Burnout or perimenopause: how do you know the difference?

Feeling drained, foggy, and like you’re running on fumes? You might assume you’re heading for burnout - especially if life’s been a lot. But what if it’s not just stress from work or life? What if your hormones are also part of the story?

Many women notice an overlap between burnout and perimenopause - the hormonal transition phase leading up to menopause. Both can cause exhaustion, anxiety, poor sleep, and brain fog, which makes it tricky to know what’s really going on.

Table of contents

1. Why burnout and perimenopause look so alike

2. The role of hormones in your energy and mood

3. How to spot key differences

4. What to do if you’re not sure

5. How to support your body and mind

Why burnout and perimenopause look so alike

Let’s be honest, most women juggle a lot. Work, family, ageing parents, maybe teenagers or sleepless nights. Add fluctuating hormones into the mix, and it’s no wonder many feel completely depleted. During perimenopause, levels of oestrogen and progesterone - two hormones that affect mood, sleep, and energy - start to fluctuate. This hormonal rollercoaster can mimic classic burnout symptoms: fatigue, irritability, poor concentration, and a shorter emotional fuse.

Quick fact: Research shows that hormonal shifts can increase your sensitivity to stress and affect how your brain processes cortisol - the stress hormone.

In other words: your body’s stress system is working harder than it used to. So even small pressures can suddenly feel overwhelming.

The role of hormones in your energy and mood

Oestrogen supports serotonin (your mood stabiliser) and helps regulate sleep and brain function. Progesterone is calming and aids rest, but when levels drop, anxiety, insomnia, and restlessness can creep in. These hormonal changes affect your nervous system. So while burnout stems mainly from external stress overload, perimenopause adds an internal layer of biological stress. The result: You may feel like your usual coping strategies no longer work.

How to tell the difference

It’s not always clear-cut, but there are clues: If your symptoms are linked to perimenopause, you might notice:

• Irregular or heavier periods

• Night sweats or hot flushes

• New levels of anxiety or mood swings

• Energy crashes that don’t improve with rest

Burnout, on the other hand, is more often tied to long-term work or emotional overload. It may show up as:

• Constant fatigue even after weekends or holidays

• Feeling detached, cynical, or emotionally flat

• Loss of motivation or purpose

• Physical tension, headaches, or stomach issues

Of course, both can exist together, and often do. Hormonal shifts can make you more vulnerable to burnout, especially if you’ve been pushing through stress for years.

What to do if you’re not sure

Start by listening closely to your body. Track your cycle and symptoms for a few months. Are your mood dips, sleep issues, or fatigue worse around your period or mid-cycle? That’s a hint hormones are at play. Talking to a women’s health doctor can also help untangle what’s going on. They may suggest checking your hormone levels, thyroid function, or stress markers to get a fuller picture. And if you are burnt out? Addressing your hormonal health can still make recovery smoother. Supporting your body through perimenopause - with lifestyle, nutrition, and sometimes hormonal therapy - can reduce stress sensitivity and improve resilience.

Tip: Small daily actions add up. Prioritise rest (not just sleep), reduce caffeine and alcohol, and eat protein-rich meals to stabilise blood sugar - all of which support hormone balance and stress recovery.

Supporting your body and mind

Whether it’s burnout, perimenopause, or both, the solution isn’t to “push through.” It’s to rebalance.

• Move gently: think walking, yoga, or swimming instead of high-intensity workouts that raise cortisol.

• Sleep like it matters: keep a consistent bedtime, avoid screens an hour before bed, and try magnesium or herbal teas.

• Nourish your hormones: healthy fats, B vitamins, and omega-3s help stabilise mood and energy.

• Ask for help: from your GP, a women’s health specialist, or even at work. You’re not weak for needing support; you’re human.

Key takeaways

• Burnout and perimenopause share many symptoms, from fatigue to brain fog.

• Hormonal fluctuations in your 40s can heighten stress sensitivity.

• Tracking your cycle and symptoms can reveal hormonal patterns.

• Supporting hormone balance can make stress recovery easier.

• You don’t have to choose between “it’s hormonal” or “it’s burn-out” - it can be both, and both deserve care.

References:

Brinton, R. D., Yao, J., Yin, F., Mack, W. J., & Cadenas, E. (2015). Perimenopause as a neurological transition state. Nature reviews. Endocrinology, 11(7), 393–405. https://doi.org/10.1038/nrendo.2015.82

Hemachandra, C., Taylor, S., Islam, R. M., Fooladi, E., & Davis, S. R. (2024). A systematic review and critical appraisal of menopause guidelines. BMJ sexual & reproductive health, 50(2), 122–138. https://doi.org/10.1136/bmjsrh-2023-202099

Maartje Niehof. “Help! Is Het Een Burn out of de (Peri)Menopauze?” Sups.care, 19 Jan. 2025, sups.care/blogs/blog/burnout-of-perimenopauze?srsltid=AfmBOopguoYpilEGMBntpRvPBoOHU0RnwQfYjnHBWUE92VEgChxKDXW0. Accessed 7 Oct. 2025.