Hi "terrible"...
Beyond the contribution of menopause, excessive fatigue and hair loss may suggest thyroid issues and/or anemia (i.e. iron, b6, b12). Severe menopause, often associated with hot flashes (and subsequent loss of sleep, then chronic fatigue) should be reviewed by your MD/DO/ND/NP for treatment with a physiological natural spectrum of hormones. Stress...of course...contributes significantly to the whole story as the adrenals have important hormonal regulators that can become less functional with prolonged stress. Anecdotally, maca and apple cider vinegar have reportedly helped (http://www.earthclinic.com/CURES/menopause.html#ACV), along with black cohosh (Am J Med 2005 19;118 Suppl 12B:98-108) and pueraria mirifica. A nice review of natural estrogens in menopause can be found
(http://jcem.endojournals.org/cgi/reprint/83/2/297?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=Pueraria+mirifica+menopause&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT)
best wishes for restored health...
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