right? and sure they do that, but that's only part of the story. These hormones actually play a role in more areas than we realize. They're talking to your gut, your brain, your muscles, basically your whole system.
[00:01:45] Your digestive tract is literally covered in estrogen and progesterone receptors, which means your gut is constantly listening to your hormones every single day. when your hormones shift, your gut feels it immediately.
[00:01:57] These receptors sit in the smooth muscle tissue [00:02:00] that lines your entire digestive system, your stomach, your intestines, all of it. And smooth muscle is what moves food through your body. It's like a wave-like motion that keeps everything flowing.
[00:02:11] So when your hormones fluctuate, that motion changes. Sometimes it slows down, sometimes it gets uncoordinated, and that affects everything. How bloated you feel, how long food sits in your stomach, how gassy you get. There's actually a whole body of research on this.
[00:02:26] Scientists published a big review in a journal called Neuro Gastroenterology and Motility, looking at how women's hormones affect digestion throughout their lives. They found that when estrogen and progesterone shift, your gut literally moves differently and becomes more sensitive to everything going on inside.
[00:02:44] And here's what makes perimenopause so tricky. Your hormones aren't just gradually declining like they do in menopause. They're all over the place. One day, estrogen is up the next day it's down. Progesterone spikes. Then it crashes. Your body is getting mixed [00:03:00] signals constantly. Think of your digestion like a conveyor belt at the grocery store.
[00:03:04] When everything's stable, that belt moves at a nice even pace, food gets processed efficiently, everyone gets checked out But during perimenopause, it's like someone keeps messing with the speed dial.
[00:03:15] The belt slows down and then it speeds up. It stutters. It doesn't completely stop, but it definitely isn't running smooth anymore, and that's why so many people feel like their digestion is off, but they can't quite put their finger on what's wrong. not dramatic.
[00:03:30] It's not food poisoning. It's just different food sits heavier in your stomach and you get bloated as the day goes on and you feel way fuller for longer than you used to. And your gut just feels more sensitive. Meals that never used to bug you suddenly feel uncomfortable, and none of this is in your head.
[00:03:46] And it's not just stress. This is mechanical. Your gut is physically moving differently because the hormone signals controlling it keep changing. And because this slowdown is subtle, most people, including doctors, [00:04:00] miss it. But even though it's subtle, it kicks off a whole chain reaction. When food hangs out in your digestive tract longer than it's supposed to, it starts fermenting more and that creates gas, and that creates bloating and that creates discomfort.
[00:04:13] Plus, when food is sitting against your gut lining for too long, it can start to irritate it, especially if your gut is already a bit sensitive. But here's the biggest thing. When digestion slows down, your body gets less efficient at pulling nutrients out of your food.
[00:04:28] Your gut is designed to absorb vitamins and minerals within specific time windows, and when those windows shift, absorption gets wonky. So even if you're eating really well, even if you're taking supplements, less of those nutrients are actually making it into your bloodstream where your body can use them.
[00:04:46] And that's why your energy and your digestion start feeling connected during perimenopause because when your gut slows down and absorption drops, your cells literally have less fuel to work with. That's when you start feeling [00:05:00] exhausted for no clear reason This is the foundation that we need to understand before we get into what we need to do about it. Perimenopause isn't just changing your hormones. It's changing how your body processes and delivers fuel.
[00:05:13] Once you see that connection, everything else makes a lot more sense and starts to click.
[00:05:18] Okay, so we just talked about how digestion slows during perimenopause. Now let's talk about what happens next, because this is where things get frustrating for a lot of women. From the outside, nothing's really changed.
[00:05:31] You're eating the same way. Maybe you're even eating better than you used to, like having more vegetables, more protein, taking your vitamins. You're trying, but you're still exhausted and you start thinking like, what am I doing wrong? You know, is this me? Here's the thing, you're probably not doing anything wrong.
[00:05:47] The problem is that energy doesn't come from just eating food. It comes from what your body can actually pull out of that food and use your digestive system has to break down food, move it through, absorb the [00:06:00] nutrients and deliver them to your cells. It's like a multi-step assembly line. So when one part of that line slows down, the whole thing gets backed up.
[00:06:07] When food sits in your stomach or intestines longer than it should, you'd think that might mean better absorption, right? Like more time equals more nutrients absorbed. But actually that's not what happens
[00:06:18] when digestion gets sluggish, your gut lining can get irritated. Your enzymes don't work as well, and the whole system becomes less efficient at getting nutrients into your bloodstream.
[00:06:29] This matters most for the nutrients. Your cells need to make energy because real energy, the kind that actually makes you feel awake and alert, that's made inside your cells, specifically inside these tiny little structures called mitochondria.
[00:06:42] Mitochondria are like little energy factories. They take the nutrients from your food plus oxygen, and they turn them into something called a TP, and that's basically the battery that powers everything your body does, your muscles, your brain, your organs, they all run on a TP.
[00:06:57] But here's the catch. [00:07:00] Mitochondria are very picky. They need specific nutrients to do their job.
[00:07:04] Things like vitamin B12, iron, magnesium, copper, if even one of those is missing, or if your body can't absorb it properly, your mitochondria starts sputtering and you feel it. There was actually a really interesting review published in 2024.
[00:07:19] It was in the journal nutrients that looked at how hormonal changes affect energy production in women who are going through perimenopause and menopause. The researchers found that even when women were eating. The same amount of food. Their cells were processing nutrients differently and making energy less efficient because of those hormonal shifts.
[00:07:40] This is huge because it means that when you're exhausted during perimenopause, it's not usually because you need more food or more willpower. It's because your cells are literally under fueled at a chemical level, that's why perimenopause fatigue feels so different from just regular tiredness.
[00:07:57] It's deeper. It's heavier. Sleep [00:08:00] doesn't really fix it, and coffee doesn't really touch it. You wake up tired, you crash in the afternoon, your brain feels foggy even when you've had like a full good night's sleep.
[00:08:09] And this is where we usually make the wrong move. So instead of more stimulants, more coffee, more energy, drinks, more pushing through, you can't stimulate your way out of a fuel problem. It's like slamming on the gas pedal when your gas tank is totally empty.
[00:08:22] It just doesn't work. It's not gonna do anything. I, let me give you a concrete example here. Let's look at iron. Iron is critical for energy because it helps carry oxygen to your cells, and it's part of the machinery that makes a TP in your mitochondria. But your body can only absorb iron when certain conditions are right.
[00:08:41] There are two types of iron in food. There's heme iron, which comes from animal foods like meat, then there's non-heme iron, which comes from plants like spinach and beans. Scientists have done studies comparing how well people absorb these two types, and they found that Myron gets absorbed way more efficiently, several [00:09:00] times more efficiently, and it doesn't need much help from your digestive system to get absorbed.
[00:09:05] Whereas non-heme iron is a little pickier. It needs good stomach acid, it needs certain enzymes, and it can get blocked by things in plant foods like phytates, so if your digestion is already a little sluggish and your gut is a little irritated, non-heme iron actually becomes hard to absorb. Heme Iron, on the other hand, has its own pathway. It just gets in. It's more direct, it's more reliable, and it's more efficient.
[00:09:29] The same thing happens with vitamin B12. B12 is absolutely essential for turning food into energy. And for keeping your brain working clearly, but absorbing B12 is complicated. You need stomach acid. You need something called intrinsic factor, and you need a healthy gut lining when digestion slows and your gut gets stressed.
[00:09:48] B12 absorption tanks, even if you're eating plenty of animal foods that contain it. And that's why brain fog and fatigue show up together so often. Your brain uses a ton of energy,
[00:09:59] [00:10:00] it is been estimated uses around 300 to 400 calories a day,
[00:10:03] and when your mitochondria aren't producing enough a TP, your brain is one of the first things to suffer that foggy spacey, can't think clearly feeling that's often metabolic, and it's happening because of what's going on in your gut. So here's what I want you to take away from this. When you're exhausted during perimenopause, it's usually not because you're not trying hard enough. It's because the nutrients aren't getting from your plate into your cells Efficiently,
[00:10:28] which means the solution isn't to force yourself harder, it's to support your body better, to choose nutrients that are easier to absorb, to reduce the friction in your digestive system and to work with what's actually happening instead of fighting against it.
[00:10:41] And that brings us to our next piece, the gut lining itself. Because it's not just about what you eat, it's about whether your gut isn't good enough shape to actually absorb it. Okay. So by now you're probably thinking, all right, I get it. My digestion is slower.
[00:10:54] I'm not absorbing nutrients at, well, so do I just eat more, take more vitamins? What's the move here? This [00:11:00] is where most people go off track because when absorption is the problem, taking more stuff doesn't actually fix it. Better stuff does. And that brings us to a word you've probably heard thrown around but might not totally understand, which is bioavailability
[00:11:14] don't let this fancy term scare you. Bioavailability is actually super simple. It just means how much of this nutrient can your body actually use? Because here's the thing, just because a food or supplement contains a nutrient doesn't mean your body can absorb it. those are two completely different questions.
[00:11:31] You can eat a diet that looks amazing on paper, tons of vitamins, minerals, all the good stuff, and still be running on empty at the cellular level if your body can actually absorb what you're eating.
[00:11:41] This is why so many people feel like they're doing everything right and still feel like garbage. They're focused on quantity. Am I eating enough? Am I taking enough supplements when their body is actually asking for quality and form? During perimenopause, when your digestion is less efficient, bioavailability becomes [00:12:00] everything.
[00:12:00] Most nutrients need a whole process before your body can use them. They need stomach acid, they need enzymes. They need a healthy gut lining. They need specific proteins to carry them into your bloodstream. And if any of those steps aren't working right, the nutrient just doesn't get in.
[00:12:14] It doesn't matter how much you ate.
[00:12:15] Now, let's talk about herbs, because they play a really different role than most people think traditional herbs don't force your digestion to speed up. They're not stimulants. They work by calming, irritation and helping your gut relax into its natural rhythm.
[00:12:30] Slippery Elm is a perfect example. I love this herb.
[00:12:33] It contains these compounds called mucilage that form a gel when they mix with water. Traditionally, slippery Elm has been used to support digestive comfort and particularly when the gut feels sensitive.
[00:12:45] Yaro is another one that I love. It's been used traditionally to support digestive ease and smooth muscle relaxation, which remember is what controls how food moves through your gut.
[00:12:56] There are a lot of other ones that are great too, but these are two herbs [00:13:00] that support your system gently, and when you combine them with collagen for gut support and other bioavailable nutrients for fuel, you're creating an environment where your digestive system can function more comfortably.
[00:13:11] One last thing I wanna mention is dosage. A lot of supplements on the market require you to take. Pretty high doses, and if your gut is already sensitive, that much can actually backfire, causing nausea, bloating, reflux, or those burps that you can get sometimes during perimenopause. Bigger isn't always better. Smarter is better, so consider lower dose formulations or talking to your healthcare provider about what dose makes sense for you so that your supplements are more sustainable long term. Okay, so if you're listening to this thinking, this actually makes sense, but what do I do with it?
[00:13:44] Here are a few practical takeaways. First, stop beating yourself up about being tired during perimenopause. Low energy isn't a character flaw. It's a sign that nutrients aren't getting from your food into your cells efficiently. If your fatigue shows up alongside [00:14:00] bloating, fullness, or digestive weirdness, look at your gut first.
[00:14:04] Second, focus on nutrient forms that are easy for your body to use. This isn't about eating more, it's about eating smarter. Pay attention to how you feel after different foods.
[00:14:15] Choose things that feel grounding and gentle on your system.
[00:14:19] The third takeaway, support your gut before you try to force energy. If your digestion fills off piling caffeine and stimulants usually backfires, focus on reducing that friction, calming your gut, and letting your digestion normalize.
[00:14:33] When your gut is calm, absorption works better.
[00:14:36] And the fourth takeaway, be careful with high doses Notice if certain supplements make you feel worse instead of better. if something makes you feel worse. Nausea, bloating, reflux. That's your body giving you feedback. Sustainable support should always feel steady, not aggressive. And finally, remember that perimenopause is your body changing how it talks to you when you listen and respond by supporting your digestion and [00:15:00] absorption.
[00:15:00] Energy can stabilize naturally. You don't have to force it. You just have to support it. That's the shift, that's where real resilience starts. .
[00:15:09] Alright, that is it for this episode of Wild is Wise. I hope you found this information helpful and useful. Thank you so much for listening and as always, stay wild. Stay wise. I'll see you next time..