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The resulting catastrophic energy deficit is a primary physiological driver of post-exertional malaise (PEM) or 'crashes,' where even minor, everyday activities trigger a disproportionate and prolonged exacerbation of profound fatigue, muscle weakness, and cognitive impairment

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PLoS One, 10(4), e0123454 10.1371/journal.pone.0123454 [DOI] [PMC free article] [PubMed] [Google Scholar] Svaren, J

Maintaining healthy folate levels, methylation, and hormonal balance early on in menopause is important for preventing health complications years down the line