The Causes of Women's Fatigue

Why are you so tired? We ask leading health experts what makes women so exhausted.

From the WebMD Archives

Worn out and weary, women across the country named fatigue among their top five health concerns of 2010 in WebMD's annual Year in Health survey (the other four were period problems, "super foods" best for nutrition, thyroid conditions, and sex and relationship issues). Here are seven of the biggest reasons you may be dragging, and ways to put the spring back into your step.

Thyroid Problems

The thyroid -- a little butterfly-shaped gland in your neck -- produces the hormones that regulate how your body burns fuel for energy. It can be overactive or underactive, but either way you'll feel sleepy.

Why? "With an underactive thyroid you can't get your engine going. With an overactive thyroid your engine's on overdrive and you start to burn out," says Sandra Fryhofer, MD, clinical associate professor of medicine at the Emory University School of Medicine in Atlanta.

Thyroid problems are more common in women, although doctors aren't sure why. "That's the big mystery. It may be related to genetics or hormones -- we don't know," says Hossein Gharib, MD, professor of medicine at the Mayo Clinic College of Medicine in Rochester, Minn.

What to do: Tests can reveal whether you need to take a manmade version of thyroid hormone to rev up an underactive thyroid, or antithyroid medicine to calm down an overactive thyroid.

Heart Disease

"We think it's just a man's disease, but it's not," says Fryhofer. In fact, heart disease is a serious threat to women -- more serious than every type of cancer, including breast cancer, even though many women believe cancer is a bigger concern.  According to the American Heart Association, nearly twice as many American women die of heart disease, stroke, and other cardiovascular diseases as from all forms of cancer.

When your heart isn't pumping efficiently, it can't get enough blood out to your body, and that can make you tired. "Fatigue is one of the most common complaints of women with heart disease," says Annabelle S. Volgman, MD, associate professor of medicine and medical director of the Heart Center for Women at Rush University Medical Center in Chicago.

What to do: If you have heart risk factors such as obesity, high blood pressure, and a family history of heart conditions, you need to have your heart checked out. Measuring your blood pressure and other simple tests such as an electrocardiogram or an echocardiogram can pinpoint whether your heart is the source of your weariness.

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Vitamin D Deficiency

"There's been an epidemic of vitamin D deficiency over the last few decades because we've been avoiding the sun," Volgman says. Other reasons include having a milk allergy, following a strict vegetarian meal plan, and having darker skin (the pigment melanin reduces the skin's ability to make vitamin D from sunlight). For some people, their digestive tract cannot absorb vitamin D well. For others, the kidneys have trouble converting the nutrient to its active form. And being overweight makes vitamin D less available for use in the body. 

Whatever the reason, too little of this essential vitamin can sap your bone strength, and some research links a deficiency of vitamin D to chronic fatigue syndrome.

What to do: A blood test can determine whether you're getting enough of your daily D. If not, a supplement can get you to the amount you need each day. The Institute of Medicine, which published new guidelines in 2010, recommends that most adults get 600 international units a day. For people 71 and older, the recommended amount climbs to 800 IU. At these amounts, you're getting enough D to benefit your bones without overdoing it and causing kidney problems or other side effects.

Iron Deficiency (Anemia)

When your blood can't carry enough oxygen to your body, you're bound to feel sluggish. "Anemia is more of a symptom than a disease," Fryhofer says. It could be a sign that you're losing too much iron in your blood during your period, or you may be deficient in other vitamins and minerals.

What to do: See your doctor for a blood test to find out whether you've got an iron deficiency or other medical problem that's affecting your red blood cell count. The solution could be as easy as taking an iron or B vitamin supplement.

Sleep Apnea

Your husband jokes that you sound like a buzz saw when you sleep, but snoring is no laughing matter. It could be a sign of sleep apnea, a condition that halts your breathing over and over again throughout the night. Every time your breathing stops, your brain jolts you awake to restart it.

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"You are never getting a restful sleep, so your body never has time to recuperate and recharge," Fryhofer says. As a result, you end up feeling drained.

What to do: Being overweight can put pressure on your airway at night, which is why weight loss is the prescription to help sleep apnea. To help you breathe more easily while sleeping, a continuous positive airway pressure (CPAP) device will keep air flowing into your airway. Once you get the hang of sleeping with a mask on your face, CPAP can "really change your life," Fryhofer says.

Lack of Sleep

While juggling a job, family, and a million other responsibilities, it's hard to squeeze in the full seven to eight hours of sleep you need each night. "A lot of women have a very hectic lifestyle and don't have a schedule that allows them to get sufficient sleep," says Hadine Joffe, MD, MSc. Joffe is associate professor of psychiatry at Harvard Medical School and director of research for the Center for Women's Mental Health at Massachusetts General Hospital.

What to do: "You want to make sure when you want to go to sleep you can sleep," Fryhofer says. Get into a calming bedtime routine. Turn on soft music. Spray a whiff of lavender on your pillow to help calm your nervous system and encourage relaxation. Sip a cup of chamomile tea, a fragrant flower extract that some health experts believe helps ease anxiety. If you still can't fall asleep, go into another room and read or do another relaxing activity for about 15 minutes, then go back to bed and try it again.

Depression

Depression and fatigue are both common in women, and the two conditions appear to fuel one another. People who are depressed are more than four times as likely to be tired, and those who are fatigued are almost three times as likely to be depressed. The stress and worry that are hallmarks of depression can keep you tossing and turning all night, and if you drag through every day you're bound to feel miserable.

What to do: "Treating the depression will give you more energy," Fryhofer says. Talk to your doctor about how you're feeling. He or she will want to know when your symptoms began, how long they have lasted, and how severe they are. Together, you can then determine the best course of treatment, which may include antidepressants, psychotherapy, or both. 

WebMD Magazine - Feature Reviewed by Brunilda Nazario, MD on March 11, 2011

Sources

SOURCES:

Sandra Fryhofer, MD, clinical associate professor of medicine, Emory University School of Medicine, Atlanta.

National Heart, Lung, and Blood Institute: "What Causes Anemia?"  

American Thyroid Association:  "Hypothyroidism FAQ." 

Annabelle S. Volgman, MD, FACC, associate professor of medicine and medical director, Heart Center for Women, Rush University Medical Center, Chicago.

Agency for Healthcare Research and Quality: "Cardiovascular Disease and Other Chronic Conditions in Women: Recent Findings."

McSweeney J. Circulation, Nov. 4, 2003; vol 108: pp 2619-2623. 

Hadine Joffe, MD, MSc, associate professor of psychiatry, Harvard Medical School; director of research, Center for Women’s Mental Health, Massachusetts General Hospital.

National Institute of Mental Health: "How is Depression Diagnosed and Treated?"

Hossein Gharib, MD, professor of medicine, Mayo Clinic College of Medicine; past president, American Association of Clinical Endocrinologists.

National Institutes of Health, Office of Dietary Supplements: "Dietary Supplement Fact Sheet: Vitamin D." 

Looker A. American Journal of Clinical Nutrition, December 2008; vol 6: pp 1519-1527.

Wortsman J. American Journal of Clinical Nutrition, September 2000; vol 72: pp 690-693. 

Institute of Medicine: "Dietary Reference Intakes for Calcium and Vitamin D."

University of Maryland Medical Center: "Lavender." 

University of Maryland Medical Center: "German Chamomile."

Skapinakis P. Psychosomatic Medicine, 2004; vol 66: pp 330-335.  

© 2011 WebMD, LLC. All rights reserved.

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