What Causes Extreme Fatigue And Exhaustion Along With Muscle Weakness?

Posted on Tue, 1 Sep 2015

Tue, 1 Sep 2015 Answered on

Tue, 22 Sep 2015 Last reviewed on

Question : Good morning I have question and concern that are occurring every month for a minimum of a week and a half to two weeks out of every month. What ends up happening is I am so exhausted and fatigue that I can barely keep my eyes open and they are very sensitive to light and I feel like I mn or have like brain fog I don't know if that makes any sense it's really difficult to explain what I'm feeling then I know that I am very weak and experience whole lot of pain throughout my entire body and the muscles and along with everything else I have mentioned. Also my speech gets really slurry at times because I don't even have the energy to talk. I can barely keep my eyes open and have a lot of muscle weakness joint and muscle pain. This does seem to happen before a menstrual cycle but it is getting worse and worse and I don't know what to do I have been anemic before after having a surgery and that is the best way to describe it. Do you know what this could be I've had multiple laps ran and everything comes back normal but this is just not right I can't drive I can't stay awake I can't keep my eyes open and the slurred speech because I'm so tired is very concerning.

Answered by Dr. Pankaj Borade (48 minutes later)

Brief Answer:
Prementrual syndrome

Detailed Answer:
dear,
welcome to HCM
The symptoms that you have put up are clearly suggestive of a prementrual dysphoric syndrome.
Its a condition that occur within a week prior to menstruation and tends to resolve within couple of days after onset of menstruation.
It is important to understand that it's a self resolving condition with no specific etiology.
However, if the symptoms are severe enough to impair the daily functioning then an intervention is indicated.
My suggestion to you are-
1) a morning brisk exercise in form of walking can help. Maintain adequate nutrition.
2) for pain analgesic meds like ibuprofen or diclofenac can be taken orally as required but not more than 2 tabs per day.
3) a brief course of antidepressant drugs can be considered, However it is advisable that you you consult a psychiatrist for its initiation.
4) if associated sleep and anxiety issues are present, a small short course of benzodiazepines can be used. Again should be on an advise of a doctor.

If the symptoms persist after menstruation, I suggest Consulating a gynaecologist is wiser, as one should rule out other uterus related and hormone related problems.

hope you find my advice helpful.
Regards,
Dr Pankaj

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Pankaj Borade (2 hours later)

So the slurred speech and nodding off is all part of this and normal? I had gastric sleeve done some years ago and lost a lot of blood. So the best way for me to explain or kinda compare it is like being anemic . Also I was advised after having bariatric weight loss surgery and I cannot take oral hormones steroids or any anti inflammatories so I am at a loss as to what I can do with this. Is it possible to become anemic prior to or during your menstrual cycle?

Answered by Dr. Pankaj Borade (10 hours later)

Brief Answer:
Few ineatogations can help to rule out anemia

Detailed Answer:
thanks for the reply.
The gastric sleeve operation in past does predispose you to nutritional deficient anemia. It can present with similar complaints.
Here an investigations of complete blood profile, vitamin 12, can be done.
However, the typical syndrome presentation and its temporal relationship with mentrual period is strongly suggestive of prementrual syndrome. Moreover, the remission of few weeks in between periods goes against the possibility of anemia.

However, a baseline investigation mentioned above is suggested.
A consulation to general physician can be helpful as proper physical examination can be conducted.
I would also suggest to consult a psychiatrist.

Welcome for further queries.

Regards,
Dr Pankaj

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj