Are you one of the many women currently struggling with PCOS and fatigue? If so, it’s not surprising. Millions contend daily with some form of fatigue. While fatigue is clinically defined as “a condition marked by extreme tiredness and the failure to function”, for quite a few of us, this description is only the tip of the iceberg. It can have a negative impact on a person’s relationships, career, and even on the ability to complete simple daily tasks.
For women suffering from polycystic ovarian syndrome (PCOS) fatigue can be a constant unwanted companion. It is not surprising that many women with PCOS are urgently looking for answers as to how to reduce or eradicate this all-encompassing lethargy. If you can relate, read on to learn more about the relationship between PCOS and fatigue, and to get my 6 tried-and-true tips for helping ease your invisible burden.
The Links Between PCOS & Fatigue
1 in 10 women worldwide receive a PCOS diagnosis. Of those, a staggering amount find themselves struggling with unexplained fatigue. But what’s the correlation? Why do both these issues share such a frustrating symbiotic relationship? While research has not yet narrowed things down to a single magic answer, we now have quite a bit of information that helps us paint a more conclusive picture.
1. Blood Sugar
Blood sugar (or glucose), is the body’s main source of energy and is vital to its daily function. Blood sugar is regulated by insulin, a regulatory hormone produced in the pancreas. Optimal blood sugar levels are directly responsible for making us feel capable of taking on our day. Too high, and one can suffer the effects of hyperglycemia. Too low, and one now has hypoglycemia to contend with.
However, seeing as 65-70% of women suffering from PCOS also suffer insulin regulation issues, this can lead to blood sugar spikes in both directions and cause a blood sugar rollercoaster. And the main side effect of these spikes? You guessed it. Fatigue.
2. Inflammatory Response
Seeing as many studies have found that suffering from PCOS goes hand in hand with suffering from chronic low-grade inflammation, this is yet another piece of the puzzle. Chronic inflammation, even low-grade, can lead to raised cortisol (stress hormone) levels, which can contribute to fatigue.
3. Sleep Issues
Multiple studies have found sleep disorders to be a common issue for women with PCOS. Obstructive Sleep Apnea (or OSA) specifically has been found to be an issue plaguing far more women with PCOS than without. OSA, the interruption of normal breathing rhythm while asleep (due to an obstructed upper airway), can make sleeping through the night extremely difficult, and often leads to lower quality sleep.
As such, even getting a full 8 hours can lead to one feeling less rested than it should. This is due to the lowered oxygen levels that go hand in hand with disordered breathing. While various sleep apnea issues can be linked to obesity, they can also present themselves in patients with well-managed weight. In addition, PCOS has also been linked to insomnia, which obviously leads to less sleep overall, adding yet another obstacle in the fight to overcome fatigue.
Iron-deficiency anemia can stem from a diet lacking in sufficient amounts of iron, as well as blood loss. While many women with PCOS find they experience irregular or non-existent menstrual cycles, others still can experience menstruation that is heavier in nature and lasts for a longer time than traditional cycles. In these cases, this extreme bleeding can understandably result in low iron, leading to anemia, adding to again to overall fatigue.
5. Low-Carb Diets
Many popular modern diets (such as the keto, or ketogenic diet) are structured around an overall reduction in carbohydrate intake. As this can have appealing effects on weight loss, many health-minded individuals have flocked to these methods. Women with PCOS, may be attracted to methods that boast effective weight-management. However, carbohydrates are our body’s preferred source of energy. Eradicating them from our diet entirely might have negative impacts on our body’s ability to function.
In fact, multiple studies have found that a ketogenic diet can have negative effects in terms of muscle fatigue. Meaning with less energy-fuel, our muscles don’t work as effectively, which leads to small tasks becoming more difficult, and a feeling of increased fatigue.
6. Medication Side Effects
Metformin, a diabetes drug that increases insulin sensitivity and helps reduce excess production of androgens, is commonly used to treat women with PCOS. Metformin’s success when it comes to treating insulin resistance (a common aspect of PCOS) leads to it being widely prescribed. It is, however, not without its own negatives.
In fact, recent studies have shown that long-term use of Metformin has been associated with lowered B12 levels, as well as anemia. Both side effects can increase fatigue substantially. If you have been on Metformin for a prolonged period of time, and are experiencing fatigue, ask your doctor about having your levels checked.
While fatigue and PCOS often go hand-in-hand, fatigue can stem from a vast range of other disorders, and your increased tiredness may be due to other factors entirely. Make sure to assess with your doctor exactly where your fatigue is rooted, to ensure your plans for treating it address the underlying cause. Regardless of where yours is coming from, here are a few tips to combat fatigue and increase energy on a daily basis.
TIP 1: Are You Eating Properly?
Luckily, proper food intake is a plan of attack that can help reduce PCOS symptoms (including fatigue), as well as overall non-PCOS related fatigue. Balance your meals to include higher fiber vegetables, complex carbohydrates (such as buckwheat or quinoa), fat and protein. Try to incorporate variety and more whole foods from plant-based sources to guarantee a range of nutrients. In addition, if you’re trying to increase your iron levels, pair iron-rich foods with ones that contain Vitamin C (which helps your body absorb iron).
Your body’s hunger signals typically occur every 3 to 4 hours. Try to honor that physiological hunger by maintaining a consistent intake of food throughout the day. Eating regular, small meals every few hours helps keep your blood sugar at normal levels, which has numerous health benefits and helps fight fatigue. Lastly, stay as present in the moment while eating as you can. It can be so easy to continue eating long after we stop being hungry, just simply from not checking in with ourselves. Ask yourself as you eat “am I finished?”. Chances are, you’ll reach a “Yes” much sooner than you would expect.
Tip 2: How’s Your Blood Sugar?
As we’ve already established, maintaining constant optimal blood sugar levels is a powerful tool to increase your well-being overall and especially when it comes to fighting fatigue. For all of us, but especially those dealing with PCOS, breakfast is key. Skipping breakfast can lead to the dreaded blood sugar rollercoaster we talked about (spikes in your insulin levels), so as best you can, make sure to eat before starting your day – ideally within an hour of waking up.
Also, balance your diet by pairing carbohydrates with protein, fat, and fiber. This helps slow down the digestion process, reducing large spikes in blood glucose. When choosing foods, try to select options that are higher in fiber for increased blood sugar control.
Tip 3: How’s Your Inflammation Level?
Seeing as chronic inflammation can easily cause or exacerbate fatigue, using your diet to combat its effects by incorporating foods rich in anti-inflammatory properties can be a great starting point. Green leafy vegetables, berries, tomatoes, nuts, fatty fish, ginger, garlic, turmeric, etc. are all great anti-inflammatory foods that have been shown to reduce plasma inflammatory markers and oxidative stress indicator levels.
Tip 4: Feeling Stressed?
We all deal with many kinds of stress on a day-to-day basis. Mental, physical, emotional, take your pick. Unfortunately, our cells do as well. In response to all stress, our adrenal glands release increased amounts of cortisol (the “stress hormone”).
On top of the negative side effects of increased cortisol (blood sugar imbalance, high blood pressure, lowered immune response), this can also deplete the amount of cortisol in the adrenal glands, leading to adrenal fatigue. Finding small rituals to increase the peace you feel in your life (a long bath, quiet time with no screens, etc.) can have a profound impact on your overall health.
Tip 5: Sleeping Enough?
No matter who we are and what we deal with, sleep is one of the most powerful tools for healing we have. Creating a routine to ensure you sleep and wake up at roughly the same hours every day is a good place to start in fixing your sleep hygiene.
Do your best to adhere to a routine that allows for 8 hours of sleep a night. Limit screen time 2 hours prior to going to bed (blue light, emitted by electronics, can make it more difficult for our bodies to relax), and try to use your bed only for sleeping. If you need to sit and rest or watch TV or read during the day, make a marked effort to do so in a chair or couch instead. This allows your brain to think of your bed as a designated sleeping area only, which makes slipping into a healthy bedtime routine much easier.
Tip 6: Did You Move Around Today?
Movement is key when it comes to regulating stress, maintaining healthy blood sugar levels, and overall fitness. Try to find room in your schedule for 30 minutes or so of joyful movement. Though when it comes to PCOS, try not to go too hard, there’s a level of intense exercise that will add to, rather than reduce your stress level/fatigue.
While research determining the exact cause of fatigue in women with PCOS is still ongoing, we have identified multiple possible contributing factors in this blog post. So, if you are someone suffering with PCOS and fatigue don’t forget to try out my 6 lifestyle and health tips listed above to help get back on track!