In people with polycystic ovary syndrome (PCOS), fatigue can be debilitating. Fatigue — extreme tiredness that doesn’t get better with rest — can make it challenging to complete daily activities, such as finishing tasks or walking a dog.

PCOS is a common condition, occurring in 7 percent to 10 percent of women of childbearing age — about 6 million in the United States — according to the Endocrine Society. Although the cause is unknown, science suggests hormone fluctuations play a role.

PCOS-related fatigue can require special care and management. According to the PCOS Awareness Association, sleep is directly related to mental health, which can affect overall health. But there are some ways to improve PCOS-related fatigue. Read on to learn why PCOS causes fatigue and get some helpful tips for managing this symptom.

The Connection Between PCOS and Fatigue

Members of myPCOSteam have reported fatigue among other more common PCOS symptoms, like irregular periods and infertility. “I occasionally suffer from severe joint pain and unimaginable fatigue, and for a few months now I have had concentration problems, which sometimes make it difficult for me to do my job,” one member said.

You might experience fatigue with PCOS for several reasons. A study in the journal BMC Endocrine Disorders found that women with PCOS have higher rates of poor sleep quality and sleep issues than those who don’t have the condition.

Having overweight or obesity along with PCOS can also lead to obstructive sleep apnea, in which breathing stops repeatedly during sleep. This condition can worsen insulin resistance and cardiovascular problems linked to PCOS. Without treatment, sleep apnea can cause daytime sleepiness and high blood pressure.

Hormones May Play a Role

Hormonal imbalances in PCOS — particularly higher levels of androgens and insulin resistance — can affect sleep, energy levels, and metabolism, contributing to persistent fatigue. Elevated androgens can also cause weight gain, irregular menstrual cycles, and unpredictable ovulation.

When you have insulin resistance, your body doesn’t respond to this hormone as it should, leading to higher insulin levels. This can increase androgen production, which may cause fatigue, mood swings, unwanted hair growth, acne, and weight gain.

Lifestyle Factors and Vitamin Deficiencies

Lifestyle factors such as poor sleep quality, high stress, limited physical activity, and certain nutrient deficiencies can make fatigue worse for people with PCOS. A simple blood test can help your doctor check for vitamin deficiencies that may affect your energy and mood.

Vitamin D supports how your body processes insulin and glucose. Correcting a vitamin D deficiency may help improve insulin resistance, regulate menstrual periods, and lower testosterone levels in women with PCOS, according to a study in Annals of Medicine & Surgery. Since a vitamin D deficiency may cause fatigue, correcting the deficiency may help.

B vitamins, including folate (folic acid) and vitamin B12, play an important role in regulating menstrual cycles and supporting fertility. If you’re very low in vitamin B12, you may also experience fatigue and mood changes. Supplementation may help ease these symptoms.

Tips for Managing Fatigue With PCOS

Although PCOS symptoms can be challenging, some science-backed tips may help you manage fatigue throughout the day and improve your overall health.

Follow an Energy-Boosting Diet

Eating a balanced diet, rich in leafy greens and other lower-carb foods like carrots and cauliflower, is important for maintaining energy levels, according to the PCOS Awareness Association. This group also recommends getting plenty of protein. Good sources include eggs, fish, poultry, and plant-based proteins like beans and tofu.

Drinking water throughout the day can help you digest food properly and stay hydrated. Your healthcare professional or a dietitian can help you develop a personalized nutrition plan.

Add More Movement to Your Daily Routine

According to Cleveland Clinic, lifestyle changes such as daily exercise can relieve symptoms like irregular periods by helping to regulate hormone levels. Research links exercise to significant improvements in energy. Most people should aim for 150 minutes of physical activity each week, or about 20 to 25 minutes a day. Exercise may also boost mental well-being in women with PCOS, according to the journal Advances in Experimental Medicine and Biology.

Create a Sleep Routine

Because PCOS often leads to fatigue, it’s important to follow a consistent sleep routine. Try to go to bed and get up around the same time each day. Turn off screens close to bedtime. Doctors also recommend avoiding alcohol. Although it can make you feel sleepy, alcohol can disrupt sleep and also raise your risk of snoring and sleep apnea.

Manage Daily Stress

Managing stress is easier said than done, especially when you’re dealing with the ongoing challenges of PCOS. But research shows that lowering stress levels can help improve sleep, energy, and even hormone balance. Some strategies that may help you relax include:

• Guided meditation — Use an app or video to help calm your mind and body.
• Focused breathing — Take slow, deep breaths to reduce tension and lower heart rate.
• Regular exercise — Move your body in ways you enjoy, such as walking, practicing yoga, or dancing.

You can also talk with a mental health professional or counselor, who can help you find personalized ways to manage stress and cope with daily challenges.

Consult a Healthcare Provider

The first step toward managing PCOS symptoms involves getting an accurate diagnosis. Talk with your healthcare provider about what you’re experiencing — including fatigue — especially if it interferes with your daily life. Remember, you are your own best advocate. You know your body better than anyone else.

Your doctor may order blood tests to check your hormone, glucose, and vitamin levels and may adjust your treatment plan based on the results. Depending on your needs, your healthcare provider might refer you to a specialist to explore possible causes of fatigue and other symptoms.

Join the Conversation

On myPCOSteam, people share their experiences with polycystic ovary syndrome, get advice, and find support from others who understand.

Do you experience PCOS fatigue? Have you found ways to manage fatigue? Let others know in the comments below.