Symptom of Endometriosis: Fatigue

Reviewed by: HU Medical Review Board | Last reviewed: June 2018

Fatigue and tiredness are two different experiences that may occur within an individual. Tiredness is a temporary feeling of weakness, exhaustion, or sleepiness that is often the result of a bad night's sleep, being overworked, or physically overexerting one's self. Tiredness often has a definitive, temporary cause, and is relieved by resting. Fatigue, on the other hand, is an unrelenting feeling of exhaustion or inner weariness. Fatigue can get stronger over time, and does not go away after resting. Fatigue may eventually impact an individual's ability to perform their daily routine or hobbies they once enjoyed. This, in turn, can affect an individual's mental and emotional well-being. Fatigue that is constant and has no obvious underlying cause is often diagnosed as chronic fatigue syndrome (CFS).1-3

Fatigue is generally constant, however, it may worsen at certain times. An example of this may be an increase in fatigue before a pain flare-up if an individual is battling a chronic condition, or an increase in fatigue before a woman's period. No two individuals will experience the same fatigue triggers, nor experience fatigue in the same way. Individuals with fatigue may find themselves napping regularly (without relief) or falling asleep when they normally wouldn't. Fatigue is a very real symptom and experience, and should be treated as such. If left unaddressed, it can greatly impact an individual's quality of life and overall well-being.1

Endometriosis & other causes of fatigue

The cause of fatigue is often related to an underlying condition within the body. As mentioned, if no apparent cause is found, an individual's fatigue may be classified as chronic fatigue syndrome. Other conditions that may lead to fatigue include, but are not limited to:

  • Anemia (iron deficiency)
  • Hypoglycemia (low blood sugar)
  • Sleep apnea
  • Thyroid issues, including hypothyroidism (underactive thyroid)
  • Endometriosis
  • Chronic inflammation
  • Chronic infection
  • Mental health issues such as anxiety, depression or grief
  • Cancer
  • COPD
  • Cardiovascular conditions
  • Diabetes or other kidney-related conditions
  • Fibromyalgia
  • Inflammatory bowel disease
  • Multiple sclerosis
  • Stress
  • Obesity
  • Concussion or traumatic brain injury

In some cases, lifestyle factors may also contribute to fatigue, including:

  • Excessive exercising or not enough exercising
  • Constant traveling
  • Not getting enough sleep
  • Medication-related side effects or drowsiness-inducing medications
  • Unhealthy eating habits
  • Drug or alcohol usage1

In relation to endometriosis, the reason for fatigue is not completely understood. Many experts speculate that fatigue is the body's long-term response to constantly battling the chronic inflammation and chronic pain that those with endometriosis often experience. Additionally, psychological stress and mental health issues that can accompany endometriosis and managing its related symptoms, such as pain during sex or infertility, may also contribute to physical fatigue.3-5

When to see your doctor

If you are experiencing signs of fatigue, especially fatigue that interferes with your daily life, it may be time to see your doctor or a member of your healthcare team. This is especially true if you feel like your fatigue is impacting your emotional or psychological well-being. Your doctor will perform a physical examination and take your personal medical history in an effort to determine if there is an underlying condition causing your fatigue. This investigation may include additional diagnostic tests such as blood work, imaging exams, or a mental health evaluation. If no obvious cause is found, you may be diagnosed with chronic fatigue syndrome.1,2

Treatment and Management

Treatment of fatigue will often center on treating the condition causing it. For example, if endometriosis lesions are causing severe, chronic pain that is thought to be contributing to fatigue, pain-relieving treatment options or surgical removal of these lesions may be pursued. If an individual's fatigue is thought to be a result of iron deficiency anemia, they may be prescribed iron supplements. However, if an individual's fatigue has no obvious cause and is considered chronic fatigue syndrome, there are often no direct treatment options. Some doctors may recommend trying antidepressant medications, however others will recommend lifestyle changes including creating and maintaining a healthy exercise regimen, eating a healthy diet, reducing or eliminating the use of alcohol or drugs, or reducing the usage of non-essential medications that may be impacting fatigue levels.1,2

If your fatigue is impacting your emotional or mental well-being, your doctor may recommend that you see a counselor or other mental health professional. They may also recommend in-person or online support groups for you to join if you need additional support.

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