Fatigue in young to middle-aged adults

Psychosocial and behavioural factors often contribute to fatigue; it is important to ask all patients about diet, exercise, drug and alcohol use and mental health.

Young to middle-aged females are the most common group of patients to present with fatigue in primary care. Life events, such as pregnancy and menopause, multiple roles and responsibilities, and occupational stress contribute to fatigue in females. Menstrual blood loss commonly causes iron-deficiency anaemia in premenopausal females, especially in those with heavy menstrual bleeding (menorrhagia) or inadequate dietary iron intake; see Iron deficiency. Females are more likely to develop mental health problems following childbirth than at any other time in their lives, especially within the first 3 months; see Perinatal depression.

Males are less likely than females to seek treatment from a general practitioner or other health professional, and often present later in the disease processAustralian Medical Association (AMA), 2018. Males may present because of concerns from their partner, problems at work, mental health issues or for a ‘check-up’ because they are feeling tired. Depression, poor sleeping habits and family conflict are common, so it is important to take a thorough history. Be aware that males may present with fatigue as a ‘cry for help’.