13/12/2025
Why am I always exhausted⌠is that from endometriosis? đđ´đď¸
GENTLE REMINDER: Iâm a husband learning behind my wife, who lives with stage IV endo and fibro. This is not medical advice but my own research and a wish to understand. Please share your real-life experiences so I can write more accurately for the next woman. Your lived truth matters more than anything. Tell me what I get right or wrong so I can keep learning and spread better awareness. THANK YOU.
If youâre reading this while feeling like your body is made of wet sand, I want to say something gently but clearly: chronic exhaustion can absolutely be part of endometriosis.
And itâs not the cute kind of tired where a nap fixes it. Itâs the heavy, bone-deep fatigue where showering feels like a marathon and you have to âprepareâ mentally just to leave the house.
So yes, endometriosis can be a reason. But what makes it cruel is that the fatigue is rarely just one thing. Itâs usually several layers stacked on top of each other, and doctors donât always explain those layers.
One layer is inflammation. Endometriosis can trigger ongoing inflammation in the pelvis and sometimes beyond it. Your immune system stays busy, like itâs stuck in âfight mode.â When the body spends energy fighting all day, it leaves less energy for living.
Another layer is pain. Constant pain is not only painful, it is draining. Pain interrupts sleep, tightens muscles, raises stress hormones, and forces your nervous system to stay alert even when you lie down. Your body can be exhausted but still unable to truly rest.
Then thereâs bleeding. This one is rarely talked about properly. If your periods are heavy, or you spot for many days, you can become low in iron. And hereâs the detail many women are never told: you can be iron deficient even if your âhemoglobinâ looks normal. Ferritin (iron stores) can be low first, and low iron stores alone can make you feel breathless, weak, dizzy, cold, or like your brain is wrapped in fog.
Another layer is digestion. Many women with endometriosis live with bloating, bowel pain, nausea, reflux, constipation, diarrhoea, or food sensitivity flare-ups. If your gut is inflamed, you may not absorb nutrients well, you may eat less, or you may fear food because of what it triggers. All of that can quietly starve your energy.
Another layer is stress and emotional survival. Not âstressâ as in âyouâre imagining it,â but stress as in living with a body that can betray you at any moment. The constant planning, cancelling, apologising, pushing, masking, and pretending youâre fine is an energy leak people donât see.
And sometimes there are âhidden partnersâ to the fatigue. Endometriosis often overlaps with things like adenomyosis, IBS-type symptoms, bladder pain conditions, migraines, and for some women fibromyalgia or other chronic pain syndromes. If more than one condition is in the room, fatigue can feel unstoppable until each piece is recognised.
If youâre exhausted all the time, here are some practical things many women told me they wish they had checked earlier. These are not cures, but they can uncover treatable contributors:
Iron studies (especially ferritin), not just a basic blood count
Vitamin B12 and vitamin D
Thyroid function
Inflammation markers if your doctor thinks itâs relevant
Coeliac screening if you have gut symptoms
Sleep quality (snoring, waking unrefreshed, insomnia, waking in pain)
And something else thatâs rarely talked about: medication fatigue. Some pain meds, some hormonal treatments, and even some anti-nausea meds can make you sleepy, flat, or foggy. It doesnât mean you should stop them on your own. It just means your exhaustion deserves a full, honest medication review instead of being dismissed as âjust endo.â
Now, gentle solutions that can actually help day-to-day, even if they donât âfixâ endometriosis:
Stop using a healthy personâs schedule
If your energy is limited, spending it like you have unlimited supply is a guaranteed crash. Many women do better with an âenergy budgetâ mindset: plan one demanding thing a day, not five.
Create two versions of your day
A low-energy version and a better-day version. If you only have one routine, youâll fail it on flare days and feel guilty. Two routines lets you still feel like you âdid life,â even when youâre running on fumes.
Treat sleep like pain management
Not as a luxury, but as a medical tool. Darkness, cool room, gentle wind-down, and protecting your bedtime can matter more than people realise.
Eat for steadiness, not perfection
Many women find they do better with protein early in the day and regular meals that keep blood sugar steady. Not âa perfect diet,â just fewer rollercoasters.
Micro-movement instead of forced workouts
If exercise wipes you out, the answer is not shame. It may be smaller movement: a short walk, gentle stretching, or pelvic-friendly mobility that calms the nervous system rather than punishing it.
Track fatigue like a symptom, not a personality trait
If you track sleep, bleeding, pain, bowel symptoms, food, and stress for a few weeks, patterns often show up. That evidence helps you advocate for yourself without having to âproveâ your suffering with emotions.
And please hear this part, because I think itâs the part that makes women cry in that quiet way: you are not lazy. You are not weak. You are not âunmotivated.â You are surviving a condition that can drain a human being from the inside out, and youâre still trying to be kind, productive, present, and normal. That is strength people donât recognise.
If you ever need a soft place to land emotionally, my FREE 130+ page eBook âYou Did Nothing To Deserve This!â was written for moments exactly like this. You can find it in my profile/bio section.
And remember, needing rest is not a moral failure, and your exhaustion deserves compassion, not criticism.
Lucjan đ