6 Hormonal Causes of Fatigue You Might Be Experiencing Right Now

Are you getting 7 to 9 hours of sleep every night but still feeling fatigued throughout the day? You know it’s not normal. But your doctor says you’re healthy.

Maybe you’ve been told it’s all in your head.

But there’s another, lesser-known cause you should consider — your hormones.

Hormonal causes of fatigue - woman tired

So, what are the hormonal causes of fatigue? And can hormonal balance prevent you from feeling tired all the time? We’ll discuss these questions and more in this article.

Which Hormones Make You Feel Tired?

Hormones are the chemical messengers of your body. For your body to function optimally, the right hormones need to be produced and secreted in the right amounts.

Let’s take a look at the top 6 that have been linked to fatigue.

DHEA and Cortisol33

Dehydroepiandrosterone (DHEA) is one of the hormones made by your adrenal glands, gonads, and brain. Your body uses DHEA to produce other hormones such as androgens and estrogens.

Your DHEA levels peak around age 25 and decline as you get older.1 Low DHEA levels have been associated with the following:

  • Low bone density
  • Cardiovascular disease
  • Memory loss
  • Breast cancer

Cortisol is another hormone produced by your adrenal glands. While best known as the body’s primary stress hormone, cortisol influences many other processes, including:2

  • Regulating inflammation
  • Controlling blood sugar
  • Controlling blood pressure
  • Managing your body’s use of carbohydrates, fats, and proteins
  • Helping control your sleep-wake cycle

Both cortisol and DHEA are involved in a common cause of chronic fatigue: hypothalamic pituitary adrenal (HPA) axis dysfunction, popularly – and inaccurately – known as “adrenal fatigue.”

As its name suggests, the term HPA axis describes the interactions between the hypothalamus, pituitary gland, and adrenal glands. When something stressful happens to you, a cascade of pathways are stimulated, resulting in the release of certain hormones like cortisol. This allows your body to respond appropriately to the stressful event.

A properly functioning HPA axis is critical for the stress response. But when the HPA axis is overstimulated – often by chronic stress – one or more of the components can fail to do its job, resulting in HPA axis dysfunction. Someone with HPA axis dysfunction may have abnormal cortisol production and disruption of other neurotransmitters and hormones, like DHEA.

HPA axis dysfunction is recognized as a potential mechanism for conditions such as mood disorders and chronic fatigue syndrome.3,4


Testosterone is best known as the hormone responsible for the development of many masculine characteristics. But women also have testosterone – just lower levels of it. Your ovaries and adrenal glands produce both testosterone and estrogen.

Testosterone influences a woman’s:

  • Muscle mass
  • Bone health
  • Libido
  • Body fat distribution
  • Mood
  • Energy

In both men and women, testosterone levels typically begin to decline as you enter your 30s. Your doctor may perform a blood test to measure your testosterone levels.

Symptoms of low testosterone to watch for include:5

  • Low sex drive
  • Vaginal dryness
  • Thinning hair
  • Fatigue
  • Weight gain
  • Mood changes, especially depression
  • Decreased muscle strength
  • Irregular menstrual cycles
  • Infertility

If you take an oral contraceptive, you may be at an increased risk of low testosterone.6


Estrogens are the main sex hormone for women, and it’s no surprise to see the incredible impact they have on our bodies. The three types of estrogen – estradiol, estrone, and estriol – affect women’s:7

  • Puberty and sexual development
  • Menstrual cycle
  • Fertility and pregnancy
  • Bone health
  • Heart health
  • Mood
  • Brain function

It’s common to experience fatigue when your estrogen levels are low, as well as dry skin, vaginal dryness, weight gain, low libido, etc.8

Studies also indicate that estrogen has potent serotonin-modulating properties.9 This means that changes in estrogen levels can also impact serotonin activities in your body.10 As we’ll discuss later, low serotonin can lead to poor sleep quality, which can cause you to feel tired.


Progesterone is another sex hormone that supports the female reproductive system.

Besides its reproductive functions, progesterone has significant and widespread effects on your brain. Specifically, progesterone can help you relax and go to sleep. This is done through the actions of a metabolite of progesterone called allopregnanolone.

Allopregnanolone is a gamma-aminobutyric acid type A (GABAA) receptor agonist, which simply means that it binds to GABAA receptors and activates them. GABAA is a type of inhibitory neurotransmitter, causing your brain to slow or calm down. The idea that we can have GABAA receptors stimulated just by metabolizing progesterone is pretty impressive.

But fluctuations in progesterone levels – and therefore changes in allopregnanolone levels – means alterations in GABA function.11

Because GABA is the primary inhibitory neurotransmitter in our brains, a GABA deficiency may lead to an imbalance between excitatory and inhibitory neurotransmitters.12 This can lead to symptoms like anxiety, stress, insomnia – all of which can make you feel tired.

Serotonin and Melatonin

Serotonin, also known as 5-hydroxytryptamine (5-HT), is both a hormone and a neurotransmitter naturally produced by your brain and intestines. As a neurotransmitter, serotonin sends signals between nerve cells throughout your body.

Often called the “feel-good chemical,” serotonin has a wide and complex range of functions that affect your mood, digestion, appetite, learning, and more.13

Low serotonin levels have been linked to poor sleep and depression.14 Without proper sleep, you naturally feel tired the next day.

Serotonin is also a precursor for another hormone called melatonin.

Melatonin, often referred to as the “sleep hormone,” is best known for its pivotal role in helping synchronize your circadian rhythm. Your body’s circadian rhythm is its internal clock that runs in roughly 24-hour cycles. It coordinates multiple processes in your body, including:15

  • Alertness and sleepiness
  • Appetite
  • Body temperature
  • Hormone release

Melatonin is released by a small gland in your brain called the pineal gland. The main function of this gland is to convey information about the day-night status from your environment to produce melatonin.16 It releases the highest level of melatonin at night, when there’s darkness, and the lowest level during the day – or when there’s light.

This explains why you may feel more tired during the winter months, when there are fewer daylight hours.

Melatonin levels also vary based on a person’s age and sex. Typically, they’re higher in adult women than in adult men.17 They remain pretty stable until approximately age 40, after which they begin to decline.

But age isn’t the only thing that affects melatonin levels.

Other factors consistently linked to changes in melatonin levels include:18,19

  • Disrupted light-dark cycles
  • Night work
  • Nutrition
  • Being overweight
  • Neurodegenerative diseases
  • Certain medications like beta-blockers

Low levels of melatonin can mean poorer quality of sleep. And as a result, you may feel more fatigued.

Thyroid Hormones

Your thyroid is a 2-inch-long, butterfly-shaped endocrine gland located at the front of your neck, just below your larynx. Despite its small size, your thyroid plays a monumental role in your metabolism, growth, and development.

Your thyroid also helps regulate vital body functions such as digestion and bone health by releasing a steady amount of hormones. These hormones include:

  • Tetraiodothyronine (also known as thyroxine or T4): The primary thyroid hormone circulating in your blood.20
  • Triiodothyronine (often called T3): The active form of T4. Approximately 20% of T3 is secreted directly by your thyroid gland. The majority of T3 in your body is converted from T4 by enzymes in organs such as the liver and kidneys.21
  • Calcitonin: A hormone involved in calcium and bone metabolism

While your thyroid produces all 3 hormones, only T4 and T3 are proper thyroid hormones.22

Although your thyroid secretes a steady amount of thyroid hormones under normal conditions, there are times when your body needs more or less.

But several things can go wrong with your thyroid gland. Your thyroid may produce too many hormones (hyperthyroidism) or not enough (hypothyroidism).

An overactive thyroid means your body may use energy too quickly, resulting in symptoms such as weight loss, hair loss, irregular heartbeat, and irritability:23

An underactive thyroid, or hypothyroidism, means your cells work slower because there isn’t enough T4. As a result of slower metabolism, you may experience fatigue, weight gain, and muscle aches or weakness.

Natural Ways to Fix Hormonal Causes of Fatigue

Now that you know about the hormonal causes of fatigue, what can you do? Here are my top tips.

  1. Test, don’t guess: It’s critical to find out the exact underlying cause of your fatigue. Many supplements, even natural ones, can have unwanted or even dangerous consequences if they’re not needed by your body or if they’re taken at the wrong dosages.
  2. Rest: Many people rely on fake energy like caffeine. But the boost in energy is only temporary, and they’re certainly not something you want to consume every day. Instead, get good, consistent rest. I also recommend optimizing your sleep hygiene and routine.
  3. Log your symptoms: Fatigue is more than feeling just a little tired after not getting enough sleep the night before. It can have a significant impact on all aspects of your life. That’s why it’s important to log all of your symptoms and their severity and share them with your doctor.
  4. Connect with your body: Mind-body connection isn’t just a theory. By listening to your body, you can tune into what it needs the most. And yes, fatigue is a clear message from your body that it needs attention. The more we listen to and connect with our bodies, the better we can understand our symptoms and notice certain patterns.
  5. Optimize your lifestyle: As discussed in this article, your circadian rhythm is your body’s master clock. And despite all the advancements in our modern society, it’s perhaps best that we look to our ancestors for tips on how to optimize our sleep patterns. This means doing your best to sleep when it gets dark and avoiding a lot of light just before bed.
  6. Consider herbs: Adaptogenic herbs like eleuthero and rhodiola are great for combatting fatigue. But before you buy some, keep in mind that herbs are medicine. Work with a trusted practitioner to find the right herbs and the right doses for your body.

Women’s Hormone Specialist in Boston

Hormones affect every part of your body. So it may not be surprising to know that there are hormonal causes of fatigue.

If you’re looking for a women’s health specialist who understands how hormones can affect your energy levels, I’m here and ready to help. I offer comprehensive testing to figure out the root cause of your fatigue and personalized solutions for your unique healing journey.

Not local to Boston? No problem. I offer tele-consults, which can be done in the comfort of your home. Schedule an initial consultation here to get started.

Schedule a free 15-minute consultation today to learn more about how I can help you.

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