PCOS and fatigue: Everything you need to know

Polycystic ovary syndrome (PCOS) fatigue is a common complaint of women with PCOS. In this article, we’re going to look at why PCOS sufferers are more at risk of fatigue and what steps you can take to reduce low energy.

PCOS and fatigue

According to a 2021 study published in BMC Endocrine Disorders, PCOS affects up to 13% of women. Women with PCOS are more likely to report symptoms of fatigue than those without the condition. Fatigue is a commonly supported symptom of PCOS.

The Royal College of Obstetricians & Gynaecologists lists fatigue and daytime sleepiness as one of the long-term health risks associated with PCOS. So, if you’re wondering, ‘Can PCOS make you tired?’ The answer is yes.

Does PCOS cause fatigue?

Yes, PCOS is strongly associated with fatigue. While some tiredness is unavoidable in our busy, modern lives, it shouldn’t interfere with your daily life. If you find yourself feeling permanently exhausted, it could be PCOS fatigue. Your doctor will want to identify the exact cause of your PCOS and develop a treatment plan to manage your symptoms.

Why does PCOS make you tired?

There are several reasons why PCOS could cause you to feel tired all the time:

• The hormonal imbalances can make you feel sluggish
• Heavy menstrual bleeding increases your risk of anemia
• Obesity is linked to fatigue
• Fatigue is a symptom of depression, and PCOS increases your risk of depression.
  

PCOS low energy is a common complaint of people with polycystic ovaries. If you are struggling with low energy and fatigue, it’s important to discuss these symptoms with your doctor. Your doctor will likely want to rule out other potential causes first, including:

• Anaemia
• B12 deficiency
• Vitamin D deficiency
• Hypothyroidism

Once these are ruled out, your doctor will determine how to treat your PCOS fatigue. Sometimes, PCOS fatigue is a side effect of the medication used to treat the condition, so your doctor will want to consider any medications you’re taking. It can also be related to sleep disorders, which PCOS sufferers have an increased risk of, so you’re doctor will investigate whether this could be to blame for your exhaustion.

PCOS: The basics

To understand PCOS low energy, we first need to understand the condition. PCOS is an endocrine and metabolic disorder. Though common, it can often be undiagnosed, with many women not realizing they have the condition.

Despite its name, PCOS has nothing to do with cysts. You usually need to meet two of the main criteria for a diagnosis. The three criteria are:

• Irregular cycles
• Excess androgen
• Polycystic ovaries

Polycystic ovaries are large, approximately 0.3 inches wide, containing follicles surrounding the eggs. These follicles often can’t release an egg, meaning ovulation fails to occur.

Common symptoms of PCOS include:

• Irregular or absent periods
• Infertility
• Hair growth on the face, back, chest, or buttocks
• Hair loss or thinning on the scalp
• Acne
• Weight gain

A 2009 study published in the Journal of Clinical Endocrinology & Metabolism found that half of women with PCOS were asymptomatic, explaining why so many women aren’t diagnosed until they seek help for infertility.

Causes of PCOS

The exact cause of PCOS is unknown, though experts believe the following issues may be at play:

Insulin resistance

Women with PCOS are more likely to be resistant to insulin. The hormone insulin controls blood sugar levels. With insulin resistance, the body produces excess insulin. Excessive insulin can cause the ovaries to overproduce testosterone. Too much testosterone prevents ovulation. Insulin resistance can lead to weight gain, which can worsen your symptoms of PCOS.  

Hormonal imbalance

It’s unknown whether the hormone imbalances are the cause of PCOS or a reaction to insulin resistance. Women with PCOS may have elevated levels of testosterone and luteinizing hormone (LH), which can interfere with ovulation. Low levels of sex hormone-binding globulin (SHBG) leave women more vulnerable to the effects of increased testosterone.

Genetics

PCOS can run in families. You have an increased risk of PCOS if a close female relative has the condition. However, scientists have not yet identified the exact genes at play.  

PCOS-related health conditions

PCOS increases your risk of several severe health conditions, and your PCOS fatigue could be due to one of these:

Diabetes

There is a link between PCOS and decreased sensitivity to insulin. According to the Centers for Disease Control & Prevention, over half of all women with PCOS are diagnosed with type 2 diabetes by their 40th birthday. Fatigue is a common diabetes symptom.

Obesity

Women with PCOS are more likely to be overweight. This could be due to the insulin resistance associated with PCOS. A 2006 study published in the Annals of the New York Academy of Sciences found that fatigue is linked with obesity.

Sleep apnea

A 2020 study published in Sleep Breath found 35% of PCOS sufferers had Obstructive Sleep Apnea. This sleep condition is characterized by stop-and-start breathing at night. As you can imagine, a disturbed night due to sleep apnea puts you more at risk of fatigue during the day.

Thyroid problems

A 2021 study published in Cureus found women with PCOS had an increased risk of subclinical hypothyroidism. Subclinical hypothyroidism is when your test results don’t meet the criteria for a hypothyroidism diagnosis, but you are experiencing symptoms of hypothyroidism, such as fatigue.

Treatment for PCOS and exhaustion

Some women with PCOS feel tired all the time. Not only does this make it difficult to get anything done, but it can also affect your mental health. It can get you down when you’re falling behind with your to-do list and canceling plans because you don’t have the energy to go out. Luckily, there are some steps you can take to fight PCOS fatigue, such as:

Exercise

It’s probably the last thing you feel like doing when a bout of fatigue hits, but gentle exercise can help boost your energy levels. Head out for a walk with a friend or podcast for company, or find a yoga or pilates workout you can do from home.

Eat a healthy, balanced diet

The food you eat affects how you feel. If you put the wrong gas in your car, it won’t run; the same goes for your body. A diet high in processed junk food can leave you fatigued and bloated. However, eating a healthy, balanced diet can give you a natural energy boost. Focus on eating fresh fruits, veggies, lean protein sources, and healthy fats.

Get plenty of rest

When you’re battling fatigue, it can feel like there isn’t enough sleep in the world to make you feel human. However, every little bit helps. If you feel exhausted during the day, take a nap where possible. Practice good sleep hygiene habits like avoiding screens before bed, going to bed at the same time each night, and relaxing before bedtime.

Weight loss

Losing weight can reduce your PCOS symptoms and your risk of developing associated long-term health problems such as high blood pressure. Weight loss isn’t easy when you have PCOS, but it is possible. The first two lifestyle changes of exercise and healthy eating could help you with your goal of losing weight.

Take your supplements

Speak to your doctor to find out which supplements they recommend to tackle PCOS tiredness. Infolic Acid is a supplement specially designed to reduce the symptoms of PCOS. Your doctor may also recommend B12, vitamin D, and iron supplements if your blood test results reveal a deficiency in these vital nutrients.  

Take care of yourself

Stress can increase insulin resistance, and fatigue is a common symptom of depression. Taking care of your mental health could help to alleviate your PCOS fatigue. A 2023 study published in Alternative Therapies in Health & Medicine found that regular yoga and mindfulness improved participants' psychological well-being. Getting enough sleep, eating a healthy diet, and regular exercise can also boost your mood.

Medication

Some medicines can help fight PCOS fatigue, so speak to your doctor if the above lifestyle changes aren’t reducing your symptoms. Several medications, including metformin, can manage your insulin levels and ease fatigue. PCOS extreme fatigue can be debilitating, and you don’t need to suffer through it. Make an appointment to speak to your doctor today.

Final Verdict

Fatigue is a symptom commonly reported by PCOS sufferers. Fatigue is a difficult symptom; many women feel it impacts their quality of life. Regular exercise, eating a healthy diet, losing weight, getting enough sleep, and protecting your mental health could boost your energy levels. Speak to your doctor to find out whether supplements and medication may help to control your PCOS symptoms and fight fatigue.

Though you can make many lifestyle changes to reduce fatigue, it can be challenging to make these changes when you’re exhausted. Try not to put too much pressure on yourself. Take it one day at a time, and try your best. You’re not perfect; nobody is, but even small changes could help you feel better and give you more energy.

Aspect Health’s science-backed PCOS plan could be the support system you’re looking for to help you succeed. A continuous monitor tracks your blood glucose, hormone, and inflammation levels to address the underlying causes of your symptoms. Your dedicated PCOS coach will create a personalized plan and support you on your journey. Get started with our PCOS program today.

References:

Centers for Disease Control & Prevention “Diabetes and Polycystic Ovary Syndrome (PCOS)” [Accessed 2024] https://www.cdc.gov/diabetes/risk-factors/pcos-polycystic-ovary-syndrome.html?CDC_AAref_Val=https://www.cdc.gov/diabetes/basics/pcos.html

Di Mario, Sofia et al. “The Use of Yoga and Mindfulness-based Interventions to Reduce Stress and Burnout in Healthcare Workers: An Umbrella Review.” Alternative therapies in health and medicine vol. 29,1 (2023): 29-35. https://pubmed.ncbi.nlm.nih.gov/36074961/

Ee, Carolyn et al. “Providing lifestyle advice to women with PCOS: an overview of practical issues affecting success.” BMC endocrine disorders vol. 21,1 234. 23 Nov. 2021, doi:10.1186/s12902-021-00890-8 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8609880/

Kahal, Hassan et al. “The prevalence of obstructive sleep apnoea in women with polycystic ovary syndrome: a systematic review and meta-analysis.” Sleep & breathing = Schlaf & Atmung vol. 24,1 (2020): 339-350. doi:10.1007/s11325-019-01835-1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7127997/

Mantantzis et al. “Sugar rush or sugar crash? A meta-analysis of carbohydrate effects on mood.” Neuroscience & Biobehavioral Reviews, Volume 101,2019, Pages 45-67, ISSN 0149-7634, https://www.sciencedirect.com/science/article/abs/pii/S0149763418309175

Mortensen, Monica et al. “Asymptomatic volunteers with a polycystic ovary are a functionally distinct but heterogeneous population.” The Journal of clinical endocrinology and metabolism vol. 94,5 (2009): 1579-86. doi:10.1210/jc.2008-2771 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684482/

Raj, Deepak et al. “Frequency of Subclinical Hypothyroidism in Women With Polycystic Ovary Syndrome.” Cureus vol. 13,9 e17722. 4 Sep. 2021, doi:10.7759/cureus.17722 https://assets.cureus.com/uploads/original_article/pdf/66745/20211005-32416-5hp37d.pdf

The Royal College of Obstetricians & Gynaecologists (Published 2015) “Polycystic ovary syndrome (PCOS): what it means for your long-term health” [Accessed 2024] https://www.rcog.org.uk/for-the-public/browse-our-patient-information/polycystic-ovary-syndrome-pcos-what-it-means-for-your-long-term-health/

Vgontzas, Alexandros N et al. “Obesity-related sleepiness and fatigue: the role of the stress system and cytokines.” Annals of the New York Academy of Sciences vol. 1083 (2006): 329-44. doi:10.1196/annals.1367.023 https://pubmed.ncbi.nlm.nih.gov/17148748/

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