Why Motivation Feels Harder Now

PLUS: More women are getting hormone therapy + Congress steps in on the estrogen patch shortage

👋 Hello friends,

Welcome to the August 18th edition of Menopaussible—bringing you the news you can use and the ⚡ energy ⚡ you need to support your menopause journey. I'm Maria Caracci Ciccolella—mindset coach and menopause advocate. (Connect with me on IG or LinkedIn!)

There is still a month of summer left on the calendar, though for most of us, the shift from summer to fall routines is already in full effect. To-do lists are being compiled and executed on, the calendar ahead is already filling up, routines put on hold for the summer, revisited. Thinking about it all is exhausting—and you may even be thinking: more than usual.

Fatigue and energy loss is a real thing in perimenopause and one of the first symptoms you may experience before associating it with this life transition. And that energy loss doesn’t just affect your ability to keep up, but also your facility to move forward, impacting every decision, every pursuit, every version of yourself you’ve been meaning to get to.
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In this issue, as always, we get to the root of it—and what you can do to reclaim it.

Why Your Energy Isn't What It Used to Be

No spoiler alert here: if you’re a recent reader of this newsletter or a “long time” subscriber, you already have some inkling that your changing hormones play a major role in your energy production.

This begins at the most cellular level of the body where energy is actually produced—the mitochondria. Both estrogen and progesterone regulate cellular energy by influencing mitochondrial function—declining levels of each, in essence, drive power outages. With less estrogen, mitochondria struggle to convert food into cellular energy, while the system creates more free radicals, leading to cellular stress and inflammation. Meanwhile progesterone, which declines more rapidly, no longer acts as a crucial stabilizer for metabolic and brain energy—its loss contributing to memory lapses and mood changes.

Then there are the compounding effects of other menopaus- related symptoms on energy, notably:

• Sleep disruption instigated by hot flashes, anxiety, sleep apnea, and joint pain from increased inflammation, which prevents the body from adequately restoring energy reserves. No rest, no fuel.
• Mood and stress brought on by higher levels of cortisol and the inability to fully relax which keep the nervous system running hot, burning through energy reserves even “at rest.”

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What It Costs You

The loss of energy may already seem like enough of a price to pay for these changes, but unfortunately they are not the only expense:

• Memory and concentration start to fragment as the brain needs fuel to consolidate information and stay sharp
• Mood is greatly affected as the brain’s ability to emotionally regulate also requires energy; when reserves are low, reactivity goes up
• And maybe most noticeable of all, motivation—the ability to initiate, sustain, and follow through on goals—plummets as it is directly tied to the brain’s energy availability

When energy goes quiet, so does everything else you've been meaning to get to.

Reclaiming Your Energy

It may feel as if you have to give in to this loss of energy as a new fact of life. The good news—like with many things menopause—is that making some adjustments can quickly recharge your batteries.

• Exercise is one area where investing a little energy can quickly generate more. Even moderate movement improves mitochondrial efficiency and sleep quality
• Nutrition focused on whole foods like fruits, vegetables, lean proteins, and healthy fats can lower inflammation and boost energy. Also consider limiting or simply avoiding alcohol and sugar, which can disrupt sleep, increase inflammation, and spike/crash energy
• Stress management to help reduce the cortisol drain is as important as adding fuel. Think about easy, accessible ways to reduce overwhelm. Stepping outside in nature and sunlight, for example, can introduce Vitamin D that supports mood, immune function, and energy regulation..
• Menopause Hormone Therapy (MHT) or non-hormonal therapies to address symptoms associated with disrupting sleep (i.e., hot flashes, night sweats, anxiety) may be worth discussing with a health provider. Treating the root cause is always more efficient than managing the symptoms downstream.

All the Paussibilities

Energy isn't just about keeping up with your to-do list. It's the currency of possibility. When it depletes, the first things to go aren't the obligations—those somehow still get done. It's the other things: the ideas you meant to pursue, the plans that get quietly unmade, the version of yourself you keep promising you'll get back to when you have more bandwidth.

The hard truth is that bandwidth doesn't just reappear on its own. But understanding where it went is the first step toward reclaiming it—not just physically, but in every area of your life where you've been running on empty.

Now that you understand where it went, the real question is what you're going to do with it when you get it back—and what's been waiting for you to have enough fuel to start.
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Reclaiming your energy is the first step. Knowing what to do with it is the next. If you've been waiting for the right moment—this might be it. Book a free clarity consult here.

Plus: News Items

Congress Is Pushing to Fix the Estrogen Patch Shortage
​Rep. Debbie Dingell (D-MI) and seven colleagues—Deborah Ross (D-NC), Eleanor Holmes Norton (D-DC), Andrea Salinas (D-OR), Jesús G. García (D-IL), Yvette D. Clarke (D-NY), Rashida Tlaib (D-MI), and Emily Randall (D-WA)—sent a letter to the FDA pressing for action on the estrogen patch shortage straining menopause treatment access. It's advocacy doing what advocacy is supposed to do—naming a problem loudly enough that it can't be quietly ignored. If patches are hard to find right now, ask your provider about oral or gel alternatives while the fix works its way through channels. And, if one of these eight represents you, this is a good week to reach out—to ask them to keep pushing, or just to say thanks. You can find your representative contact information here.

More Women Are Getting Hormone Therapy—Nearly Double Since 2017

​New data from Epic Research shows hormone therapy prescriptions have nearly doubled since 2017, led by women in their late 40s and early 50s. That's not a trend—it's a shift. More women are asking the question, and more doctors are saying yes. Take it as evidence that speaking up about symptoms is starting to move the needle clinically, not just culturally.

Dr Juliet McGrattan Running and Menopause Are you a runner struggling with menopause? Get weekly tips, advice and inspiration from Dr Juliet for healthy and happy training. Subscribe​