Understanding PCOS and Fatigue

Understanding PCOS and Fatigue

You might not know it, but there’s thousands of people around the UK living with PCOS. As a condition with a range of visible symptoms, it can be easy to forget that it affects the body internally, as well as externally. There’s one symptom that many will point to as having a massive impact on their daily life: fatigue and a lack of energy. It can be debilitating and demoralising, leaving many asking just why it’s a symptom in the first place.

In this article we’ll explain the relation between PCOS and fatigue, examining just how the various symptoms of the condition impacts energy levels. It’s surprising to learn just how large an effect these small cysts and a slight change to the body’s chemistry can have. If you feel this daily frustration, read on to get a better understanding on just why it happens…

PCOS Overview

You might be reading this without a full grasp of what PCOS actually is. Standing for polycystic ovary syndrome, the condition alters what are known as follicles on the ovaries; bumps less than a centimetre in size. These follicles are normally harmless, but in those with PCOS they are undeveloped, meaning that the eggs that are usually released by them are trapped. This can prevent ovulation and cause one of PCOS main symptoms: irregular periods. Another well-known symptom is an increase in ‘male’ hormones in the body, which can cause body and facial hair to grow thicker, along with acne and greasier skin.

The aforementioned hormonal change is how PCOS has one of the biggest impacts on the body. It’s related to higher-than-normal amounts of insulin, the hormone that controls when sugar is used and stored. This increase is due to PCOS causing insulin resistance in the body. Weight gain can be an effect of this, and is common amongst those with PCOS.

Unfortunately, only the symptoms of PCOS can be treated in the vast majority of cases, with doctors recommending a healthy lifestyle and weight loss. Surgical options to tackle follicles directly is limited to the most severe and painful of incidences (usually reserved for when it threatens fertility). For the vast majority of the population, it’s something to be dealt with on a daily basis.

Fatigue and Tiredness

So what exactly is this link between PCOS and feeling like you have no energy? Much like many medical explanations, it’s multi-faceted and complex. With the impact of the condition being felt all over the body, the reason for one person’s fatigue may be different to another’s. The first link we’ll examine is not entirely understood, even to those in the medical field.

The Thyroid and PCOS

Located in the neck, the thyroid is an important gland that dictates many processes in the body, for example your metabolism, heart rate, mental functions and digestion. These are all controlled via hormones in the blood – this is where the link between malfunctioning thyroids and ovaries overlap.

A malfunctioning thyroid releases these hormones in the wrong quantities – either too much or too little. We’ll be examining when the thyroid is ‘underactive’ and doesn’t produce enough hormones, known medically as hypothyroidism. Some of the symptoms of this may sound familiar: weight gain, irregular or heavy periods and, of course, tiredness.

Many of these overlap with PCOS, and for good reason. A study from 2015 found that 27% of women with PCOS had antibodies in their system that can damage the thyroid and cause hypothyroidism (as compared to about 8% of women without). This raises the possibility that PCOS can be a cause of fatigue via its unintended attack on the thyroid, although the conclusion to the study errs on the side of caution and suggests more long-term research to prove the link more concretely.

The link between PCOS and thyroid function is closer than many expect. In fact, hypothyroidism can actually cause PCOS-like damage to healthy ovaries. Also, it can cause increases of testosterone in the blood – the ‘male’ hormone that can cause body hair and facial hair growth. The connection between the two conditions runs deep enough that doctors have to completely rule out thyroid issues before then can officially diagnose PCOS.

For the thyroid to function at its best, it requires iodine to produce its valuable hormones. If you suspect your thyroid isn’t working at its best, try upping your sources of this chemical: animal produces like dairy, chicken, fish and pork, and supplements. Of course, if you suspect more serious issues, visit your GP.

Blood Sugar Levels

As mentioned previously, the hormonal changes associated with PCOS affect how the body utilises insulin. As you might know, insulin is crucial in glucose management, as it determines how much each cell in the body receives: too much and the excess gets stored as fat and as glycogen in the liver; and any that doesn’t get used by cells leaves the body via urination. As you can imagine, your cells receiving the right amount of glucose means they have enough energy to function correctly.

With the resistance and overproduction of insulin common with PCOS, blood sugar levels can fluctuate, with the body not getting enough sugar and then reacting by flooding the system with insulin just to get a small amount. This has tangible, visible effects: feeling shaky, mood swings and fatigue. These occur after eating, or are often attributed as an ‘afternoon slump’, when combined with naturally lower energy levels. It can be frustrating to feel these symptoms right after having a hearty meal, as though the body isn’t getting those nutrients at all.

Unfortunately, it’s harder to curb insulin resistance, since it’s a consequence of long term damage caused by PCOS. A healthy lifestyle and diet can help, just as losing weight can help with its absorption. The best way to find a solution is to talk to a doctor, since they can measure the severity of your condition and act accordingly.

Adrenal Fatigue

This particular explanation of fatigue is interesting, as it involves not only bodily processes, but also an individual’s lifestyle.

Adrenal fatigue is, as the name might suggest, a failing of the body to cope with a seemingly-endless amount of stress. The adrenal glands are found above the kidneys, and play the role of releasing hormones like adrenaline and cortisol, the ‘stress hormone’.

These hormones prepare our body for the fight or flight response; the reaction to life-threatening danger, where we prepare to either attack the threat or abscond from it. This was crucial for our human survival in ancient times, but in the modern era other things can trigger it: difficulties at work, relationships troubles and money issues, to name a few. For many of us, stress is unavoidable and constant – we don’t get a chance to catch our breath between threats, like our ancestors.

A collection of the many stress hormones released are known as adrenal androgen hormones. Some of these can be converted into testosterone, which can disrupt the hormonal balance in the body and cause the PCOS follicles to form on the ovaries. Interestingly, it’s theorised that this form of the condition (named Adrenal PCOS) can cause similar lumps to form on the adrenal glands, constantly releasing hormones and causing the gland proper to shrink.

Naturally, all of this can make it easy for fatigue to build, since your brain and muscles are ready to fight for its life constantly. It’s more than just losing sleep; allowing yourself to simply slow down and relax can also be difficult. But exactly that – allowing time for self-care and getting more sleep every night – are two of the ways to help curb adrenal PCOS.

Other ways to reduce the stress hormones in your body include meditation, yoga, stopping any high intensity exercising (this can create more cortisol), and reducing your intake of caffeine. There’s a huge amount of advice online on how to destress, all of which will help you find your energy after having it sapped away by adrenal PCOS.

Problems Sleeping

It can be more than just stress than can prevent you from getting a good night’s rest. Of course, not getting a full 8 hours of sleep is a huge dent in your energy store for the day. Another way that PCOS can cause issues is sleep apnoea.

Sleep apnoea is interrupted breathing while sleeping, because of shallower breaths or a blocked airway. This is usually preceded by loud snoring or gasping and is common in those who are overweight. Other symptoms include waking up with a headache, night sweats and feeling depressed through the day. What many don’t know is that these interruptions to sleep aren’t always something that cause people to fully wake up or even remember the next morning. Sometimes it’s just waking up the next morning tired and not knowing why.

The biggest thing to do to help against sleep apnoea is losing weight – not the easiest thing to do with PCOS. Other advice includes stopping smoking and reducing how much you drink, as alcohol can loosen muscles in the throat.


It can be frustrating to be doing everything right and still feeling tired. Hopefully this article has shed some light on how polycystic ovary syndrome can affect your energy levels. Typically, the answer isn’t straightforward, but there are some avenues to explore if fatigue is taking over your life.

As always, if you have any concerns or serious fatigue issues, ask your GP for professional medical advice – there may be other issues at hand other than what’s mentioned here.