3 types of fatigue solo

3 Causes of Fatigue We Rarely Talk About + How to Get More Energy | Dr. Jolene Brighten

Episode: 53 Duration: 0H43MPublished: Hormones

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In this eye-opening episode of The Dr. Brighten Show, Dr. Jolene Brighten unpacks the three hidden causes of fatigue most doctors miss and the real reasons so many women are running on empty. If you've ever been told it's just stress, aging, or that you need more sleep, this episode will feel like both a truth bomb and a roadmap.

Through powerful insights on PCOS, neurodivergence, and cortisol dysfunction, Dr. Brighten connects the dots between your symptoms and your physiology—so you can stop blaming yourself and start getting your energy back. Expect practical, science-backed tools you can use today to finally feel like yourself again.

What Causes Fatigue + How to Get More Energy

  • Why 90% of women report exhaustion—and why most never get a real diagnosis
  • The most overlooked cause of fatigue in women with PCOS (hint: it’s not your ovaries)
  • How inflammation, insulin resistance, and high testosterone create a perfect storm of energy crashes
  • The real reason you're sleeping 8 hours and still waking up feeling drained
  • The critical role of cortisol dysregulation in the “wired but tired” spiral
  • Why your brain may struggle to generate energy if you’re neurodivergent (and what to do about it)
  • How masking, sensory overload, RSD, and anxiety uniquely drain ADHD and autistic women
  • What “walking through mud” fatigue feels like and how to spot it
  • How fruit, fiber, and protein timing actually affect energy (and why skipping breakfast backfires)
  • Why continuous glucose monitors (CGMs) can change the game for early insulin issues
  • How your partner's support—or lack of it—can affect your sex drive, safety, and stress hormones
  • The simple nighttime rituals that help rewire your stress response and restore your sleep cycle

The 3 Causes of Fatigue We Cover

We start by breaking down PCOS fatigue—one of the most common yet overlooked energy issues in women. Dr. Brighten explains why PCOS is not just a reproductive condition but a full-body metabolic issue that can lead to intense fatigue, even in women who “look healthy” on paper. You’ll learn how insulin resistance, chronic inflammation, cortisol misfiring, and androgen dominance all work together to drain your energy—and exactly what to do about it.

Next, we dive into neurofatigue, a type of exhaustion rooted in brain-based challenges like ADHD, autism, RSD, and anxiety. This section explores how dopamine crashes, overstimulation, and masking take a real toll on your energy—and provides actionable solutions, from sensory resets to food-based dopamine support.

Finally, we explore stress-adaptation fatigue—commonly known as “adrenal fatigue” but more accurately described as HPA axis dysregulation. Learn how your cortisol curve gets disrupted by long-term stress, night shifts, or motherhood—and how to gently reset your system with targeted habits that restore calm, balance blood sugar, and bring energy back online.

Dr. Brighten also answers Ask Dr. Brighten listener questions on painful sex, anovulation, and what to do when your doctor dismisses your symptoms.

This Episode is Brought to You By:

👉 Dr. Brighten Essentials Optimal Adrenal Kit – Restore your energy naturally and get better sleep. Use CODE  POD15 for 15% off

LMNT: receive your exclusive gift with purchase – Helping you support your child’s development with science-backed products.

Whether it’s a supplement, lab testing service, or wearable—this is where you'll spotlight your featured partners. Be sure to align them with energy support, PCOS, or neurodivergent health for relevance.

Links Mentioned in This Episode:

  • Is This Normal? by Dr. Jolene Brighten – Includes libido support & lube recommendations

Don’t forget to subscribe, share, and leave a review. These small actions help us bring this life-changing information to more women who need it. Thank you for being part of the healing revolution.

Transcript

[00:00:00] 

B: In some surveys, up to 90% of women say they feel exhausted most days of the week, and yet only a tiny fraction ever get real answers as to why and what's going on and worse. They're often told, it's just aging. I always love that one. Oh, you're 30, you must be old. Or it's stress, right?

Because women, our biggest problem is we just don't handle our stress. Like again, it's all on you, or that you just need to get more. Sleep and I just wanna say like, as a new mom, like, yeah, we need to get more sleep.

Or if you're in perimenopause, sure, but what if it's not just sleep? What if it's not just stress? What if it's not just part of aging? So what if I told you that your exhaustion, like feeling flatline, fatigue isn't normal, it's just common. And in today's episode, we are uncovering three hidden types of fatigue that you may have been living with and calling normal and that your doctor [00:01:00] more than likely has missed.

We're going outside of the anemia talk or hypothyroidism for which I have episodes on, and I want to talk today instead of these three major areas that are impacting women's lives and are being completely glazed over. Not even talked about when it comes to feeling bone tired. And in this episode, you're gonna walk away with real strategies to get your hormones and your energy back on track. Whether you're dealing with hormonal crashes, neurodivergence burnout, or the wired yet tired cortisol spiral. And listen, if you are a subscriber, thank you so much. And if you're not yet.

Let's hit that subscribe button and hang out together more. And right now, as you're listening to this, wherever you're listening to this podcast, please leave a review. Leave a comment. It helps us so much. Well, it's a small step for you, us at the Dr. Brighton show. It's a really big deal. We celebrate it, we appreciate it, and it helps signal to [00:02:00] all the powers that be that this is the kind of information that they should be putting in front of women so that women can heal their bodies and understand them much better.

 Okay, so with that said, let's get into it. We're gonna start by talking about PCOS fatigue, polycystic ovarian syndrome. So we're gonna kick this off with a type of fatigue that is wildly underdiagnosed and often completely misunderstood. That is. PCS fatigue. Now, PCS or polycystic ovarian syndrome is the most common hormone disorder in reproductive age women, and yet.

yet.

We still largely ignore one of its most debilitating symptoms, which is crippling daily exhaustion. We're not talking about I stayed up too late tired. We're talking about I can't get out of bed tired. Caffeine does nothing tired. If you have PCOS and you're familiar with this, you're probably [00:03:00] nodding your head right now.

And with PCOS fatigue, this can sometimes feel like. Uh, you know, uh, what I had one patient say to me is, I feel like I'm walking through mud all day kind of tired. Like, you know, when your feet sink into the mud and you can barely move forward. It's that kind of fatigue where it's not just like, Hmm, I yawn, I feel tired sitting at my desk.

It's that I'm physically tired. I feel unable to move. Right now my limbs are struggling. And here's the kicker. Most women are never told that PCOS can even cause fatigue. And if you're not familiar with what PCOS is, PCOS. It, it has, uh, three hallmark signs that we look for that are the Rotterdam criteria, which is anovulatory or irregular ovulation.

So no ovulation, irregular ovulation happening. So that looks like irregular periods. Hair growth where you don't want it. Chin, chest, [00:04:00] abdomen, hair loss on the head. This is hyperandrogenism. You could have acne, oily skin. And, uh, you might have polycystic ovaries, but odds are you probably won't because, um, we only really see that in younger people, and it is not one of the most important symptoms to look for.

But I wanna break down. Why does PCS fatigue happen? Because it's. Not just about, uh, estrogen, progesterone, testosterone, which is a lot of what PCOS gets reduced to, it gets reduced to being a reproductive issue when it's really a system-wide endocrine metabolic issue. So up to 70% of women with PCOS have some degree of insulin resistance, even when they're not overweight.

And I did a whole episode on insulin resistance. I, um, definitely gonna link to that because it's really important that you get the right lab work done. And I go through that in detail along with what you should be looking for in terms of lab results. Now, this insulin resistance makes your [00:05:00] cells bad, bringing glucose in and generating energy.

And so the result is blood sugar swings, energy crashes, brain fog all day. Um, it's not a good, it's not a good way to go through life. So that's the first part of PCS we have the insulin resistance, the insulin dysregulation taking place.

Now number two is inflammation. PCOS is associated with low grade chronic inflammation that keeps your immune system basically turned on all the time. And guess what? That burns through your energy reserves. It stresses your mitochondria. Which are like the little cellular energy factories, little power plants of your cells.

And it demands a response from cortisol. 'cause cortisol helps dampen inflammation. And that's the third part of what's going on with PCOS. We can see cortisol dysregulation because PCOS creates an internal stress response. Your HPA access that I've talked about in [00:06:00] other episodes. Again, I'll put it in the show notes if you want a deeper dive on that.

The, this is basically the system that controls cortisol. It can become dysregulated. Even more so there can be a form of PCOS where you are actually getting androgen production happening from the adrenal glands by way of DHEA. So with PCOS and this cortisol picture, you might feel wired but tired, struggle to fall asleep or wake up feeling unre refreshed.

And those are all classic signs of stress adaptation fatigue that's being layered on top of PCOS. Now the fourth thing is androgen excess. So I told you androgen excess is one of those hallmark signs of PCOS. So that's high testosterone, but it also can be high DHEA and that can disrupt sleep quality, and it makes it harder to get into restorative deep sleep.

So you might even be like, you're like, I'm logging eight hours to get into [00:07:00] bed. I'm, I go to bed, I wake up. But like, I don't, I don't, I don't feel refreshed. You may not be getting that deep sleep. Now, why is this PCOS fatigue so often missed?

Here's the frustrating part. Most doctors are focused on bikini medicine. That is wherever a bikini would fall on your body, that's all they see. 'cause you were born with ovaries. Most doctors when, if you actually get the diagnosis of PCS, when you do get the diagnosis, they're just like focused on your period.

Um, and usually just your period. So they're like. Let's just give you the pill and let's worry about fertility in the future. If you ever decide that you wanna have a baby, they're not talking to you about inflammation or insulin resistance or the fact that you're at higher risk for type two diabetes and cardiometabolic disease in your future.

It's a very punt the ball of like, let's just get a withdrawal, bleed with the pill and we'll call it, we fixed your hormones, and that's all. It's all dishonest [00:08:00] and women deserve a lot better and PCOS women, like the real talk is if you're not actively trying to conceive, you usually just get brushed off.

There's like this algorithm where doctors are like, do you want a baby? No, just take the pill. See you later. We'll see you when we see you. You do want a baby? Oh, stop everything. We have to help her get pregnant and really. Whether or not you wanna have a baby shouldn't dictate the quality of care you're getting.

And when it comes to PCOS, when it is actually diagnosed, fatigue is rarely treated as a core issue because so few practitioners are trained to connect the metabolic inflammatory adrenal pattern that drives all of this. And. Not to mention it can take two to three practitioners, sometimes even more just to get the diagnosis.

So PCOS is just, it's a really frustrating thing that here we are in 2025 and this stuff is still playing out in women's medicine. [00:09:00] So let me say this very clearly. If you have PCOS and you are tired all the time, it's not in your head, it's in your biochemistry. So wanna talk to you about what you can do to restore your energy.

Now we're gonna talk solutions and this is where you start to take your power back. Because the thing about PCOS, and I love these new guidelines that came out and they were like, lifestyle and nutrition be should be first intervention for every woman because it's. So effective with managing PCOS. Now, one of the number one things that we do, and this is gonna help your energy, is we stabilize blood sugar.

And it's literally like it's your full-time job and it's super lame 'cause you get so little wiggle room As somebody who has multiple autoimmune diseases, I fill this where I'm like, why can't I just be the person who eats in and out and be fine? Just that's not in the cards for me. So. And, and you know what?

Honestly, there's way better food. There's way better food out there anyhow, [00:10:00] so what we need to be doing is eating 20 to 30 grams of protein at every meal. We wanna include healthy fats and fiber, getting fiber for a total of 25 to 35 grams daily. And if you go to dr brighton.com/plan, I actually have an anti-inflammatory.

Recipe plan that, um, it's a meal plan with 21 recipes that'll show you how to start integrating these, the higher protein meals and getting more fiber. I do wanna say about fiber. If you haven't been eating a lot of fiber, we don't hit 25 grams all at once. We really wanna go to like bowel tolerance. So what I often do with patients is I add five grams a day for a week and then we go to five grams more the next week, and we work our way up to that.

The other thing we wanna do is that we wanna be eating. If you eat grains, we wanna eat whole grains. [00:11:00] If you eat carbs, we wanna partner those carbs with protein fat and make sure that we're having fiber come in. Why that will help you blunt the glucose spike so that you're not spiking glucose all at once, and it will help you fill full longer.

 Now, I know a lot of people talk about how, uh, PCOS, you should just go no carb, low carb. The thing is, is you've gotta be bringing fiber in. You cannot refute the research that shows less visceral adiposity for which you are at risk for and will make you more exhausted, less visceral adiposity, the more our fiber intake is around that 25 grams.

Plus, you also need to avoid skipping breakfast, and you actually wanna front load your calories earlier in the day. To support the circadian insulin sensitivity, but also starting the day with more protein car. Most people are gonna do better with their carb loading happening earlier in the day than at night.

That's [00:12:00] definitely individualized. If you're like, no, actually, I'm totally fine. If you're someone who wears a continuous glucose monitor, I know this is like so controversial, so lemme just like take a minute here. Um, because I don't know why continuous glucose monitors became so controversial, but I've used them in my patients with PCOS and

people are like, how dare you use a continuous glucose monitor if you don't have diabetes or you haven't been diagnosed with diabetes. It's like, okay. Hold up. Slow your roll. Why the hell are we waiting? Until you have a diagnosable condition and your eyes are already being damaged, and your kidneys are already being damaged, your heart is being damaged, like damage is done, okay?

It has happened. When you get that diagnosis of diabetes, now I will refer you to the episode that I did all about insulin resistance, what to be testing for, how to catch things sooner. But here's the thing. 70% of women with PCOS have insulin sensitivity issues or insulin resistance [00:13:00] that stimulates the ovaries to produce androgens.

This is one of the mechanisms that leads to anovulatory cycles. So not ovulating, irregular ovulation, poor egg quality, um, lots of androgen production. Uh, not having periods. So you get endometrial hyperplasia, big buildup of endometrium. Then we end up with the risk of endometrial cancer in the future.

Like, do you see where this is going? So if I could put a continuous glucose monitor on you and listen, like sometimes we're successful in getting insurance to cover it. Love that. But sometimes it is a barrier. It's hard. It's hard to get access to that. If I can put a continuous glucose monitor on you.

And you can have real time data of exactly how your system is responding to your food and you can start to optimize your insulin sooner and you never get that diagnosis of diabetes, which you are absolutely staring down with PCOS. Like, why wouldn't we do that? It is so shortsighted, but also like, I just don't get this like hating on people wanting to be as proactive as [00:14:00] possible.

This mindset in the United States where it's like, just wait until you have diabetes, then you can do something about it like. That's, no, that's not for me. I bet it's not for you either, and that's why you're here because you're like, no, I would like to live optimal health, not just like finding disease and then move, trying to reverse it.

Anyhow, so I do wanna talk about the anti-inflammatory aspect though, because um, it is important with PCOS that you are increasing your Omega-3 fatty acids. Like getting cold water, fish, salmon, mackerel, sardines, bringing in herbs like turmeric, ginger, making sure that you're eating magnesium rich foods.

If you know you have PCOS considering something like my acetol. That has been shown in multiple research studies to not only help with insulin sensitivity, but it supports regular ovulation energy production, a quality, and it is best when you are pairing my acetol with de chiro acetol. [00:15:00] I even like to bring in extra support like chromium and having nutrients that are shown to support blood sugar and androgens, that you'll find that in our Myo Acetol Plus formula.

I'll go ahead and link to that. So if you wanna see an example. You can buy my supplement. You can not buy my supplement and just use it as an example of a guideline of what to look for in a supplement. But I formulated it based on what the research has told us is most helpful for PCOS. But I want to reiterate that we are starting with diet and lifestyle first.

So it's not like you can just take my acetol. Skip your Omega-3 fatty acids, eat whatever you want and everything will be fine. I wish it was that way sometimes, 'cause that would be like really easy answer. Uh, but it's just not that way. It's, that's the reality. Now the other thing we wanna look at, and this is true for like literally any human on the planet, uh, but definitely those with PCOS, is we want to limit our sugar intake.

By way of added [00:16:00] sugar, people freak out about fruit in PCOS. I am not as concerned about that. Like, look, if you're gonna sit down and you're gonna eat an entire bowl of fruit and that's your meal, we might have problems. This is, this is honestly where like continuous glucose monitor shows us that we have problems like, you know, beans for example.

Those act a lot like a carbohydrate. However, I've had patients with a continuous glucose monitor and they're like. I'm fine. When I eat beans, I have no spikes. I have other patients who are like, oh my God, beans are like the worst thing for my system. Anyhow, I just wanna remind you that fruit is not the devil.

It's not your enemy. Fruit is full of antioxidants. Uh, they're so good for your brain health, ovarian health. When you've got an inflammatory condition like PCOS, you've got free aeros happening. These fruit is full of antioxidants to help with that. What we're more looking at is how many other sources of added sugar we could bringing [00:17:00] in.

So are you drinking soda or pop? Are you eating like a cookie with lunch and dinner? Are you eating ice cream every single night? Um, you know, are, are you eating yogurt that has added sugar in it? Are you eating something that you were like, I thought this was a health food. I thought this was a good protein bar that has added sugar in it.

Now, that's not to say don't ever eat a cookie. Like I might eat some ice cream. I'll tell you that. Uh, it's to say we wanna, we wanna limit to 25 grams or less in a day, and we wanna be mindful that that's not our meal. Donut is not breakfast. Um. It's gotta be like a hearty breakfast, right? I'm not saying you can never have a donut.

I'm just saying that like we have to think about protein, fiber, fat first, and then do we have the other fun foods later? Right? There are fun foods. They're not gonna be nutrient dense, but they're gonna be like sole reviving Ds in some ways, right? And sometimes these are [00:18:00] about, um. Situations where we are with, uh, friends and family.

So I don't ever want anyone to feel like they're being deprived, but I want you to start to build mindfulness around what does your sugar intake look at? Like, and one of the sneaky places these days where sugar intake is just off the chains is, um, electrolyte beverages. And I've had patients who are like.

I think I'm doing everything right and we like start ta talking through stuff. 'cause they're like, I'm still struggling. And you know, with belly fat is usually the thing that comes up with my patients, but they're still struggling and we, we go through and when the electrolyte comes up and it's like some electrolyte beverages have 25 grams of sugar, I'm like.

Oh, okay. So when you thought you were doing 25 grams and then you were drinking this thing and, and you missed it, like, we're doing 50 grams in a day and we know that is associated with more visceral adiposity. So the fat that packs around your organs, that is going to increase inflammation anymore, ev even more.

And [00:19:00] the, uh, propensity towards insulin resistance. And the nutrient dense foods that have things in it, like magnesium, chromium, I talked about that in the insulin episode. How good chromium is for blood sugar management and Omega-3 fatty acids, like those foods that are gonna help with your blood sugar, help with inflammation. Those are, those are gonna be nutrient dense.

Food. So again, focusing on how much nutrient density can we bring in, how can we optimize our blood sugar with diet and still enjoy those other foods, but not taking them to excess, that starts to cause metabolic damage. I actually, um, if you read beyond the pill, you know, I refer to this as metabolic obscenities, where you're literally cussing at your body because you're like, I'm just going to eat a donut for breakfast, or I'm just gonna drink black coffee for breakfast.

And the body's like, I don't like this. No, thank you. Now the third thing we wanna be doing with PCOS is get moving but gently. Okay. So forget the HIT bootcamp. Extreme [00:20:00] kind of burnout if you are so fatigued. Okay, so for PCOS fatigue, we're looking at walking long walks, getting your heart rate up to a fat burning zone with that strength training.

Yes, and gentle movements. These are all your sweet spots. If you are. Pushing it over, grinding it, and you're already tired, you're gonna feel more tired. You're gonna feel less motivated for the next time. And these gentle movements, they can improve insulin sensitivity without spiking your cortisol. So. We love that, and you're still doing intense workouts.

You're just not pushing yourself to such an extreme where you just feel wiped out and fatigued. Other thing we gotta look at is fixing your circadian rhythm. So getting sunlight, 30 minutes within waking no screens, one hour before bed, or at least. 30 minutes before bed. Think about magnesium glycinate like 150 300 milligrams before bed.

Lavender spray on your pillow. Nice warm shower in a cold bedroom, and a consistent [00:21:00] bedtime routine, even on weekends that has you sleeping in a completely dark room. Skipping sleep. Getting poor sleep one night is trouble for your insulin, your blood sugar the next day and that's gonna impact your energy.

Insulin and glucose get off your brain. Energy production gets off. Now we now, we're not just tired physically, but our brain, we like do a task and we're like, mama, why am I so tired? Energy production. What are the mitochondria doing now? The fifth thing I would say is to ask your provider to test the full picture.

You wanna look beyond just testosterone, and in fact, for women with PCOS, we wanna look at free testosterone and sex hormone binding globulin as well. Other things you should ask for that I covered in the insulin episode is fasting insulin, uh, hemoglobin A1C, uh, CRP c-reactive protein, which is a marker of inflammation.

We, uh, also wanna look at ferritin because this could [00:22:00] be related to a low iron issue. Getting A-C-B-C-A complete blood count will tell us about. Are you iron , deficient and, you know, your provider might wanna do an A CTH and an 8:00 AM cortisol, or you might have a functional medicine or naturopathic physician who wants to do a four point salivary cortisol or maybe like a Dutch test to look at your cortisol cortisone ratio, DHEA, what is happening throughout the day.

Lab testing can be helpful to understand what else is going on and how extreme, uh, has the body already taken things before we've caught it. So I hope that helps with PCOS. I wanna now talk about our second type of fatigue, which is neuro fatigue. That's what we're gonna call it. Okay? So this is a kind of fatigue that doesn't come from your body.

It comes from your brain. And so. If you are somebody who has been diagnosed with A [00:23:00] DHD, autism, pathological, demand avoidance, rejection, sensitivity, dysphoria, uh, high functioning anxiety, or you're somewhere else in the neurodivergent. Bucket. It's incredibly common to experience this fatigue, especially in women because we are expected to be able to multitask.

Many of us are mothers or caretakers of another kind like we're, we've got societal expectations to do more. However, on top of being expected to do more, we're expected to mask more, so we're constantly adapting. You're managing like 50 open tabs in your brain all at once, and you're doing it while trying to act like everything is totally fine.

So masking is a state of trying to seem neurotypical. When you're not in a neurotypical world so that you fit in and you have friends, it's a normal thing for you to want to do, but [00:24:00] here is what happens. Dopamine can crash, leaving you feeling unmotivated, foggy, emotionally flat. Sensory overload, leaves you feeling fried after just a trip to the grocery store.

Oh my God. Knee and Costco with like amber glasses, noise canceling headphones. And still sometimes I'm like, forget this card. I gotta go. There's too many people I'm getting touch. The music people are offering me fricking like samples left and right. Some people love that. I am not one of those people. Uh, and, and you know, with all of that, uh, you know, there's the added layer of things like rejection, sensitivity, dysphoria, RSD, that makes, um, even like small perceived criticism or just feedback feel devastating, like physically devastating, and then that takes more energy from you.

If you have anxiety and depression, they're often. Co-occurring. Just so you know, they're not a character flaw and we know that fatigue [00:25:00] are symptoms of that. If you are neurodivergent, there is evidence that your brain already struggles in energy generation, that your mitochondria are not as effective and efficient at producing energy, uh,

ugh,

that you are.

Um, you've got inflammation sometimes. That's impacting energy production. So this all isn't just a mental thing, it's a real biological fatigue from running your nervous system in overdrive all day. And I also wanna say like if you have anxiety and depression. That can also be rooted in inflammation, mitochondrial dysfunction in your brain.

And so all of these things can leave you fatigued. We, and we don't talk about this, doctors don't talk about this, and yet we have to recognize it. And if you recognize yourself in any of this, here's what you can do. So number one thing. Create energy boundaries. This is a practice, okay? And you're never gonna be perfect at it.

I certainly am not [00:26:00] you, but you don't have to say yes to everything, okay? Start by asking, does this cost or give me energy? Literally, I will do this practice. Um, sometimes I'll just say like, is this an infinity with me? Like, okay, so is it, is it something that's actually like vibing with me? And then I'll be like.

How much is it gonna cost me versus gonna give me, it's a no if it's gonna be too much of a cost. My kids deserve a mom fully functioning. Okay. We also need to fuel our brain first thing in the morning. I. Protein, healthy fat. That's dopamine support. Think things like eggs, avocado, Greek yogurt, chia seeds, uh, even a high protein smoothie if you're on my newsletter.

Um, when the burnout episode came out, and I'll link to that, you'll know that I put in like the burnout breakfast, which is like the laziest. To breakfast that you could possibly make that's still nutrient dense, that's looking, and I literally was like, this is just, you're grabbing stuff from your fridge and putting it on your plate and it's not perfect, but really the structure is all the same.[00:27:00] 

Protein, fat, fiber, getting nutrient dense foods in. And this is where, um, for my neurodivergent patients, I actually recommend that they put like a list of foods and they, um, so they, they put a list of foods of like, here's protein, here's fat, here's like, you know, fiber sources, and they just laminate it and put it on their fridge.

So that when they're in that mental fatigue, they just go up to their fridge and they're just like, what can I pick? And they're like, you know, not everything's gonna be in your fridge at all times, but it like takes such a load off when it comes to the thinking. And anytime you can get your brain to do less, uh, you know, of the executive function heavy lifting. When you're struggling with fatigue, the more you're gonna be able to like, prioritize in other ways for your, it'd be like brain save the energy production for later. Okay. Second thing that I want you to think about, or maybe this is the third.

Oh no, I'm like, maybe I need a brain break. Sensory [00:28:00] reset breaks is what I was gonna talk about. So taking 10 minutes to decompress, like just go lie down. I don't care if it's on your office floor. Put on noise canceling headphones. Stem with something that feels good. Get some squishy balls, um, you know, just fidget spinners, like whatever feels good to you.

Your nervous system will Thank you for just taking 10 minutes to relax. And it can even look like going for a walk outside. If getting out into a park in nature feels good for you. We also wanna support emotional regulation. And I recommend that you work with a mental health, therapist or somebody in the mental health arena to support you.

But you may also want to take magnesium glycinate, Omega-3 fatty acids and go through a practice of naming your feelings and naming things in the moment so that you're present. So I'm like sitting here right now. I'm barefoot. You can't see, uh, but. I'm barefoot and my carpet is fuzzy, so I can be like, oh, I feel that the carpet is [00:29:00] fuzzy.

I can feel the cool air on my skin. I can also feel the sweat in my armpits. That's nasty. But it's also true and it's very bringing me into the present moment. I can feel my hair resting against my skin. I can hear the buzz of the fan.

So getting into your senses helps. Reset you in the present moment and, and bring you back in from a brain that's often sensory overload because it's taking in everything in the environment. 

Now I did an episode with Dr. Ann Louise Lockhart. If you're somebody who struggles with RSD anxiety creeping in, she gave a lot of great tips for kids. They work for adults too. I will link to that. One of the things she said was, eating something sour in the moment can snap you back into your reality, get you out of that anxiety.

You can also try grounding yourself with box breathing, so like 4, 4, 4, 4. That's gonna be inhale for four, hold four, exhale for four, hold four. Or maybe you [00:30:00] do a four and six. Inhale for four, exhale for six, and the other things that you can try is like 30 seconds of humming and other things that stimulate the vagus nerve that can really help with anxiety and the RSD sensations as well.

I have a whole episode actually on vagal nerve stimulation. I should definitely link to that. Well, I will. It'll be in the show notes for you. So. I do wanna say this isn't about fixing your brain, it's about supporting it like the incredible processor it is. So it's not that you're broken or that something is wrong with you.

You are neurodivergent trying to adapt to a neurotypical world that was never made for you and it's overwhelming. You are having a normal response, but it's so exhausting and we have to hold space for that. Now the last type of fatigue I wanna talk about is the stress adaptation fatigue. And almost every adult finds themselves here at some point in their life.

Okay? So what I call the stress adaptation fatigue is the classic wired and tired [00:31:00] adrenal fatigue. Air quotes around the adrenal fatigue, 'cause that's an old term we don't use anymore. You might still use it. I don't judge you for it, but what the correct term is. HPA dysregulation because that's what the research has told us is true.

Your adrenal glands do not get tired. It is that your brain and adrenal communication gets off. So in this, you're gonna wake up groggy, but you're gonna still try to push through the day and then at night you can't fall asleep because your brain won't shut off. A-D-H-D-P people experience this a lot. I will link to the entire episode about A DHD sleep problems 'cause there's some very specific strategies that you need, but.

What this is in every body is what happens when your cortisol rhythm is out of sync. At first, your body tries to adapt to stress by overproducing cortisol, but eventually the system crashes because you can't have elevated cortisol for prolonged periods of time. It's dangerous at a cellular level to be exposed to all of that.

So. [00:32:00] The system crashes, and that's when we cue afternoon crashes and insomnia. Anxiety, that feels like it's no reason blood sugar, that you feel like you can never control, an energy that just never feels restored no matter how much you sleep. So. This is something that is common, uh, you know, based on your work.

So we see a lot with lawyers, doctors, night shift workers. Moms, moms get something I call the reverse cortisol curve where they get trained by a baby to be up at night. So instead of their cortisol spiking in the morning, now there's cortisols coming up at night like, bless the baby who's, you know, can't regulate its blood sugar.

It needs you to be up at night, but we have to find a way to recalibrate our system. Now, if you're a night shift worker, thank you for the work that you do. It's gonna be a bit more of a struggle for you. And in those cases, we're often using melatonin when it is time to sleep to try to support your body's [00:33:00] antioxidants and you getting good sleep.

I. Some of these other things will also work for you. So listen in. We want to try to front load energy cues, so getting sunlight in your eyes within 30 minutes of waking and moving your body, even if it's just stretching and eating within an hour. So even if you're a night shift worker, and let's say you're waking up at four o'clock in the afternoon.

We're trying to keep a circadian rhythm that's in line with your work, so you can do this too. Uh, this one is a little like, is this for the normal schedule people is to stop caffeine by 10:00 AM. I know this one's hard, but caffeine intake late in the day can spike your cortisol and your stress hormones at the wrong time, and that can wreck your sleep and that can deepen fatigue.

So especially if you're a slow metabolizer of caffeine, that caffeine can stay around like it's half life can be like eight hours or more in some people. So if you are drinking [00:34:00] caffeine. At 3:00 PM like do the math, like you're gonna be up later. We also need to create a cortisol friendly bedtime routine.

So again, no screens within an hour, but if you are gonna look at screens, let's use some blue light blocking devices, either glasses or you know, an app. Um, nothing over stimulating. Instead, 30 minutes before bed, try to add journaling, meditation. Warm shower, knitting, crocheting puzzles, things that help you wind down and is a nice little bonus.

I think this is always nice for everybody.

 put your legs up the wall for five minutes. This can help calm your nervous system. If you're in the neurodivergent group that we talked about, covering yourself in a weighted blanket, putting an eye mask on, like doing, um, you know, some like sensory retreating is what it is from your environment can really help your nervous system get into that calm state.

As we talked about before, the vagus nerve stimulation, the [00:35:00] deep breathing, those things encourage parasympathetic activity. That's the rest and digest aspect of your nervous system, so those can be really helpful and anchoring your body in safety. You're not being dramatic. Your body needs signals to feel safe, especially if you're born with ovaries, because you have to be super sensitive to the environment, to the stressors of the environment, because there's a potential you could get pregnant and should we have a baby?

Is it safe to have a baby? Can I run from a predator? Like what? What do does our body need to do?

So.

So doing daily rituals, comforting routines, even smells like lavender or vanilla essential oils in your bedroom. These kinds of things can send safety signals. Now, before we finish this podcast episode today, I'm gonna do some ask Dr.

Brighton questions again, but I want to recap. So firstly, three types of fatigue. We talked about PCS, fatigue, neuro fatigue, and stress adaptation [00:36:00] fatigue. PCS fatigue isn't laziness. It's your body asking for hormonal repair and support. Neuro fatigue. I mean, it's in your head, but it isn't all just in your head.

It's how your brilliant brain potentially burns out. So we want to get ahead of it. See the episode on burnout, because those early warning signs, we want to heed stress adaptation fatigue. It means your survival system is working overtime. We have to send safety signals to the body. And while none of these are just normal.

They are incredibly common, but they're also absolutely something that you can fix. So as you listen to this episode today, I just want you to think like, what is one strategy, just one that I can try this week to implement. And, um, if you're like, I, there's so many and I wanna try them all, start with sleep.

. That's gonna be your best bet. Now before we go into the ask Dr. Brighton questions, if this episode gave you an [00:37:00] aha moment, helped you feel more seen, please share it with a friend. Leave me a quick review. It truly helps the show reach more women who need it, and I am just so grateful for your support, always. So let me grab these, ask Dr.

Brighton questions and let's get into it.

Okay.

this one's a little sensitive, so I'm not going to say the person's name, but. I have painful sex, but not painful periods. My doctor said This is impossible and I should have a glass of wine and use more loop. I can't even get through that without laughing because it's so freaking dumb that doctors are still saying that.

I'm so mad about it, like women deserve better. Ugh. If you're a doctor and you're saying that and you just heard me. Do, do better. Like what is wrong here? Okay. So, okay. I will link to the episode with Dr. Deanna Mendez where we talk all about pain with sex and um, what is going on from a pelvic floor perspective, because there [00:38:00] is usually some kind of pelvic floor dysfunction, whether it's vaginismus.

Which is the spasming of the introitus, the opening of the vagina, whether there are trigger points there. So I definitely encourage you to listen to that episode. Actually watch it on YouTube because she brings out a model and shows you everything there. But the other thing that I will say. Yes, vaginal dryness could be a valid reason.

So we tend to have a drier time, at least half of our cycle when progesterone is up. We can also have vaginal dryness happening. Perimenopause, menopause, this is where vaginal estradiol is a great thing to use along with lubrication. So I talk all about lube and is this normal? My book, best types of lubes, lubes to definitely avoid, uh, what's going on with vaginal dryness and discharge.

Definitely check that out. However. The other thing I would say is that we talked about in this episode about se signals of safety. Sometimes we're not feeling safe, and that's not to say your partner did something outright to harm you, but [00:39:00] that's saying that you have to feel safe. Like if you, so when we talk about pain with sex, we're talking about penetration.

When we're talking about penetration, we're talking about someone entering your body that's incredibly vulnerable. And if you don't have safety signals. And that usually it comes by way. So in the everyday, like there's been no trauma or anything, the everyday average woman's experiences is, am I being supported with housework with the children, with my career?

Like, do I feel support from you? Men will often say things like, my job is to protect you. Yes, from the stress of life, there's no bears and tigers, so simmer down over there with that. You are here to protect from the stressors of life by alleviating the stressors of life. And that is how you send a safety signal.

Now, if you haven't been checked out by a gynecologist, definitely get checked out. 'cause there could be structural issues going on as well. So there can be changes happening with the cervix, the uterus, and. There can also be issues, uh, you know, with like endometriosis [00:40:00] for example. Very common to find it in the posterior fornix.

That's the back bottom of the vagina. And, um, the, the, the adhesions can cause pain with sex. The other thing I would say that you should be aware of, and this the last thing I say is that your cervical position changes. Um, it's gonna, your uterus and your cerv gonna move up and back when you're near ovulation and they're gonna be down lower as you get closer to your period.

That means. Positions can be painful, that are deeper with penetration when the uterus is lower. And while some women can have a cervical orgasm and they feel good having their cervix stimulated, some women get knocked in the cervix and it is more painful than being kicked, kicked in the testicle. So also just be aware of positions as well.

And when somebody is having. Pain because of deep penetration. Sometimes the best thing you can do is as a woman, you take the lead of being on top because you can control the depth of, uh, the penetration. Um, I said that was gonna be the last thing, but this [00:41:00] feels like a little add-on there. Um, I did talk about this and is this normal?

But if length is an issue, which sometimes it is very rare, but it can be an issue, uh, there are actually o-rings that you can get, that you can place. On the penis that controls the depth of penetration as well. Dope. I hope that's helpful. I always appreciate your guys' questions.

Okay. This question is, what can I do about an ovulation? So I'm bringing this up here because we talked about an anovulation in this episode. Anovulation is the lack of ovulation. So the first thing you can do is get a workup because why I. Because why? We need to know that. Is it polycystic ovarian syndrome?

Is it insulin resistance playing a role? Is it hypothyroidism? Is it functional? Hypothalamic a amenorrhea. I. You are not eating enough, you are moving too much, or you've got just tremendous stress in your life. The what to do about it depends on the cause of it. I wish I could say, you know, we know that [00:42:00] Myo Acetol, for example, can help with restoring ovulation and it's supporting your body's ability to get back to ovulation.

My own osteos not gonna help. If the answer is it's 'cause you are in the menopause countdown, right? Uh, that's a very different situation that's going on. My acetol is not gonna help if the answer is you're only eating 800 calories a day. So that's the first thing we have to do is figure out why. And I wish I could just tell you like do one thing.

 

Like this is so easy, but it's really about getting down to the root cause of why are you not ovulating as you should. And then we address there. All right. Thank you so much as always for being a part of the Dr. Brighton show. You drive the conversation, so always let me know what did you love, what do you want to hear more of, and what other topics would you like to have us explore?