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Откуда берётся усталость после 40 и как вернуть силы

5 минут чтенияПроверено специалистом VIA-L · 17.10.2026

Вроде бы спите, вроде бы едите как обычно, а сил нет с самого утра. К обеду хочется лечь, к вечеру — ничего не хочется. Первая мысль — «не хватает витаминов». Но чаще всего дело не в них.

Что чаще всего стоит за усталостью

Снижение эстрогена действительно влияет на выносливость. Но усталость в этом возрасте гораздо чаще идёт от другого — и почти всё это можно проверить и поправить:

Поэтому начинать стоит не с баночек «для энергии», а с проверки.

Признаки, с которыми — на анализ, а не «бодриться»

⚠️ Отдельный случай: если после нагрузки на следующий день становится резко хуже — на часы или сутки, — наращивать нагрузку через силу нельзя. С этим — к врачу.

Что возвращает силы

Движение. Самый сильный рычаг энергии из всех известных. Лучше всего работает сочетание: силовые тренировки, короткие интенсивные отрезки с полным отдыхом между ними и лёгкое кардио. Хуже всего — «всё время средне-тяжело». Хорошая новость: в первые годы после менопаузы тело особенно отзывчиво к тренировкам.

Белок с утра. Белковый завтрак в течение часа-двух после подъёма. Пропущенный завтрак и скачки сахара сами подстёгивают гормоны стресса — и днём наступает провал.

Ходьба после еды. 10–15 минут после основных приёмов пищи сглаживают «сахарные качели» и послеобеденную сонливость.

Якорь сна. Подъём в одно и то же время все семь дней и дневной свет утром. Иногда самое простое — лечь на полчаса раньше.

Что убрать

Алкоголь, рафинированные сладости и ультраобработанная еда, хронический недосып, интенсивные тренировки без восстановления — убрать эти «утечки энергии» важнее, чем что-то добавить.

А добавки?

Еда и движение сильнее любой из них. Железо — только по анализу на ферритин, не вслепую. Витамин D можно и без анализа. Магний и витамины группы B добавляют энергии, только если их не хватает. Модные «бустеры молодости» (NMN, NR и подобные) у людей энергию в исследованиях не улучшили — мы их не советуем.

Когда к врачу

Что попробовать на этой неделе

На чём основано

Статья написана по темам базы знаний VIA-L. За ними стоят опубликованные работы — вот они:

  1. Cognitive Behavioural Therapeutics for Insomnia Symptoms in the Perimenopause Through to the Early Postmenopausal Period — The Cochrane Database of Systematic Reviews, 2026 doi
  2. Effectiveness of Non-Pharmacological Interventions for Insomnia Related to Natural Menopause: A Meta-Analysis of Randomized Controlled Trials — Maturitas, 2026 doi
  3. An Integrated Anti-Aging Framework Targeting NAD+ Homeostasis, Mitochondrial Quality Control, and Redox Stability: Roles of NMN/NR, PQQ, and EGT — Redox Biology, 2026 doi
  4. Safety and Efficacy of Individualised Exercise and NAD+ Precursor Supplementation in Patients With Friedreich's Ataxia in the USA: A Single-Centre, 2 × 2 Factorial, Randomised Controlled Trial — Neurology, 2026 doi
  5. A Digital Mindfulness Intervention Improves Sleep Efficiency and Heart Rate Variability in Healthy Adults — Scientific Reports, 2026 doi
  6. Nutritional Modulators of Sleep: A Narrative Review of Vitamins, Minerals, Amino Acids, and Their Neurobiological and Chronoepigenetic Mechanisms — Chronobiology International, 2026 doi
  7. Do Menopausal Symptoms Signal Early Biological Aging? Mitochondrial, Endocrine and Clinical Insights — Climacteric : The Journal of the International Menopause Society, 2026 doi
  8. The Role of Exercise-Mediated Mitochondrial Quality Control Remodeling in Aging — Frontiers in Cell and Developmental Biology, 2026 doi
  9. Cost-Effectiveness of First-Line IV vs Oral Iron for Iron-Deficiency Anemia in Women With Heavy Menstrual Bleeding — Blood Advances, 2026 doi
  10. Cognitive-Behavioral, Acceptance-Based, and Mindfulness-Based Interventions for Psychological and Sleep-Related Symptoms During Menopause: A Systematic Review — Acta Psychologica, 2026 doi
  11. Integrative Approaches to Perimenopause — The American Journal of Medicine, 2026 doi
  12. Hormonal Modulation With Withania Somnifera: Systematic Review and Meta-Analysis of Randomized-Controlled Trials — Planta Medica, 2026 doi
Показать все (118)
  1. Insomnia and women: exploring vulnerability, impact, and intervention — Sleep & Breathing = Schlaf & Atmung, 2026 doi
  2. OSA in Women: Associations With Reproductive Aging and Screening Challenges — Chest, 2026 doi
  3. Pharmacological and Non-Pharmacological Treatments for Chronic Insomnia in Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-Analysis — Sleep Medicine, 2026 doi
  4. Reframing menopause and menopause hormone therapy as opportunities for healthy aging — Science, 2026 doi
  5. Diagnosis of Primary Mitochondrial Diseases — Muscle & Nerve, 2025 doi
  6. Effects of Exercise Training on Mitochondrial and Capillary Growth in Human Skeletal Muscle: A Systematic Review and Meta-Regression — Sports Medicine (Auckland, N.Z.), 2025 doi
  7. Effects of Nutrients and Diet on Mitochondrial Dysfunction: An Opportunity for Therapeutic Approaches in Human Disease — Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie, 2025 doi
  8. The Combination of Physical Exercise and Slow-Paced Breathing on Psychophysiological Indices of Emotion Reactivity, Psychosocial Stress Reactivity and Recovery: A Multimodal Investigation — Behaviour Research and Therapy, 2025 doi
  9. The Effect of Probiotic Consumption on Fatigue Severity and Sexual Function Among Postmenopausal Women: A Double-Blind Randomized Controlled Trial in the West of Iran — Menopause (New York, N.Y.), 2025 doi
  10. Role of Circadian Health in Cardiometabolic Health and Disease Risk: A Scientific Statement From the American Heart Association — Circulation, 2025 doi
  11. Effectiveness of 2 Just-in-Time Adaptive Interventions for Reducing Stress and Stabilizing Cardiac Autonomic Function: Microrandomized Trials — Journal of Medical Internet Research, 2025 doi
  12. Chrononutrition Interventions for Mental Health: Addressing Atypical Depression, Ultra-Processed Food Use Disorder, and Circadian Dysregulation — Frontiers in Psychiatry, 2025 doi
  13. Iron Deficiency in Adults: A Review — JAMA, 2025 doi
  14. Psychiatric and Cognitive Outcomes of Iron Supplementation in Non-Anemic Children, Adolescents, and Menstruating Adults: A Meta-Analysis and Systematic Review — Neuroscience and Biobehavioral Reviews, 2025 doi
  15. Comparison of diagnostic algorithms used in guidelines on nutritional anaemias in adults — PloS One, 2025 doi
  16. Adrenal Insufficiency in Adults — JAMA, 2025 doi
  17. An Integrative Approach to HPA Axis Dysfunction: From Recognition to Recovery — The American Journal of Medicine, 2025 doi
  18. Elinzanetant for the Treatment of Vasomotor Symptoms Associated With Menopause: A Phase 3 Randomized Clinical Trial — JAMA Internal Medicine, 2025 doi
  19. Fezolinetant and Elinzanetant Therapy for Menopausal Women Experiencing Vasomotor Symptoms: A Systematic Review and Meta-Analysis — Obstetrics and Gynecology, 2025 doi
  20. Menopause and Movement: Exercise for Better Sleep and Psychological Well-Being-a Systematic Review — Menopause (New York, N.Y.), 2025 doi
  21. Omega-3 Fatty Acids and Sleep: Recent Advances in Understanding Effects and Mechanisms — Current Opinion in Clinical Nutrition and Metabolic Care, 2025 doi
  22. Biomarkers of Mitochondrial Disorders — Neurotherapeutics : The Journal of the American Society for Experimental NeuroTherapeutics, 2024 doi
  23. The Modern Management of Uterine Fibroids-Related Abnormal Uterine Bleeding — Fertility and Sterility, 2024 doi
  24. ACR Appropriateness Criteria® Management of Uterine Fibroids: 2023 Update — Journal of the American College of Radiology : JACR, 2024 doi
  25. A clinical study evaluating low dose ferrous fumarate vs — Scientific Reports, 2024 doi
  26. Identification and management of preoperative anaemia in adults: A British Society for Haematology Guideline update — British Journal of Haematology, 2024 doi
  27. Shoden Promotes Relief From Stress and Anxiety: A Randomized, Double-Blind, Placebo-Controlled Study on Healthy Subjects With High Stress Levels — Heliyon, 2024 doi
  28. Hypopituitarism — Lancet (London, England), 2024 doi
  29. European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and Therapy of Glucocorticoid-Induced Adrenal Insufficiency — The Journal of Clinical Endocrinology and Metabolism, 2024 doi
  30. Performance of Dehydroepiandrosterone Sulfate and Baseline Cortisol in Assessing Adrenal Insufficiency — The Journal of Clinical Endocrinology and Metabolism, 2024 doi
  31. Components and Delivery Formats of Cognitive Behavioral Therapy for Chronic Insomnia in Adults — JAMA Psychiatry, 2024 doi
  32. Network Meta-Analysis Examining Efficacy of Components of Cognitive Behavioural Therapy for Insomnia — Clinical Psychology Review, 2024 doi
  33. Effects of Mind-Body Exercise on Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-Analysis — Menopause (New York, N.Y.), 2024 doi
  34. Stimulus control for insomnia: A systematic review and meta-analysis — J Sleep Res, 2024 doi
  35. Social jetlag and obesity: A systematic review and meta-analysis — Obes Rev, 2024 doi
  36. Potential Biomarkers of Mitochondrial Dysfunction Associated With COVID-19 Infection — Advances in Experimental Medicine and Biology, 2023 doi
  37. Mediterranean Diet and Mitochondria: New Findings — Experimental Gerontology, 2023 doi
  38. Impact of Geroscience on Therapeutic Strategies for Older Adults With Cardiovascular Disease: JACC Scientific Statement — Journal of the American College of Cardiology, 2023 doi
  39. Laboratory Testing for Mitochondrial Diseases: Biomarkers for Diagnosis and Follow-Up — Critical Reviews in Clinical Laboratory Sciences, 2023 doi
  40. Randomized Crossover Clinical Trial of Coenzyme Q10 and Nicotinamide Riboside in Chronic Kidney Disease — JCI Insight, 2023 doi
  41. Changes in Cortisol Awakening Responses (CAR) in Menopausal Women Through Short-Term Marine Healing Retreat Program With Specific Factors Affecting Each CAR Index — PloS One, 2023 doi
  42. The Relationship Between Heavy Menstrual Bleeding, Iron Deficiency, and Iron Deficiency Anemia — American Journal of Obstetrics and Gynecology, 2023 doi
  43. Oral Gonadotropin-Releasing Hormone Antagonists for the Treatment of Uterine Leiomyomas — Obstetrics and Gynecology, 2023 doi
  44. Effects of Sleep Fragmentation and Estradiol Decline on Cortisol in a Human Experimental Model of Menopause — The Journal of Clinical Endocrinology and Metabolism, 2023 doi
  45. Ocimum Tenuiflorum Extract (HOLIXERTM): Possible Effects on Hypothalamic-Pituitary-Adrenal (HPA) Axis in Modulating Stress — PloS One, 2023 doi
  46. GABA-ergic Modulators: New Therapeutic Approaches to Premenstrual Dysphoric Disorder — CNS Drugs, 2023 doi
  47. The Effect of Caffeine on Subsequent Sleep: A Systematic Review and Meta-Analysis — Sleep Medicine Reviews, 2023 doi
  48. Clinical and cost-effectiveness of nurse-delivered sleep restriction therapy for insomnia in primary care (HABIT): a pragmatic, superiority, open-label, randomised controlled trial — Lancet, 2023 doi
  49. Oral Micronized Progesterone for Perimenopausal Night Sweats and Hot Flushes a Phase III Canada-Wide Randomized Placebo-Controlled 4 month Trial — Scientific Reports, 2023 doi
  50. Optimizing Sleep Across the Menopausal Transition — Climacteric : The Journal of the International Menopause Society, 2023 doi
  51. Relationship between daytime napping with the occurrence and development of diabetes: a systematic review and meta-analysis — BMJ Open, 2023 doi
  52. Impact of Nutraceuticals and Dietary Supplements on Mitochondria Modifications in Healthy Aging: A Systematic Review of Randomized Controlled Trials — Aging Clinical and Experimental Research, 2022 doi
  53. Interventions for heavy menstrual bleeding; overview of Cochrane reviews and network meta‐analysis — Cochrane Database of Systematic Reviews, 2022 doi
  54. Iron Deficiency Anemia: Impact on Women's Reproductive Health — Fertility and Sterility, 2022 doi
  55. Uterine bleeding: how understanding endometrial physiology underpins menstrual health — Endocrinology, 2022 doi
  56. Guideline for the laboratory diagnosis of iron deficiency in adults (excluding pregnancy) and children — British Journal of Haematology, 2022 doi
  57. Iron deficiency screening is a key issue in chronic inflammatory diseases: A call to action — Journal of Internal Medicine, 2022 doi
  58. Human adaptative behavior to Antarctic conditions: A review of physiological aspects — WIREs Mechanisms of Disease, 2022 doi
  59. Modulation of the Hypothalamic-Pituitary-Adrenal (HPA) Axis by Plants and Phytonutrients: A Systematic Review of Human Trials — Nutritional Neuroscience, 2022 doi
  60. Systematic review and meta-analyses on the effects of afternoon napping on cognition — Sleep Med Rev, 2022 doi
  61. A Portrait of Obstructive Sleep Apnea Risk Factors in 27,210 Middle-Aged and Older Adults in the Canadian Longitudinal Study on Aging — Scientific Reports, 2022 doi
  62. Disruption of Sleep Continuity During the Perimenopause: Associations With Female Reproductive Hormone Profiles — The Journal of Clinical Endocrinology and Metabolism, 2022 doi
  63. Chrono-Nutrition: From Molecular and Neuronal Mechanisms to Human Epidemiology and Timed Feeding Patterns — Journal of Neurochemistry, 2021 doi
  64. Estrogen Deficiency Induces Mitochondrial Damage Prior to Emergence of Cognitive Deficits in a Postmenopausal Mouse Model — Frontiers in Aging Neuroscience, 2021 doi
  65. A Review of Clinical Guidelines on the Management of Iron Deficiency and Iron-Deficiency Anemia in Women With Heavy Menstrual Bleeding — Advances in Therapy, 2021 doi
  66. Diagnosis and Treatment of Luteal Phase Deficiency: A Committee Opinion — Fertility and Sterility, 2021 doi
  67. Effect of Long-term Supplementation With Marine Omega-3 Fatty Acids vs Placebo on Risk of Depression or Clinically Relevant Depressive Symptoms and on Change in Mood Scores: A Randomized Clinical Trial — JAMA, 2021 doi
  68. Omega-3 Fatty Acids for Depression in Adults — The Cochrane Database of Systematic Reviews, 2021 doi
  69. Omega-3 Long-Chain Polyunsaturated Fatty Acid and Sleep: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Longitudinal Studies — Nutrition Reviews, 2021 doi
  70. Sleep During Menopausal Transition: A 10-Year Follow-Up — Sleep, 2021 doi
  71. Effects of a Short Daytime Nap on the Cognitive Performance: A Systematic Review and Meta-Analysis — Int J Environ Res Public Health, 2021 doi
  72. Improving Diet for Psychiatric Patients : High Potential Benefits and Evidence for Safety — Journal of Affective Disorders, 2020 doi
  73. Estrogenic Control of Mitochondrial Function — Redox Biology, 2020 doi
  74. Assessment and Management of Heavy Menstrual Bleeding — JAMA, 2020 doi
  75. The Allopregnanolone to Progesterone Ratio Across the Menstrual Cycle and in Menopause — Psychoneuroendocrinology, 2020 doi
  76. Hormone Therapy for Postmenopausal Women — The New England Journal of Medicine, 2020 doi
  77. Feeding Mitochondria: Potential Role of Nutritional Components to Improve Critical Illness Convalescence — Clinical Nutrition (Edinburgh, Scotland), 2019 doi
  78. Abnormal Uterine Bleeding in Reproductive-Age Women — JAMA, 2019 doi
  79. Screening and Management of Bleeding Disorders in Adolescents With Heavy Menstrual Bleeding: ACOG COMMITTEE OPINION, Number 785 — Obstetrics and Gynecology, 2019 doi
  80. Chronotype and Social Jetlag: A (Self-) Critical Review — Biology (Basel), 2019 doi
  81. Positive Psychological Well-Being and Cardiovascular Disease: JACC Health Promotion Series — Journal of the American College of Cardiology, 2018 doi
  82. Biomarkers for Mitochondrial Energy Metabolism Diseases — Essays in Biochemistry, 2018 doi
  83. Antifibrinolytics for heavy menstrual bleeding — Cochrane Database of Systematic Reviews, 2018 doi
  84. A New Model for Adrenarche: Inhibition of 3β-Hydroxysteroid Dehydrogenase Type 2 by Intra-Adrenal Cortisol — Hormone Research in Paediatrics, 2018 doi
  85. Effects of Mind⁻Body Exercises (Tai Chi/Yoga) on Heart Rate Variability Parameters and Perceived Stress: A Systematic Review With Meta-Analysis of Randomized Controlled Trials — Journal of Clinical Medicine, 2018 doi
  86. Effect of Omega-3 Supplements on Vasomotor Symptoms in Menopausal Women: A Systematic Review and Meta-Analysis — European Journal of Obstetrics, Gynecology, and Reproductive Biology, 2018 doi
  87. Symptoms of menopause — global prevalence, physiology and implications — Endocrinology, 2018 doi
  88. Effects of Pharmacologic and Nonpharmacologic Interventions on Insomnia Symptoms and Self-Reported Sleep Quality in Women With Hot Flashes: A Pooled Analysis of Individual Participant Data From Four MsFLASH Trials — Sleep, 2018 doi
  89. Mitochondria and ageing: role in heart, skeletal muscle and adipose tissue — Journal of Cachexia, Sarcopenia and Muscle, 2017 doi
  90. Mitochondrial Function and Mitophagy in the Elderly: Effects of Exercise — Oxidative Medicine and Cellular Longevity, 2017 doi
  91. Understanding Adaptogenic Activity: Specificity of the Pharmacological Action of Adaptogens and Other Phytochemicals — Annals of the New York Academy of Sciences, 2017 doi
  92. Omega-3 Versus Isoflavones in the Control of Vasomotor Symptoms in Postmenopausal Women — Gynecological Endocrinology : The Official Journal of the International Society of Gynecological Endocrinology, 2017 doi
  93. Surgery versus medical therapy for heavy menstrual bleeding — Cochrane Database of Systematic Reviews, 2016 doi
  94. Non‐anaemic iron deficiency – a disease looking for recognition of diagnosis: a systematic review — European Journal of Haematology, 2016 doi
  95. Altered Diurnal Pattern of Steroid Hormones in Relation to Various Behaviors, External Factors and Pathologies: A Review — Physiology & Behavior, 2016 doi
  96. The Role of Ovarian Sex Steroids in Metabolic Homeostasis, Obesity, and Postmenopausal Breast Cancer: Molecular Mechanisms and Therapeutic Implications — BioMed Research International, 2015 doi
  97. Estrogen: An Emerging Regulator of Insulin Action and Mitochondrial Function — Journal of Diabetes Research, 2015 doi
  98. Duration of menopausal vasomotor symptoms over the menopause transition — JAMA Intern Med, 2015 doi
  99. Pooled Analysis of Six Pharmacologic and Nonpharmacologic Interventions for Vasomotor Symptoms — Obstetrics and Gynecology, 2015 doi
  100. MicroRNA-23a Mediates Mitochondrial Compromise in Estrogen Deficiency-Induced Concentric Remodeling via Targeting PGC-1α — Journal of Molecular and Cellular Cardiology, 2014 doi
  101. Efficacy of Omega-3 for Vasomotor Symptoms Treatment: A Randomized Controlled Trial — Menopause (New York, N.Y.), 2014 doi
  102. Treatment for Mitochondrial Disorders — The Cochrane Database of Systematic Reviews, 2012 doi
  103. Practice Bulletin No — Obstetrics and Gynecology, 2012 doi
  104. Cortisol Stimulates Secretion of Dehydroepiandrosterone in Human Adrenocortical Cells Through Inhibition of 3betaHSD2 — The Journal of Clinical Endocrinology and Metabolism, 2011 doi
  105. Acute Emotional Stress and Cardiac Arrhythmias — JAMA, 2007 doi
  106. Suppression of the Hypothalamic-Pituitary-Ovarian Axis in Normal Women by Glucocorticoids — Biology of Reproduction, 1993 doi

Доказательная сила у этих работ разная: где-то крупные обзоры и мета-анализы, где-то отдельные небольшие исследования. Шаги в статье — простые меры заботы о себе с низким риском, а не лечение, и подходят не всем.

Это общие сведения, а не назначение. Обследование и лечение подбирает врач.

Приложение VIA-L

VIA-L — приложение для женщин с 35 и мужчин с 40 лет: сон, энергия, настроение и тело в период гормональных перемен. Простыми словами, по вашим данным — и с проверкой, что помогло.

Все статьи библиотеки есть и в приложении.

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