What Causes Fatigue in PCOS?
Dr. Renuka Dangare

Dr. Renuka Dangare

May 11PCOS

What Causes Fatigue in PCOS?

This blog has been compiled by Komal Adhlaka, a content writer for Proactive For Her.

PCOS or polycystic ovarian syndrome can be diagnosed if any menstruator is ticking off 2 out of 3 criteria -

  1. Irregular periods : Unpredictable periods, periods >35 or <20 days apart or missed periods.
  2. Raised androgens : Labs showing elevated levels of testosterone or DHEAS or acne and increased coarse hair on the face, neck, upper chest or arms of a menstruator.
  3. Polycystic ovaries on ultrasound.

Although diagnosing PCOS looks fairly straightforward, it comes with a myriad of physical and mental health concerns that can be difficult to cope with. Unexplained fatigue is one of them. More often than not, the causes of this fatigue are fairly easy to correct and getting your lifestyle back on track can help with resolving this symptom.

PCOS and Fatigue

Fatigue can be more draining for women with PCOS, as it can cause poor performance at work, loss of balance between personal and professional life, and a reduced ability to fulfill desired responsibilities towards themselves and others.

Causes of fatigue in PCOS

PCOS fatigue can be caused by the following reasons:

1. Adrenal fatigue

  • ‘Adrenal fatigue’ (or more accurately HPA- Axis dysfunction), is when you’ve been stressed for a long time, and your stress response ends up impacting your body's hormonal balance.
  • This stress can come from psychological stress like being slammed at work, health or financial crisis in the family or due to physical reasons like over-exercising, lack of sleep and often eating too little. 
  • When we are under chronic stress our adrenal glands pump out cortisol, our stress hormone as well as a hormone called DHEA-S.
  • Excess stress hormone prevents the release of LH from the pituitary and stops ovulation. Excess DHEAS also prevents ovulation and further worsens acne and excess hair growth.

2. The blood sugar imbalance

  • Insulin resistance is one of the biggest underlying causes of PCOS.
  • It could be the main factor behind your fatigue if-
  1. you have a family member with PCOS or diabetes
  2. you have skin darkening on the nape of your neck or under the breast called “ acanthosis nigricans”.
  3. you have skin tags or small growths of skin on your neck or armpits.
  • Insulin resistance can cause erratic increases in your body’s insulin levels in response to glucose in your blood.
  • Hyperinsulinemia and constantly fluctuating blood sugar levels can cause irritability, anger and fatigue.

3. Lack of essential vitamins and minerals

  • Vitamins and minerals are essential for all reactions in our body, including stress response and energy. For example, iron transports oxygen around our body, so if we do not have enough iron, we simply can’t get enough air which can make us feel very tired.
  • If you have insulin resistance, you’re likely to be deficient in Vitamin D, Chromium and Manganese. These can worsen your mood and make you feel exhausted too.
  • The B Vitamins are also critical energy production in your body. If you don’t have enough B vitamins, then this energy production would slow down or not occur.
  • Metformin depletes the body of vitamin B12, and 30% of people who take Metformin are at a higher risk of becoming vitamin B12 deficient.

4. Hypothyroidism

  • Our thyroid is the major controller of our metabolism, so when it’s underactive, we’ll not only be burning less energy but also feel excessively tired and may also have brain fog.
  • Your symptoms may also include poor concentration, feeling sluggish or lethargic, low appetite, feeling bloated or constipated and poor sleep.

5. Mental Health Concerns

  • Burn-out is described as a state of physical, emotional, and mental exhaustion. Described as an occupational syndrome, burn-out may happen if you are exposed to excessive and prolonged stress in your workplace.
  • Also, mood disorders, like anxiety and depression, are common causes of fatigue.
  • Depression can aggravate chronic fatigue syndrome. 

6. Anemia

  • You may develop anaemia if there is iron deficiency in your blood or if you are suffering from a medical condition that causes blood loss, such as haemophilia and menorrhagia (heavy menstrual bleeding). 

fatigue in pcos

Ways to manage fatigue in PCOS

1. Balanced diet

  • Eat more non-starchy vegetables like carrots, beans, lettuce, broccoli, spinach, asparagus, tomatoes, etc. 
  • Carbohydrate-dense foods like brown rice, sweet potatoes, rice, fruit, etc are easily digestible and help in better metabolism. 
  • Add lean protein to your meals like eggs, salmon, tuna, grilled chicken, etc. 
  • Cook your vegetables with healthier oils like olive oil, desi ghee, coconut oil, etc.  
  • Keeping meal times and blood sugars consistent is the best way to avoid fatigue.

2. Manage sleep patterns 

  • Sleep and wake up at the same time every day.
  • Besides, reducing the caffeine intake since coffee exerts additional stress on the adrenal glands, adds to chronic lethargy, anxiousness, disruption of hormones, and irritability.
  • Increased caffeine intake interferes with a peaceful night’s sleep, so you might have to take your last cup of coffee before 4 pm.
  • Eliminate any blue light exposure from electronic devices a few hours before bedtime since it negatively affects health and sleep patterns.
  • Lastly, manage your physical, emotional, and environmental stress by adopting healthier lifestyle habits like sleeping early and waking up early, morning jog, meditation, etc. Such activities help in improving your sleep cycles.

3. Manage stress 

  • Simplify your daily schedule. Do only a handful of things to avoid fatigue and stress. 
  • Schedule mini breaks and relax. Taking some ‘me time’ off can help you feel refreshed and less stressed. 
  • Feeling stressed out can stimulate a hormonal response in your body, which may give way to adrenal fatigue. Practice yoga and meditation to avoid adrenal fatigue.
  • Light exercises like walking, swimming, and cycling can also help fight stress. 

4. Increase your insulin sensitivity

  • Eat a low to moderate carbohydrate diet with 20%- 25% carbs (majorly from low GI sources) of your overall diet.
  • Ensure you exercise for about 3-5 days each week, combining resistance, HIIT, and restorative workouts.
  • Take supplements with inositol NAC or natural substances like cinnamon, and apple cider vinegar. 

5. Improve thyroid health

  • Thyroid health can be improved by maintaining a lifestyle that involves regular exercise, proper hydration, and a well-proportioned diet full of eggs, fish, and fruits.
  • If you have been experiencing symptoms of hypothyroidism such as increased weight

6. Regulate your menstrual cycle (hormonal balance)

  • Increasing your insulin sensitivity may help to balance the body’s hormone levels; however, high androgen levels can also disrupt your menstrual cycle.
  • Androgen excess can thus be managed by managing your stress levels and supplementing your diet with nutrients like zinc, etc. 

7. Stay hydrated 

  • Drink 3-4 litres of water daily to stay hydrated. Hydration keeps your exhaustion at bay. 

Final Words

Your health care professional can guide you to improving your PCOS fatigue. However, eating a good diet and supplementing it with the required vitamins and minerals is equally important. Work on identifying your stressors and meaningful ways to cope with stress, one of the major causes of hormonal imbalance.

Disclaimer - This information is provided for educational purposes and should not be construed as medical advice. Please consult with your healthcare practitioners before undertaking any changes in your diet or adding supplements.

ProactiveForHer is a digital clinic for women, offering accessible, personalized, and confidential healthcare solutions. We offer products and services for out-patient health concerns of Indian women, across their lifetime - from puberty to pregnancy to menopause. To know more on the sexual and reproductive health of women, visit https://www.proactiveforher.com/