Although doctors do not yet have a clear understanding of why endometriosis causes fatigue, it is common in nearly all women with the condition. One explanation is that chronic pain in the pelvis and other areas of the body disrupts sleep, causing malaise throughout the day. In addition, constant pain can lead to stress, which causes fatigue for various reasons. Inflammation also activates the immune system, which makes the body work harder to prevent illness and subsequently reduces energy levels.

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