Why Am I So Tired All the Time with PCOS? Here’s What Could Be Going On

If you’ve been wondering why you feel exhausted no matter how much sleep you get, you’re not alone. Fatigue is one of the most frustrating, and often overlooked, symptoms of PCOS.

It’s that heavy, wired-but-tired feeling where your brain’s foggy, your motivation’s low, and your body just won’t keep up. You wake up tired, rely on caffeine to get through the day, then crash hard in the evening.

And yet, when you ask for help, you might be told your blood tests are “normal”, or that your tiredness is just stress, motherhood, or poor sleep habits.

But here’s the truth: PCOS-related fatigue is real. And there are usually underlying reasons for it, especially if you've recently stopped the pill or are trying to rebalance your hormones naturally.

1. Blood Sugar Rollercoasters and Energy Crashes

One of the most common, and most fixable, causes of fatigue in PCOS is poor blood sugar regulation.

Even if you don’t have diabetes, insulin resistance is very common with PCOS. It means your body struggles to move sugar from the blood into your cells properly.

This leaves you:

• Craving carbs and sugar

• Needing caffeine to stay alert

• Feeling shaky or irritable if meals are delayed

• Crashing mid-afternoon

If you start the day with toast, cereal or coffee alone, you're setting up that spike-and-crash pattern. Over time, this constant blood sugar instability feeds fatigue, weight gain, hormone disruption and poor sleep.

What helps: In Week 1 of the PCOS Hormone Shift Method, we start by stabilising blood sugar using simple food swaps:

• 25–30g of protein at breakfast

• Adding healthy fats (like avocado, seeds or olive oil)

• Choosing slow carbs (like oats, lentils, sweet potato)

• Eating every 3–5 hours to stay steady

When blood sugar flattens out, many women feel more energised within a few days, fewer crashes, fewer cravings, clearer thinking.

2. Chronic Inflammation Can Drain Your Energy

Low-grade inflammation is common in PCOS. It’s not the same as being acutely ill, it’s more subtle and long-term. But it still affects how your body functions, especially your energy systems.

Inflammation can interfere with:

• How your cells produce energy (ATP)

• How insulin functions

• How your brain signals hunger, fullness and motivation

Women with inflammation often feel “tired but wired”, with symptoms like:

• Brain fog

• Poor recovery after exercise

• Joint aches or puffiness

• Digestive symptoms like bloating or IBS-type symptoms

What helps: In Weeks 4 and 5 of the programme, we focus on reducing inflammatory load by:

• Swapping processed oils and refined carbs for omega-3 rich foods

• Adding colourful plant foods high in fibre and antioxidants

• Supporting the gut and nervous system with simple daily habits

For many women, this shift not only supports hormones, it helps lift that all-day tiredness too.

3. Nutrient Depletion After the Pill

If you've recently come off hormonal contraception, fatigue might be linked to nutrient gaps.

The pill can deplete key nutrients needed for energy production and hormone balance, including:

• B vitamins (especially B6 and B12)

• Magnesium

• Zinc

• CoQ10

• Vitamin D

And if your diet hasn’t been supporting your hormones consistently, or if digestion’s been off, those gaps can build up without you realising.

What helps: In Week 2, we look at food-first ways to top up energy nutrients, and where testing or targeted supplements might be helpful. This isn’t about taking a handful of pills, just supporting your body’s natural repair processes.

If you’re feeling tired, wired, and stuck after stopping the pill, this is a piece worth exploring.

4. Sleep Disruption from Hormone Imbalance

Poor sleep doesn’t just leave you groggy, it can disrupt your entire hormone picture.

And with PCOS, hormone shifts can cause sleep issues like:

• Struggling to fall asleep (often linked to cortisol dysregulation)

• Waking in the night (sometimes from blood sugar dips or stress hormones)

• Feeling unrefreshed even after 7–8 hours

If you’ve tried the usual NHS sleep hygiene tips with no success, it may be time to look deeper at circadian rhythm, stress and nervous system regulation and evening blood sugar patterns.

What helps:

• A protein-rich dinner with calming magnesium-rich foods

• Switching screens for real wind-down time

• Supporting cortisol rhythm with light movement and rhythm in your day

We layer these changes in Week 6, once your food foundations are in place.

5. You’re Doing Too Much and Burning Out

This one’s harder to measure, but it’s important.

So many women with PCOS are high-achievers. You might be juggling work, family, workouts, appointments and pressure to "fix" your health, all at once. Your body may simply be in energy debt.

And when you're pushing through with caffeine and willpower, your hormones (especially cortisol and insulin) eventually push back.

What helps: Learning to spot early signs of burnout and giving yourself permission to pause and rebuild is a huge part of the work I do with clients.

In the programme, we use gentle coaching and realistic weekly steps to reduce overwhelm and get your energy back without asking more of your already-stressed system.

Final Thoughts: Fatigue Isn’t “Just PCOS” – It’s a Message

If your energy has flatlined, it’s not because you’re lazy or undisciplined. It’s likely because your hormones, blood sugar, inflammation or nutrient status need attention.

But, these things can shift. Not overnight. Not through restriction. But through simple, targeted changes, layered in one step at a time.

Inside the PCOS Hormone Shift Method, we work together to uncover what’s keeping you stuck and build a way forward that supports real energy, real progress, and a better relationship with food, your cycle and your body.

Want help figuring out why you're so tired, and what to do about it? Book a free discovery call to explore whether the programme is a good fit for you.

I am a BANT registered nutritionist. I specialise in female intimate health and hormone balance, helping busy women struggling with PCOS

I offer nutrition advice with online consultations locally in Manchester, across the UK and Europe. Are you ready to take the first step towards a healthier, more energetic you?

Book a free discovery call to find out more about my Nutrition Programme for optimal hormone balance, weight loss and more energy!

Updated in July 2025 to reflect new PCOS research and nutrition strategies. 

DISCLAIMER: The content on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.