Irregular periods and hormonal imbalance are some of the Polycystic Ovary Syndrome (PCOS) that are widely known and spoken about. Besides this, it can cause excess hair growth, acne and infertility as well. However, many women find themselves become silently suffering from PCOS fatigue. Fatigue and exhaustion are the most common consequences of PCOS. While PCOS does not directly lead to fatigue, the symptoms of the condition can often lead to daytime sleeping, exhaustion as well as snoring.

Fatigue is one of the most common symptoms of people suffering from PCOS, states the PCOS Awareness Association (PCOSAA). The research also states that the hormonal imbalances caused by PCOS can lead to lethargy and sluggishness. Besides the physical symptoms, the psychological consequences of depression and anxiety can also lead to PCOS fatigue.

What is PCOS?

PCOS is a hormonal syndrome which affects women of reproductive age. The World Health Organisation (WHO) states that 8–13 percent of women of reproductive age suffer from PCOS. However, up to 70 percent of cases are undiagnosed, states the organisation. “PCOS occurs due to hormonal and metabolic imbalance, says obstetrician and gynaecologist Dr Rohan Palshetkar. Some of the most common signs of PCOS are:

• Irregular periods due to no egg growing (anovulation)
• Excess androgen levels (may appear as excessive hair growth, acne and baldness)
• USG showing the polycystic appearance of ovaries
• Metabolic issues such as insulin resistance, weight gain, difficulty in losing weight and developing type 2 diabetes.

PCOS fatigue: Why does it happen?

PCOS doesn’t directly have a connection with fatigue, but it attributes to it. This condition starts to occur when your ovaries create more of the androgen hormone. This hormonal imbalance can often lead you to feel sluggish and exhausted throughout the day. This can be associated with insulin resistance as well, another consequence of PCOS. Inability to sleep well, heavy periods and vitamin deficiency can also happen due to PCOS, and all of these can lead to fatigue as well.

A study published by BMC Endocrine Disorders, states that fatigue is seen as a barrier to even adopting lifestyle changes that can make a person feel better. It states that women with PCOS feel fatigued due to poor sleep quality as well as sleep disorders.

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Physical causes of PCOS fatigue

The physical causes of PCOS fatigue are as follows:

1. Weight gain

One of the causes of PCOS is obesity and weight gain. A research paper titled Polycystic Ovary Syndrome (PCOS) Symptoms, Causes & Treatments, states that more than 70 percent of women suffering from PCOS, also suffer from obesity. Obesity, in turn, leads to fatigue as well as disturbed sleep. This obesity-induced fatigue is very common in PCOS patients.

2. Hormonal imbalance

PCOS happens due to hormonal imbalances in the body, and this often leads the patient to feel excessively fatigued. The PCOS Awareness Association states that these hormonal imbalances can lead to sluggishness as well as lethargy.

3. Sleep apnea

A study, published by the Sleep Medicine Clinics, states that there is an unexpectedly high prevalence of obstructive sleep apnea (OSA) in women suffering from PCOS. This happens due to alterations in sex steroids since they are high in androgen and low in estrogen levels, as well as increased visceral adiposity ie excessive fat that develops around the centre of the body. Metabolic disturbances in the body can also lead to OSA.

4. Inflammation

Women with PCOS often suffer from low-grade chronic inflammation, according to research published by the National Institutes of Health. Patients of PCOS are also at an increased risk of non-alcoholic fatty liver disease. These conditions can lead to daily fatigue sleep disorders and changes in appetite.

What are the psychological causes of PCOS to cause fatigue?

PCOS is associated with anxiety and depression. Due to the physical changes in appearance like weight gain, hair loss, acne etc, it can play a role in causing depression and lack in confidence. A study, published in Psychological Medicine, reports that around 27-50 per cent of women with PCOS are diagnosed as depressed. Prolonged inflammation can also result in depression as it leads to high cortisol levels. Depression is treated as a specific underlying cause of PCOS. This depression can often lead you to feel fatigued and have no interest in activities that you liked to do earlier.

What are the other health conditions that PCOS can cause?

Besides, PCOS fatigue, other health risks are also associated with the condition. “Patients with PCOS have a higher risk of developing Type 2 diabetes, hypertension, increased cholesterol levels, heart disease and endometrial cancer,” says Dr Palshetkar.

How to treat PCOS fatigue?

Here are some of the best treatment options for PCOS-induced fatigue.

1. Lifestyle modification

This is the first line of treatment that helps reduce insulin resistance and also restores the hormonal balance. If this doesn’t work, then medication is added to assist the treatment process.

2. Eating a balanced diet

The PCOS Awareness and Association states that a balanced diet goes a long way in dealing with fatigue due to PCOS. It states that half our plates should have low-starch vegetables such as carrots, cauliflower, and green vegetables. A quarter of the plate should be full of carbohydrates such as quinoa and root vegetables. The rest of the plate should have proteins. Also, make sure to eat every four hours.

3. Hydration

Hydrating yourself well can also help with PCOS fatigue. Have at least eight glasses of water a day to keep yourself hydrated and energized.

4. Workout

It is very essential to work to remain active. The NHS states that working out regularly, every morning will help you feel less tired. A 15-minute walk can help energise you as well. However, start with less, and work your way up.

5. Work on your sleep schedule

Make sure you set a strict sleep schedule for yourself. This would include going to bed and waking up at a fixed time every day. Don’t watch screens two hours before bed, and avoid caffeinated drinks and heavy meals close to bedtime too. Reading a book, or taking a relaxing bath can help as well.

6. Supplements

Your doctor is sure to provide you with supplements that are to be taken daily to deal with your fatigue. He might give you Inofolic Alpha supplements as well as vitamin D and Iron supplements that will help with the fatigue. Inositol might also be prescribed.

Summary

PCOS is a very common condition in women, caused due to a hormonal imbalance. PCOS fatigue is a common consequence of this condition and can hamper your daily life in several ways. Depression, lack of proper sleep as well as irregular insulin levels and heavy periods can make this fatigue worse.