It's normal to feel tired around your period — here are 5 ways to feel more energized during your period

• Many factors lead to period fatigue, including hormonal changes, blood and iron loss, dehydration, and stress.
• Getting extra sleep, exercise, and going on hormonal birth control can all help combat period fatigue.
• If fatigue is extreme and persists after the menstrual cycle, you should see a doctor and be checked out for iron deficiency anemia or a thyroid disorder.
• This article was medically reviewed by G. Thomas Ruiz, MD, OB/GYN Lead at MemorialCare Orange Coast Medical Center in Fountain Valley, California.

Period fatigue is the tired feeling people sometimes get before or during their period that affects up to 90% of women, according to one study. Many factors can contribute to period fatigue, including insomnia and hormonal changes.

Learn more about what causes period fatigue and what you can do to boost energy levels during your period.

What causes period fatigue?

It's hard to pinpoint what might be contributing to your period fatigue because many factors may be at fault.

Hormonal changes. During menstruation, your body experiences changes in hormone levels that can leave you feeling tired, Mandal says. During a typical 28-day cycle, estrogen rises for two weeks, then drops sharply after ovulation, staying low for the weeks before and during your period.

"Estrogen levels peak and then decrease quickly before the onset of the menstrual cycle, which can cause fatigue and sluggishness," Mandal says.

Some women experience a corresponding drop in the neurotransmitter serotonin as their estrogen levels fall. Having low serotonin levels has been linked to depression and fatigue, so a drop in serotonin levels could help explain period fatigue, Mandal says.

Blood and associative iron loss. Additionally, the blood loss during your period can contribute to fatigue due to a loss of iron. If you have heavy bleeding or you're already prone to lower iron levels, this may result in temporary anemia, a condition caused by iron deficiency that comes with symptoms including fatigue. A heavy period is defined as a blood loss of over 80 cc per month.

Dehydration and stress. Lifestyle factors, including dehydration and stress, can also contribute to period fatigue, Mandal says. While these are general causes of fatigue — not specific to your period — staying well hydrated and reducing stress during your period could help combat fatigue, Mandal says.

Ways to combat period fatigue

Lifestyle changes can help with period fatigue, Mandal says. Here's what she suggests:

Get extra sleep. It's best not to fight your feeling of fatigue; try to get the extra sleep your body is craving, Mandal says. "In general, getting some extra shut-eye always helps with feeling better," she says. It's important to block more time for sleep — or a daytime nap — since your sleep can be interrupted by PMS symptoms or the need to use the bathroom. Aim for more than the recommended 7 hours each night.

Try to destress. Irritability is a symptom of PMS, but managing stress levels can help keep period fatigue at bay, Mandal says. "Managing stress can help avoid high cortisol levels, which influences other hormones in the body and can lead to fatigue," she says.

Exercise. Getting exercise can give you a boost of energy, Mandal says. A 2014 study found that, specifically, aerobic exercise like running can help with PMS-associated fatigue.

Snack smart. Eating whole foods and avoiding processed foods can help reduce symptoms of PMS, including fatigue. "Eating clean, natural foods helps to avoid further hormonal disruptions," Mandal says. "You are what you eat."

Consider birth control. If period fatigue is having a big impact on your life, you can talk to your doctor about a hormonal birth control option, Mandal says. "For some women, oral contraceptives may make the symptoms of fatigue and PMS less severe. [They] can help with heavy bleeding which can lead to iron deficiency and help with some of the emotional symptoms of PMS."

When to see a doctor

If your fatigue is so severe that it interferes with your day-to-day functioning, you should talk to your doctor to make sure there are no underlying health concerns.

"For women whose fatigue is more extreme and persisting after the menstrual cycle, [they] should be checked out for iron deficiency anemia and thyroid disorders," Mandal says.

Severe fatigue is also a symptom of premenstrual dysphoric disorder (PMDD), a severe form of PMS that affects about 5% of women. PMDD is often treated with medications, including antidepressants and birth control. If you believe that you might be experiencing PMDD, talk to your doctor, Mandal says.

Although some period fatigue is normal, consult with your doctor if lifestyle changes don't improve your energy levels, she says.

Takeaways

Although fatigue during your period is sometimes a sign of an underlying health concern, usually it's nothing to worry about.

"It is relatively common to experience fatigue before and during your menstrual cycle," Mandal says.

Learning how to manage your symptoms can help you feel better during your period, and your doctor may be able to provide guidance.

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• 9 reasons why your period may be late, including stress, changes to sleep schedule, and more
• The 4 best home remedies for period cramps
• The truth about period syncing and the real reason you may be experiencing it
• What everyone should know about birth control, from the types to effectiveness
• How birth control pills work by tricking the body into thinking it's already pregnant