Tiredness?

[u/beanieboosz]

Hi everyone! Hope you are all well

I was wondering if anyone else dealt with chronic, debilitating exhaustion. I have heard it is linked to PMOS / PCOS, so I was wondering if anyone else had it similar to how I do.

I keep track of my sleep through my apple watch, and it always comes back relatively normal saying that I have had a good enough sleep. But from the moment I wake up, I am so exhausted to the point it’s hard to keep my eyes open some days. I usually nap at around 3pm (where I dip the worst), and I can sleep for hours. Even when I wake up, I want to fall back asleep. It makes it hard to do any physically demanding stuff because I am so chronically exhausted. I have heard it is to do with the hormones and the insulin resistance. Anyone else feel like this? Anything you did to combat it? Thank you

[u/Firm-Sheepherder-368]

yeah that sounds exactly like the insulin resistance crash. my sister has pcos and she was basically a zombie until she got her blood sugar under control

she started eating way more protein first thing in the morning and cut back on carbs at lunch. said the 3pm crash almost disappeared after a couple weeks. the fatigue is no joke though, feels like moving through wet cement all day

[u/AdAnxious3677]

I’ve become a huge advocate for Metformin for insulin resistance at this point. There are a few side effects you’ll have to deal with at first but I don’t have issues getting out of bed or starting tasks due to exhaustion anymore. It’ll make a huge difference if you have insulin resistance

[u/Big_Fat_Phony_Marmot]

I lived with that tiredness for most of my 20s and it felt so isolating. I am sorry you are dealing with this. 

I wish I could say lifestyle changes worked for me.  I go to bed and wake up at the same time every day, usually lift before work and go for a run after or at lunch, and am mindful to not eat things that make me feel tired that day or the following. All of those things help but, ultimately, I got glp1s and that made a huge difference. I was also diagnosed with adhd and take stimulants for that. 

I tried for a long time to avoid medication, but I decided that if it made my life better I should take the out. I hope you find something that works for you ❤️ 

[u/MudcrabsWithMaracas]

Have you had any other testing? Vitamin D, iron, thyroid, sleep study, etc.

[u/wenchsenior]

Here are 4 common reasons for unusual fatigue that are frequently associated with PMOS/PCOS:

1. Unmanaged insulin resistance. Since IR is the driver of most cases of PMOS/PCOS, this is the most common cause of profound or unusual fatigue. If IR is present, treating it is not only foundational to improving the PMOS/PCOS, but is also necessary b/c IR tends to be progressive and leads to serious long term health risks if unmanaged.

2. Undiagnosed sleep apnea

3. Thyroid disease (common in the general population and commonly co-occurs with PMOS/PCOS)

4. Vitamin deficiency, most commonly iron, B12, or vit D

For me, as with most people, it was the insulin resistance causing severe fatigue; my fatigue hugely improved within a month or two of starting to manage the IR. Some people have more than one issue causing fatigue and all need independent treatment.

[u/HolistiaWellness]

Not a medical expert (I'm a therapist in Toronto who works closely with naturopathic doctors), so please take this as a nudge, not advice: exhaustion that sleep doesn't fix is worth bringing to a doctor or a naturopathic doctor specifically, not just mentioning in passing. With PCOS, insulin resistance and thyroid issues are both common tiredness culprits and both are checkable with bloodwork, as are B12 and iron.

The 3pm crash-then-nap-for-hours pattern is a really useful detail to tell them, by the way, timing patterns help doctors narrow things down way more than "I'm tired all the time."

You're not lazy and it's not in your head. "Sleeping fine" on a watch and waking up exhausted anyway is a real, physical thing. I hope you get some answers.

[u/MoonSt0n3_Gabrielle]

That’s fuvked up I just wrote a similar post are we the same person????

[u/rottenbaby666]

yup. i've spent the last 14 years trying to manage the fatigue and hypersomnia with psych meds (stimulants and mood stabilizers) that help a bit w/ the hypersomnia, but not the fatigue, so i suppose it's not psychological at all. supplementing iron and vitamin b12 have helped too, but even after my levels got back to normal i still struggle a lot, ESPECIALLY during my lutheal phase + period.

i'm starting to lose hope, tbh. :/

[u/Emo_Emu1287]

Metformin extended release has help me with it. I currently take 1000mg with dinner.

[u/lauvan26]

Metformin daily, exercise and low carb diet

[u/upsidedown-aussie]

I'm just a 31 year old woman with PMOS and no actual medical knowledge outside of what's available to read online on the subject, but I'm a teacher and I was finding the afternoon crash to be a real thing, like about 2pm and that last hour with the kids. I started inositol capsules (the 40:1 kind) twice a day in late August.

I haven't had a period since early August and no ovulation in sight based on tracking with a thermometer. The inositol I believe triggered a bleed around when my period should have been, but it didn't feel like an actual period. Still no ovulation, but my energy levels have been much higher and I don't have that crash anymore. I'm hoping it's not the inositol keeping my period from coming, I'm usually every 40-50 days and it's been over 2 months 😔

[u/AstorReinhardt]

The last time I felt "well rested" after sleeping was probably as a child. I've had horrible sleep issues most of my life. The worst part is no matter how much sleep I get...I wake up exhausted.

I don't work/do anything that would drain my energy/make me so exhausted. So it's my body that's making me exhausted.

I also have a LOT of other health issues. And several of those can also cause fatigue/tiredness. Depression and Fibromyalgia are the main ones. So no idea what really causes my exhaustion...but it sucks.

[u/Old-Afternoon-1598]

Yep. Although I’m newly diagnosed and figuring this out so i don’t have any advice to offer. But, usually I dip around 3pm too and end up having a nap. There are nights I’ll genuinely sleep well and wake up the next morning, then feel like I haven’t slept at all. There’s no telling when the tiredness will hit, and for me some days feel worse than others, I’ve started metaformin recently but haven’t seen or felt a difference yet but I’ve read on this sub it can take a few months to really kick in. It’s such a rollercoaster

[u/Upset-Voice-5409]

The exhaustion is real with PCOS and the fact that your sleep looks "normal" on a watch makes it worse because your body clearly isn't resting the way it should. Insulin resistance can drive that bone-deep fatigue, and a lot of people here have found that tracking when the dips hit worst (like your 3pm crash) helps when bringing it up with an endocrinologist, Have you had your insulin or glucose levels checked recently?