How to Deal with PCOS Fatigue

How to Deal with PCOS Fatigue

Do you feel like you’re constantly exhausted? Fatigue is one of the most common complaints I hear from women with PCOS! This isn’t a shocker considering PCOS is a hormonal condition with many physical and psychological effects in the body. Compound this with restricted eating patterns and it’s highly likely you’ll end up feeling fatigued. The good news is that PCOS fatigue can often be improved with diet and lifestyle changes! It’s time to put your detective cap on. Once you figure your the cause, you can do something about it.

Causes of PCOS fatigue

We work too much, don’t get adequate sleep and are stressed to the max with life so it’s not unusual that 75% of people report frequently feeling tired. But women with PCOS may be at even more risk of chronic fatigue due to hormone imbalances, sleep disorders, higher rates of mood disorders and more.


  • eating too little Iron deficiency. Iron deficiencies can lead to fatigue and hair loss, both of which are common in PCOS
    **What to do: a simple blood test checking one or more of the following: Complete blood count, hematocrit, hemoglobin, serum iron, ferritin, transferrin and total iron-binding capacity (TIBC).
  • Vitamin B12 deficiency. This deficiency can cause megaloblastic anemia, fatigue and neurological symptoms like poor memory, numbness and depression. Metformin, a common medication for PCOS can cause depletion of Vitamin B12.
    **What to do: get your Vit B12 levels checked in a blood test on a regular basis, especially if you are taking metformin.
  • Being dehydrated. Water makes up 80% of our muscles and 70% of brains. Even mild dehydration can cause decreased energy levels and mood, as well as sports performance,
    **What do to:  Drink up!
  •  Consuming inadequate calories and or carbs. Calories from protein, fat and carbs provide fuel to your body. Taking your calories too low will not only lead to poor energy levels but can also slow your metabolic rate. In addition, it can worsen your PCOS by acting as a stressor to your body (especially if you have the “adrenal” type of PCOS)
    What to do: don’t take your calories too low. I don’t recommend less than 1400 calories for most women with PCOS. And experiment with your carb intake. Taking it too low can lead to fatigue, but on the other hand, eating too many can have the same effect.
  • Don’t go too long without eating. Intermittent fasting is the rage right now. And while it may work for some women, it can lead to headaches and exhaustion for others. I’m not a fan of anything stricter than 14 hours or more of fasting.
    **What to do: pay attention to how your body feels. Some women feel best eating every few hours, whereas to others feel best having 3 meals a day with nothing in between.
  • Blood sugar/insulin spikes and crashes.  Most women with PCOS have insulin resistance which means they are more susceptible to blood sugar spikes, excessive production of insulin followed by blood sugar crashes … and plummeting energy and mood.
    **What to do: eat balanced meals with some protein, fat and healthy carbs. This will provide a more even pattern of blood sugar and insulin


  • thyroid problemThyroid imbalance. It’s estimated that 25% of women with PCOS have a thyroid imbalance. But often times it goes undiagnosed.
    **What to do: Get a full thyroid test done including TSH, free T3, free T4, reverse T3 and thyroid antibodies
  •  HPA- Axis dysfunction. Approximately 30% of women with PCOS have high levels of DHEA-S. This is an androgen that’s produced in the adrenal gland, often in response to stress.  Chronic levels of stress can lead to an HPA – Axis dysfunction, when your stress response just doesn’t work properly anymore. This stress can come from psychological stress or physical stress like overexercising, not getting adequate sleep, or eating too little.
    **What to do: work on managing stress, getting adequate sleep, not overdoing exercise, try yoga.


  • Poor sleep habits. Spending too much screen time late at night and  having a poor bed time routine can have a major impact on disrupting your sleep. The blue light from screens interferes with production of the sleep hormone, melatonin.
  • Sleep apnea. Sleep apnea is a condition when you stop breathing in the middle of the night and can increase the risk of serious health conditions, including heart disease. It affects 30% of woman with PCOS.
  • pcos circadian rhythm disruptionCircadian rhythm disruption. Women with PCOS have been shown to have higher rates of circadian rhythm disruptions.
    **What to do: discuss any sleep problems with your doctor and make sure you get screen for sleep apnea. Work on your “sleep hygiene” and get off screens at least 1 1/2 hours before bed. Consider getting blue light blocking glasses to wear in the evening.


  • Depression/anxiety/stress. Depression can make your energy levels feel depleted. It can also affect your energy levels.
    **What to do: find ways to soothe yourself, try yoga or meditation, seek support from family and friends, and/or seek counseling.


  • Over- exercising (or not doing the right exercise for you): Whether you’ve been told to exercise more by your doctor, or you’re trying to exercise away those pounds, it’s not uncommon to see women with PCOS spending too much time in the gym. Chronically feeling fatigued can be a sign of excesive exercise. Your muscle needs rest to repair themselves. Without adequate rest and fuel from a healthy diet, your
    **What to do: cut back on the exercise. Or try a different type of exercise. Your
  • Rule out other medical causes. Chronic fatigue can be a indication of a health problem.
    **What to do: discuss this with your doctor.

Do you suffer from low energy levels? 




I especially love problem-solving, whether it’s helping women defeat issues plaguing them for years, helping a busy executive find practical ways to get heart healthy, or providing tips to help you reverse diabetes. That’s why I’m on a constant quest to expand my knowledge by staying on top of the latest research.

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