Why am I always tired? Common reasons women feel exhausted

It is normal to feel tired sometimes, after a late night, a busy week or a sick child. It is not something you simply have to live with when it goes on for weeks.

Many women are told "everyone is tired" or "it's normal at your age". Sometimes that is true, and a few changes help. But tiredness that never lifts can also be a sign of something a doctor can find and help with. The NHS advises seeing a doctor if you have been feeling tired for a few weeks and are not sure why.

There is rarely one neat answer. These are the common reasons, and more than one can be true at once. Only a doctor can tell what's going on for you.

Sleep. Too little sleep, broken sleep, or sleep that does not feel restful. Late nights, a baby or a toddler, a snoring partner, a phone in bed, or a mind that won't switch off. The NHS suggests regular sleep times and relaxing for a couple of hours before bed, without screens in the last hour. If worries keep you up, read about sleep and overthinking.

Low iron. Iron deficiency anaemia can cause tiredness and lack of energy, shortness of breath, a racing or pounding heartbeat, and paler skin than usual. The NHS says heavy periods and pregnancy are very common causes.

The thyroid. An underactive thyroid can make you feel extremely tired. It can also cause weight gain, low mood, feeling cold, constipation, dry skin or hair, and heavy or irregular periods. The NHS says symptoms usually develop slowly and can be easy to miss.

About 1 in 6 Indian women has an underactive thyroid. That is one reason doctors in India often check the thyroid when a woman is tired all the time. Read more about thyroid and tiredness.

Low mood and stress. The NHS lists stress, depression and dealing with life's challenges among the causes of tiredness. Depression itself can bring a lack of energy. If you have also been feeling low for weeks, mention both when you talk to someone.

Your cycle and hormones. Tiredness is a common premenstrual symptom. The NHS lists feeling very tired among the main symptoms of PMOS, the new name for PCOS. In the years before menopause, poor sleep and night sweats can leave you drained.

Blood sugar. The NHS lists diabetes among the physical causes of tiredness, and a doctor can check for it with a blood test.

Your whole load. Work, the home, children, elders, and being the one who remembers everything. Carrying all of it with no time to rest is tiring in itself, and it can hide the other reasons on this list.

Many women in India play several roles at once: professional, daughter, partner, mother. You are always planning ahead. This is often called the mental load, and carrying it is tiring in itself.

You may be thinking:

• Have I finished my assignment?
• Is there enough food in the house?
• Have I called Mum?
• What do I need to do tomorrow?

Many women in India are the last to rest and the last to see a doctor. You book everyone else's appointments, remember everyone's medicines, and keep going. Tiredness becomes background noise, and by the time it gets attention it has been there for months.

Because so many women around you live the same way, it can feel like part of being a woman. Being used to feeling tired doesn't mean you should ignore it.

Being told "it's normal" can make it harder to ask again. But tiredness that lasts is worth a proper look, for the same reason you would want it looked at in your mother, your sister or your daughter. Asking for a check is not making a fuss. It is how the causes on this list get found.

The doctor decides which tests you need, based on what you tell them and an examination. Common ones for tiredness include blood tests that check for anaemia, the thyroid and diabetes.

• For anaemia: a full blood count, which checks your red blood cells.
• For the thyroid: a blood test for thyroid-stimulating hormone (TSH) and thyroxine (T4).
• For blood sugar: a blood test for diabetes.

You don't need to ask for every test yourself, and more tests are not always better. Tell the doctor everything you have noticed. They will choose what makes sense.

These steps from NHS advice on tiredness can help, whatever the cause turns out to be.

• Keep regular sleep and wake times, and aim for enough sleep for you.
• Put screens away an hour before bed, and relax for a while before you lie down.
• Eat regular, balanced meals and move a little every day.
• Go easy on alcohol, and avoid tea or coffee close to bedtime.
• Notice the patterns: is it worse before your period, after bad nights, or on heavy work days?

If tiredness does not lift after a few weeks of this, that is useful information too. It is a reason to see a doctor, not a reason to try harder.

You don't need to change your whole life. Start by taking an interest in what your body is telling you.

• Instead of saying “I'm always tired”, note when it started and what else has changed.
• Instead of blaming yourself for feeling overwhelmed, recognise how much you are carrying.
• Instead of ignoring a change because you're busy, take some time to speak to a doctor.
• Instead of pushing yourself to keep going, give yourself permission to ask for help.

Your body is not a problem to solve. It is a part of you that deserves to be heard.

• How long you have felt tired, and whether it is every day.
• Your sleep: when you go to bed, when you wake, and whether you feel rested.
• Your periods: are they heavy, irregular or changing? Are you pregnant, or have you had a baby in the last year?
• Other changes: weight, feeling cold, hair, skin, breathlessness, a racing heart.
• Mood and stress: low mood, worry, a heavy load at home or work.
• Any past blood test results, especially haemoglobin, thyroid or sugar.
• Any medicines or supplements you take.

Talk to a doctor if you have been feeling tired for a few weeks and don't know why, or if tiredness is making daily life hard to manage. That is what the NHS advises.

A Nari health counsellor can listen, help you describe what you have noticed, and book you with a Nari doctor. The doctor can look for causes such as the thyroid or low iron and prescribe the tests you need. Counsellors never give medical advice; medical decisions come from a Nari doctor.

See a doctor sooner if tiredness comes with breathlessness, a pounding heart, heavy periods, weight changes you can't explain, or low mood most days. If you have chest pain, severe breathlessness or you faint, call 112.