Obstetrics & Gynecology in Augusta, GA

Too Pooped to Play

“I’m sick and tired of being sick and tired!” 

“I just have no energy.”

     One of the most common problems of the 21st century woman is fatigue.  I am not exaggerating by stating that well over 40% of women I see in my office complain at some stage of their life of excessive tiredness.  Lack of energy is not a local phenomenon either (in spite of the claims of one woman who was sure that SRS had something to do with her low energy level.  Of course this was the same gal who had been nabbed by aliens and forced to watch reruns of “Geraldo”).  National statistics are equally as impressive.  One study even went as far to claim that 30.3 % of adolescents experienced excessive fatigue (PEDIATRICS Vol. 119 No. 3 March 2007, pp. e603-e609) 

   The classification of fatigue runs the gamut from a transient mild tiredness to a debilitating lack of energy.  One of the inherent problems in studying a condition such as this is the subjectivity of the diagnosis.  Those who suffer with chronic fatigue are often perceived as malingerers and pa
tronizingly dismissed.  There is still reluctance on the part of many medical practitioners to legitimize chronic fatigue syndrome, the most extreme form of tiredness, as a genuine entity; however, this appears to be an area where the science is finally catching up with the clinical observation.  As with any medical problem that is poorly understood, the treatment of excessive fatigue is varied, sometimes unconventional, and often unsuccessful.  It is important to distinguish chronic fatigue syndrome from “garden variety” tiredness as they differ in numbers of symptoms and degree of disability.  For many sufferers it comes down to how much the lack of energy interferes with normal day to day activities.  The Center for Disease Control in Atlanta has set down certain criteria for physicians and researchers to use in making the diagnosis of chronic fatigue syndrome.  A CFS diagnosis should be considered in patients who present with six months or more of unexplained fatigue accompanied by other characteristic symptoms. These symptoms include:

  • cognitive dysfunction, including impaired memory or concentration
  • exhaustion and increased symptoms for more than 24 hours following physical or mental exercise
  • non-refreshing sleep
  • joint pain (without redness or swelling)
  • persistent muscle pain
  • headaches of a new type or severity
  • tender lymph nodes
  • sore throat

  You can see from these symptoms that there is tremendous overlap with other common problems.  We all may experience some of these problems some of the time. The key is the persistence and intensity of the problem and, importantly, no other medical or emotional troubles that serve as a cause.

   There is hope!  Since becoming a more universally defined syndrome, additional research has been done on ways to thwart this bothersome illness.  Many of these treatments and suggestions also apply to the woman who has only mild symptoms.  So whether you are unable to get out of the bed or just collapse at the end of a busy day, these pointers may be worthwhile pursuing.

     First and foremost, get a good checkup by your doctor.  Many medical conditions such as hypothyroidism, menopausegyn, Lupus, depression, anemia, and sleep apnea have fatigue as a primary symptom.  If you check out well with your doc, consider the following:

1.  Check your sleep habits.  We are a culture of sleep deprivation.  It makes logical sense that if we don’t sleep restfully we will be tired the next day.  I am amazed at the number of folks that forget this simple connection.  Improve your sleep and your energy will rebound.

2.  Force yourself to get off the couch.  Multiple studies show the positive effect of exercise on energy level.  You may be saying, “I would exercise if I wasn’t so darn tired!” It is tough, but forcing yourself to do something, even a good walk, will, over time, improve your energy level.

3.  Garbage in equals energy gone.  We are what we eat, and this applies to energy level.  In fact, energy derives from the body’s ability to metabolize food.  If we put molasses in our car’s gas tank, it won’t go far.  If we put junk in our gas tank, we won’t go far!

4. Reduce stress.  Stress magnifies everything!  The more stress, the more your lack of energy.  It’s as if the body tries to shut down to save itself from the stress. The more you can minimize stress, the more energy you will have.

  I realize this is a very superficial treatment of very complex solutions, but maybe it can stimulate you to investigate these approaches on your own. 

Sleep problems? You’re not alone.

It is estimated that over 40 million Americans suffer from some sort of chronic sleep disorder and almost 90% of those are unidentified or undiagnosed!  That’s a considerable number of folks exposing themselves to bad infomercials at 2 AM.  I must admit that I traditionally related sleep disorders to older people and shift workers, but a recent study from the National Sleep Foundation indicates that almost 36% of 18-29 year olds have a sleep issue that disrupts their life.  In a time of budgetary restraints and fiscal precariousness, sleep problems have been estimated to cause 16-20 billion dollars of economic losses to business and industry.  We don’t often associate sleep problems with other major population health risks such as heart disease and diabetes, yet sleep disorders are every bit as important to the health of the nation as other maladies.  Women are particularly hard hit as 79% report sleep disturbances during pregnancy, 36% report sleep problems in the peri-menopause and menopause time periods, and 24% say sleep problems interfere with them caring for their family.

Sleep deprivation can lead to chronic tiredness, moodiness, frustration, difficulty in controlling emotions, inability to concentrate adequately, and problems with abstract thought.  In other words, sleep deprived individuals are generally not happy folks!  There is good evidence that a lack of adequate sleep can lead to an impairment in immune function, metabolic problems, weight gain, and hypertension.  The National Highway Safety Administration has said, “Drowsiness has been the cause of 100,000 traffic crashes every year, killing more than 1500 Americans and injuring another 71,000.”  Some physicians believe sleep disorders are the most unrecognized common malady we face today.

The average adult needs about 7 1/2 to 8 hours of sleep a day to feel rested and allow the body to rebuild, refresh, and rejuvenate.  Obviously this number is a generalization as some individuals require less and some more, so it is vital to determine honestly your threshold.  In general, older adults require a bit less sleep to avoid problems; however, it is not as dramatic difference as some would imagine.  A common yet often missed cause of sleep problems are various medicines and drugs.  Caffeine, alcohol, nicotine, steroids, decongestants, antidepressants, and blood pressure medicines are just a few of the ingested substances that can keep you awake.

Healthy sleeping habits for the family

  • Fix a bedtime and fix an awakening time
  • Avoid napping during the day
  • Avoid alcohol before bed
  • Avoid caffeine containing beverages 4 – 6 hours before bedtime
  • Avoid heavy, spicy, or sugary foods before bed
  • Regular exercise is good but not before bedtime
  • Comfortable bedding
  • Bedroom cool, dark, quiet
  • Bedroom reserved for sleep – NOT a work room
  • Go to bed only when sleepy
  • If unable to sleep, move to another room
  • Return to bed only when sleepy
  • Avoid a visible bedroom clock with a lighted dial
  • Don’t let yourself repeatedly check the time!
  • Turn the clock around or put it under the bed


There are a few herbal medicines that have been minimally helpful in promoting sleep for some people.  These include Valerian root, Kava, Chamomile, and in older individuals-melatonin.  The worst thing to do is nothing…sleep problems rarely spontaneously resolve.  Don’t ignore the issue and take steps to a more restful sleep today.