If you feel completely exhausted in the days leading up to your period, we get you. As your hormones begin to fluctuate in preparation for your “time of the month,” it can be so tempting to just curl up on the couch and avoid that looming to-do list. But if you’re trying to get to work or school, or simply just have more energy throughout the day, you may find yourself searching for answers on how to perk up during your cycle, going so far as to Google, “Why am I so tired three days before my period?”

Turns out, fatigue is a pretty common premenstrual syndrome (PMS) side effect. A recent global survey found that PMS fatigue, in particular, affects about 60 percent of menstruating people¹. Research shows this extreme tiredness often begins in the week or two before your period² is due to arrive, becoming most intense on days three and two pre-period.

But why exactly does this fatigue happen? Here, we dive into the top reasons why period fatigue occurs, and how to get re-energized with different lifestyle habits and self-care practices.

5 reasons you’re so tired 3 days before your period

Besides just being tired from lack of sleep, stress, etc., there are a few main reasons why you might be fatigued before your period, in particular. Here’s a breakdown of the top causes.

1. Your hormones are fluctuating

Decreases in the hormones estrogen and progesterone are the chief drivers of most PMS symptoms, including low energy. And you can start to notice this decrease around three days before your period, says Jill Krapf, MD, a board-certified gynecologist and Evvy medical contributor. “PMS symptoms [as a whole] tend to intensify during this time, so in combination with the rapid hormone fluctuations, individuals can be more prone to tiredness and mood swings,” she explains.

2. You have less “feel-good hormones”

As reproductive hormones like estrogen and progesterone fluctuate, your brain’s levels of “feel-good hormones” like serotonin (a neurotransmitter partly responsible for mood, memory, and sleep regulation) are also taking a nosedive. As a result, you may feel a little more sad, emotional, or irritable in the days before your period shows up. According to the Mayo Clinic, mood changes can also often be accompanied by lethargy, sluggishness, and even cold symptoms for some people—also known as the “period flu.”

You might be even more prone to mood changes if you have an underlying mental health condition like depression or anxiety, even if it’s being managed with things like therapy and medication. Experts will sometimes call this phenomenon “premenstrual exacerbations.”

3. You’re eating more refined carbohydrates

While not everyone gets a major sweet tooth in the days leading up to their period, many menstruating people report having cravings for specific foods while PMSing, especially foods higher in refined or sugary carbohydrates (chocolate, anyone?). While there’s nothing wrong with indulging in your favorite treats, too many refined carbohydrates—like white bread, pasta, or baked goods—can actually mess with your sleep quality at the end of the day, leaving you feeling drained the following morning.

The reason why? Foods high in sugar or refined/simple carbs (i.e., not whole grains) tend to cause your blood sugar to slightly lift, leading to an eventual “crash” that leaves you feeling drowsy.

Ultimately, we’re not saying you have to completely avoid your fave comfort foods (especially when you’re on your period!), but cutting back or balancing your diet with things like whole grains (oatmeal, brown rice, wheat bread), protein, and healthy fats, should help stabilize your blood sugar, and therefore, your energy.

4. You have another physical health issue

It’s possible that extreme tiredness three days before your period (or in general before your period) could mean you have an underlying health problem that isn’t being addressed. “Some women who experience extreme period fatigue and tiredness may be suffering from an underlying medical condition such as anemia (low iron or red blood cell levels), an underactive thyroid, or a gynecological condition,” Dr. Krapf says.

Another thing to note: Like certain mental health issues, many physical health issues can cause an uptick in symptoms right before your period, which could make you feel more tired than usual. This includes conditions like chronic fatigue syndrome, irritable bowel syndrome (which could explain the period diarrhea and even asthma.

5. It could be PMDD

Around five percent of menstruating people have a condition called premenstrual dysphoric disorder (PMDD), which is essentially a very extreme form of PMS. According to Dr. Krapf, intense fatigue can be just one of many signs of this disorder. “However, people with PMDD also typically experience obvious emotional and behavioral symptoms such as sadness and hopelessness.” Other symptoms can include widespread pain, anxiety, or irritability.

Unlike PMS, PMDD symptoms are not typically confined to the three days before your period. Most people with PMDD are affected for a full one to two weeks leading up to menstruation, and most often require a multi-layered treatment approach including talk therapy, antidepressant medication, birth control, and lifestyle changes to reduce stress.

How to deal with fatigue 3 days before your period

The good news is that there are plenty of tools you can use to help cope with pre-period fatigue, whether it lasts for one day or sticks around for a while. Here are some lifestyle changes and tips experts recommend.

1. Get enough sleep

Not everyone needs more shut-eye before their period. But if you tend to get exhausted pretty easily, that’s your body’s way of telling you to log some more snooze time, Dr. Krapf says. If you know you’re always a zombie on the third day before your period, make it a point to go to bed earlier for a couple of nights leading up to that point. Also, there’s no shame in taking a quick afternoon nap!

2. Eat foods that help sustain your energy levels

Try to eat more wholesome, balanced snacks and meals each day, to avoid blood sugar spikes or crashes. “Certain foods such as nuts, low-fat dairy products, salmon, sardines, and leafy greens can help increase your energy levels and reduce PMS symptoms,” Dr. Krapf says.

When you do reach for some energy-boosting carbs, opt for ones that take longer to digest (like whole grains, fruits, veggies, or beans) over things like white bread or pasta, white rice, or sweetened snacks or drinks. Dr. Krapf also recommends trying to go alcohol-free before your period, too. Not only can alcohol mess with your blood sugar, but it can affect your sleep, leaving you groggy in the morning.

3. Get daily exercise

Working out when you’re tired might sound counterintuitive. But physical activity is a major mood and energy booster, says Dr. Krapf. Recent studies have also found exercise is proven to reduce PMS symptoms like fatigue, along with pain, mood swings, and bloating.

You don’t have to do a super intense workout to reap the benefits, either, BTW. Just 30 minutes of moderate aerobic exercise like walking, swimming, or riding your bike can be enough to perk you up. (And remember: if you have a day or two where you don’t feel like working out, that’s also okay!)

4. Try relaxation exercises

Finding things that help you relax before and during your period is also important. This could involve taking a gentle yoga class, a midday meditation or deep breathing break, or even getting a massage in the days before your period. Studies have also found that activities that promote relaxation are great for reducing fatigue and anxiety³, including when those symptoms are related to PMS.

5. Try taking vitamins and supplements

While there’s no guarantee that vitamins and supplements will completely spring you back to life, some might be able to help ease pre-period symptoms that lead to fatigue. (Just be sure to check in with your healthcare provider before adding them to your routine, Dr. Krapf recommends.) Some potential period fatigue fighters include the following:

• Calcium
• Vitamin B6
• Omega-3 fatty acids
• Dried chaste berry (A dietary supplement thought to relieve premenstrual syndrome.)
• Black cohosh (An alternative supplement thought to help relieve certain menstrual and menopausal symptoms, though more scientific research is needed to confirm these benefits.)

When to see a healthcare provider

Pre-period fatigue isn’t something you have to just “deal with” when it happens every month or so. If you’re consistently wiped out (think: bone-tired exhausted, weak, or dizzy) and lifestyle changes aren’t helping, let your healthcare provider know. You can talk about your symptoms together and decide on the best way to manage them.

FAQ

How many days does period fatigue last?

Everyone’s different, but in general, cycle-related symptoms like fatigue can start up one to two weeks before your period as your levels of estrogen and progesterone start to fall. “Your energy levels will usually return to normal within a few days as your hormone levels start to increase again,” Dr. Krapf says.

Should you sleep more on your period?

There’s no official recommendation here, but in general, it’s never a bad idea to get more sleep when you’re extra tired—which can happen before your period. “It’s important to listen to your body and remember that a good night’s sleep can go a long way,” says Dr. Krapf.