Adrenal Fatigue and PCOS – Are They Exhausting Partners?

Do you feel exhausted, even after a good sleep? Or get the shakes… Maybe feel like you can’t cope well with the slightest of stressors. Do you use coffee or chocolate to pep you up, and a nanna nap to calm you down? Are your relationships suffering, weight gain is easy and the fat hard to shift, or do you struggle with insomnia, depression, fibromyalgia, asthma, hayfever or have had a nervous breakdown?

Maybe you even feel like you could fall asleep in the middle of the day, right where you are, right now!

You may be suffering from adrenal fatigue and PCOS.

PCOS and adrenal fatigue
Adrenal fatigue and PCOS… Do they go together?

As I’ve often talked about, there are many links between PCOS and stress. So, let’s look at what happens in stress, as this will then help you understand why your adrenals – those teeny tiny little powerhouses that sit on top of each kidney and release adrenaline – become fatigued, exhausted, plum tuckered out!

Insulin is a hormone that grabs the excess sugar (glucose) from your blood and guides it into your cells, where it is safer and can be used to run your body and for future energy needs. When we are stressed, our body reduces our insulin sensitivity. This means we keep more glucose in our blood.

Why does this happen?

Well, blood glucose gives us the extra energy we need to fight off the proverbial saber tooth tiger – to act against a stress. It’s called the fight or flight response.

In modern day society, we tend not to face too many life-threatening situations, thank goodness! But, our body is hardwired this way. It is hardwired for your survival. When we face a stress, our hormones change to help us fight or run away. The trouble is, many stressors today are constant.

why does adrenal fatigue occur
How does this affect our adrenal glands?

Insulin resistance keeps sugar in our blood. However, this flight or fight response is meant to be short-lived. Once the threat has passed, our insulin sensitivity and our body should return to a relaxed state. Our blood sugar levels should return to a healthy range.

But, with the chronic stress so common in many of our lives, this does not happen. We see many of the changes common in women with PCOS occur, like reduced sex hormone binding globule (SHBG), increased free hormones like oestrogen and testosterone, reduced gut function (digestion is not a priority when compared to becoming the main meal for a scary predator!) and the same can be said for fertility (it’s not an ideal time to have babies when stressors, like being the hunted or facing famine, are present).

Our insulin’s ability to work in an efficient way can become compromised. We can have a spike in blood glucose, and a soar in insulin, and then a corresponding THUD as our blood sugar levels crash. This is common in women with PCOS. It’s why around 3-4pm you may feel tired and grumpy, foggy headed and experience cravings.

Adrenal fatigue energy slumps
What happens next and why are adrenal fatigue and PCOS linked?

When your blood glucose levels become too low, your body releases adrenaline. Your amazing adrenal glands act incredibly quickly to remedy your falling blood sugar levels because this is a serious problem. A sudden increase in adrenaline liberates sugar from your cells and back into your blood. It can save your life and give you the energy needs to fight or take flight.

That ‘hit’ of adrenaline can cause the shakes, those tummy butterflies, that feeling of being on edge and primed for action.

This is a healthy response to a short-term stress or attack. It’s when your face ongoing stress, that this is a problem.

blood sugar and pcos

As a colleague of mine says “You Can’t Sprint A Marathon”

Your adrenals are like a sprinter, they are not made to be ‘on’ at full pace all the time. As you can imagine, an athlete trying to sprint a marathon will do very well for the initial 100 metres, but will tire well before the end of the long race. This is synonymous with your adrenal glands.

What are the signs of adrenal fatigue?

Dr Lam has a comprehensive list on his site, which include:

Signs and Symptoms of Adrenal Fatigue:

  • The tendency to gain weight and an inability to lose it, especially around the waist
  • A higher frequency of the flu and other respiratory diseases and these symptoms tend to last longer than usual
  • The tendency to tremble when under pressure
  • Reduced sex drive
  • Lightheaded when rising from a horizontal position
  • Unable to remember things
  • Lack of energy in the mornings and in the afternoon between 3 to 5 pm
  • Feel better suddenly for a brief period after a meal
  • Often feel tired from 9 – 10 pm, but resist going to bed
  • Need coffee or stimulants to get going in the morning
  • Crave salty, fatty, and high protein foods such as meat and cheese
  • Increased symptoms of PMS for women; periods are heavy and then stop, or are almost stopped on the 4th day, only to start flow again on the 5th or 6th day
  • Pain in the upper back or neck for no apparent reason
  • Feel better when stress is relieved, such as on a vacation
  • Difficulties in getting up in the morning

To find out more, visit this insightful Adrenal Fatigue Article by Dr. Lam.

pcos fatigue

How can you find out if you might have adrenal fatigue?

If you have many of the signs and symptoms we’ve talked about so far, there is a good chance you do.

I always assess this for patients who are new to me, as this is a commonly overlooked and significant problem.

adrenal fatigue in pcos
What can you do to conquer your Adrenal Fatigue?

You don’t have to struggle with this health issue.

In women with PCOS, it is important to take a holistic approach that considers both adrenal fatigue and PCOS.


Because there are overlaps in these conditions, and if you don’t address one, you can’t effectively address the other. They really do often go hand in hand. You need to understand and comprehensively set a plan to deal with your stress, your adrenal fatigue and to discover how to get healthy!

Otherwise, the overwhelming effects on your life can be devastating. I see so many women with PCOS living a life ‘less than’. Less than they want in love, in health, in energy, in happiness, even in money and professional satisfaction. Adrenal fatigue and PCOS can hold you back in so many ways, not least of all because it keeps you surviving, not thriving. This needs to change.

In Conquer Your PCOS – The 12 Week Intensive, I’ve dedicated three full modules to these issues. This is a quarter of my most complete and comprehensive course, so you can see how critical is it to all things PCOS.

What Is Stress Conquer It’s Devastating Effects – Module 9
Adrenal Fatigue & PCOS Relaxation Secrets – Module 10
Get Mentally, Spiritually & Emotionally Healthy – Module 12

You can’t conquer your PCOS naturally if you don’t fix these challenges, but the great news is, there is hope and there are answers.

I hope this post has helped to shed some light on why you may be feeling the way you are, that it’s absolutely NOT in your head (even though other health professionals may not have been able to discover any real answers for you) and that there is so much you can do to turn this around.

From PCOS to perfect health, with love,

Dr. Rebecca Harwin
The PCOS Expert
Nutritionist, Author, Chiropractor

P.S. Please share this article. So many women out there are struggling with both adrenal fatigue and PCOS and don’t know what is wrong with them. Many suffer in silence, and many will not find answers in mainstream medicine. Adrenal fatigue, although common, is not widely known. Visit this article to read more about adrenal fatigue now.

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6 Responses to Adrenal Fatigue and PCOS – Are They Exhausting Partners?

  1. julie May 26, 2015 at 12:42 am #

    Hi Dr. Harwin,
    I’m wondering whether PCOS that is not treated can eventually cause adrenal fatigue and thyroid problems. If a woman who is supposed to menstruate does not menstruate for an extended period of time, could the drop in progesterone levels induce adrenal fatigue and/or thyroid problems? thanks so much!

    • Dr Rebecca Harwin May 31, 2015 at 3:50 am #

      Hi Julie,

      We certainly know that women with PCOS are more likely to experience hypothyroidism. This can reduce Follicle Stimulating Hormone, and cause the ‘cysts’ (or immature follicles) of PCOS, and you are right, adversely effect ovulation and progesterone levels. We also know that Thyroid Stimulating Hormone above 2.5 is linked to insulin resistance… Which comes first? That’s no as easy a question to answer, and with my patients, I prefer to address both.

      Adrenal fatigue is stress related, and so potentially, insulin resistance related as well. It really is amazing how much the changes in stress and those in PCOS look alike. I discuss adrenal fatigue in my 12 week program, but there are links between all three. Again, it’s a little like the chicken or the egg… Which came first? It’s a complicated web, and I believe we need to look at each aspect in a holistic, related way to get the best outcome.

      Warm regards,

      Dr. Rebecca Harwin.

  2. Onehotmama May 17, 2016 at 10:38 am #

    I was reading your post. It seems you’ve written my life story. I am slowly making the recovery from stage 3C adrenal fatigue. My PCOS won’t improve. I reacted badly to metformin. I am going to explore D chiro inositol soon. Your remark about the 3-4 pm grumpiness caught my attention.
    Since I found out about adrenal exhaustion, I have become more aware about stressors. I move away from them.However, I am still obese, infertile and depressed. I remain hopeful though. Great work. We need more people to be aware of adrenal exhaustion.

  3. Samanthan JOnes June 1, 2017 at 9:46 am #

    I have adrenal insufficiency and PCOS and am struggling to lose weight. I work full-time and a mum of three so I do experience some level of stress. I have changed my perception around a lot of stressors and so am pretty calm most of the time but am still suffering many symptoms. I have tried various adjustments to my diets, but since starting treatment for the A I have not lost a single pound. I am completely fed up – any advice?

  4. Rebekah Lee January 4, 2018 at 1:21 am #

    Hello Dr. Harwin

    I am 24 years of age and for the past three years I have felt tired, exhausted, and not having any energy for most days. I have been to the doctors countless times and the doctor has diagnosed with the depression and anxiety. I feel like there is something more going on than just this. I have been put on depression medication and anxiety medication to help. Although the medication does seem to help me I still get tired over doing the simplest task. I have recently been to see a chiropractor and mentioned this problem to him. He lied me on my stomach and stroked his hand down my back. As he came to the middle of my back, my back was very tender. The chiropractor said that the pain had to be coming from the adrenal glands located in the middle of my back and believe this is true. Once he worked on me I felt better.

    All of the symptoms that were listed above are spot on.

    I also have PCOS. This condition has caused me to have high blood pressure, depression and anxiety worse. Not too long ago I was diagnosed with this condition.

    I need help on what to do from this point. I am tired of going back to the doctor time and time again just to try more depression medication to help me have more energy.

    • Dr Rebecca Harwin June 2, 2018 at 8:11 am #

      I’m so sorry to hear of your struggles Rebekah, and sorry for such a slow reply.

      There is much wisdom that exists in what’s considered the alternate health system which is absent from the mainstream, and vice verse. I feel it is best to utilise both systems to find what works for you.

      As a Chiropractor, I’ve seen incredible changes in those patients under care. It sounds like a trial of regular care might be a good option.

      It sounds like it would also be worth consulting with a Naturopath or Integrative Doctor who specialises in adrenal fatigue. It this is the cause of your signs and symptoms, it will likely make a wonderful difference to have your health restored.

      How have you been going with everything of late?

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