Persistent fatigue that does not improve even after eight hours of sleep is one of the most common yet often overlooked concerns discussed during a gynaecology appointment. Many women get used to functioning with only half their usual energy, attributing it to age, workload or the “modern pace of life”. However, ongoing tiredness is rarely a diagnosis in itself. It can be a sign that several factors are affecting the body at the same time.

Hormonal factors and energy

Energy levels can be influenced by thyroid function, reproductive hormones, sleep quality and stress. Even mild changes in thyroid function may be associated with fatigue, feeling cold, dry skin or changes in weight and mood.

Oestrogen and progesterone can also affect sleep, mood and overall wellbeing. When their balance changes, for example during different stages of the menstrual cycle, perimenopause or menopause, some women may wake up feeling unrefreshed regardless of how long they slept.

Nutrient deficiencies that can be mistaken for “laziness”

Low iron stores, measured through ferritin, as well as low vitamin B12, vitamin D or magnesium levels may contribute to fatigue in some people. These nutrients are involved in oxygen transport, nervous-system function and normal energy metabolism.

However, a general multivitamin is not always the answer. It is important to identify whether a deficiency is actually present, consider possible causes and choose any supplements individually.

Movement, posture and muscle tension

Spending long hours at a computer or exercising with uneven loading patterns can contribute to chronic muscle tension and discomfort. This may affect sleep quality, reduce daily activity and create a constant feeling of physical exhaustion.

Rest alone may not be enough if movement habits, posture or pain are contributing to the problem. Gentle, regular movement and appropriate support from a qualified specialist can be part of recovery.

Stress as a constant background

Persistent fatigue often has an emotional component. This is not necessarily about an acute stressful event, but about ongoing tension that keeps the nervous system in a state of alert.

Long-term stress, poor sleep and constant overexertion can affect recovery, mood, libido and the body’s ability to cope with everyday demands. This is not something a person simply needs to “push through”. It is a signal worth addressing.

Why general advice is not always enough

Advice such as “get more sleep and take vitamins” may not address a situation where several factors are present at once, such as low iron stores, thyroid changes, poor sleep, chronic stress or reduced physical activity.

Persistent fatigue requires an individual assessment. During a consultation, we can review your symptoms, medical history, lifestyle, nutrition, sleep, stress levels and, where appropriate, test results or ultrasound findings. The aim is not to find a “magic pill”, but to understand the possible causes and create a realistic, personalised plan to support your health and energy over time.

2026 © Elena Konovalova