At some point or another, pretty much all of us have dealt with bloating. It’s that belly-based feeling of tightness, fullness, and discomfort that may or may not be accompanied by a distended stomach. There are many potential causes for bloating: Sometimes it’s caused by gas and constipation, sometimes it’s caused by eating foods your body disagrees with, and sometimes it’s caused by polycystic ovary syndrome (PCOS).
In fact, bloating was the most commonly reported symptom of PCOS in a 2021 study that evaluated cycle-tracking app users who said they have PCOS. Luckily, there are ways to manage bloating triggered by PCOS. Read on to learn how to do just that—and what causes people who have PCOS to get bloated in the first place.
Why does PCOS cause bloating?
There are a few reasons why PCOS can cause bloating. We’ll break them down here.
Hormone imbalances and water retention
PCOS is a reproductive condition that is associated with hormone imbalances. When your hormones are out of whack, all kinds of things can happen in your body. One of these is anovulation, or when an egg (or ovum) doesn’t get released during the menstrual cycle. During a typical ovulation cycle, the body produces estrogen and progesterone in the perfect combination. When you don’t ovulate, estrogen and progesterone aren’t balanced and this can lead to water retention, and thus, bloating.
PCOS is often linked to an imbalance in the gut microbiota. (This may be because of the insulin resistance and chronic inflammation that many people with PCOS experience.) When the bacteria in your gut are out of balance, you may experience gas, constipation, diarrhea—and bloating. It’s also worth noting that people with PCOS are more likely than people who do not have PCOS to experience irritable bowel syndrome (IBS). Both conditions are linked to gut imbalances and inflammation and may be part of the root cause of bloating.
Metformin, a medication commonly prescribed to people with PCOS, can sometimes cause bloating. About 25% of people who take the drug experience bloating (as well as gas, diarrhea, constipation, and stomach pain).
If you’ve been prescribed Metformin and find that it makes you feel bloated, don’t immediately stop taking it. Instead, talk with your healthcare provider to see if they can work with you to find a solution. (For example, taking it with food may help reduce bloating.)
What is PCOS belly?
The term “PCOS belly” comes up a lot in writing about PCOS in relation to bloating. But… what is it, exactly? The first thing to know is that it’s not a scientific term. Instead, it’s often used as a catch-all to refer to the fact that people who have PCOS often have higher fat deposits in the abdominal area. The excess fat can lead to inflammation, which may contribute to the feeling and appearance of bloating.
How to manage PCOS bloating
For the record, you don’t have to do anything if you’re dealing with bloating. Everyone experiences it from time to time, so it’s nothing to be ashamed of. But if it makes you feel uncomfortable, you can try a few things.
Regular exercise can help reduce a whole slew of symptoms associated with PCOS—including bloating. Exercise can help you maintain regular ovulatory cycles which may help reduce water retention and bloating. Exercise also helps promote healthy bacteria growth in the gut.
Additionally, physical activity assists in the natural movement of food through your gut, called peristalsis. Peristalsis is a wave-like contraction that pushes food through the digestive system. Walking, exercising, doing chores, or really moving in any way can help your body do the work of pushing food along. This can reduce “transit time,” which means food doesn’t sit and create as much gas in the GI system, therefore reducing bloating.
You don’t need to do a specific kind of exercise to access anti-bloat benefits. One study that evaluated the impact of strength training and aerobic exercise on people with PCOS found that all forms of exercise provided benefits. In other words, anything that gets you moving—whether it’s a walk, yoga, or lifting weights—is fantastic.
Take a probiotic
Taking a probiotic supplement may help balance the gut microbiome and alleviate some symptoms of PCOS, according to one recent study that evaluated the effect of probiotics on adolescents with PCOS and obesity. Probiotics have also been shown to reduce bloating and stomach discomfort in people with IBS and other gastrointestinal conditions.
As always, before adding a supplement to your routine, it’s best to check with a healthcare provider. They will also be able to give you recommendations on what dose, variety, types of bacteria, and length of probiotic treatment time might be right for you. You can also increase your probiotic intake with or without supplements by consuming cultured and fermented foods, like sauerkraut, kimchi, yogurt, kombucha, natto, paneer, aged cheese, curtido, and kefir.
Sufficient hydration is good for, well, pretty much everything. For people with PCOS, it’s especially helpful for relieving fluid retention and bloating. This is because fluid retention is often a symptom of dehydration—when you aren’t drinking enough water, your body has a hard time getting rid of fluid, storing it outside of your veins and creating fluid retention all over your body. When you’re hydrated, it’s easier for your body to eliminate waste.
Drinking anything without added caffeine or large amounts of added sugar will help with routine hydration. Take note if you see a difference in bloating when consuming still water, rather than sparkling or carbonated beverages. Some people find that the gas bubbles can exacerbate stomach distension and bloating.
Monitor your diet
Keep an eye on the foods you eat and how they make you feel. If you can, it may be helpful to keep a food diary or log to see if any particular foods trigger bloating more than others. Some bloating is normal and expected as you make changes to your diet, such as increasing fiber intake. However, you may find that specific foods always cause bloating, even after introducing them slowly. Some of the most common include dairy, gluten, refined carbohydrates or high-sugar items, high-fat items, etc.
Once you have a record of the foods that cause discomfort and bloating, it may be helpful to set up an appointment with a dietitian or other health professional to talk it over.
Allara Health provides personalized treatment for hormonal, metabolic & gynecological conditions that utilizes a holistic plan that merges nutrition, lifestyle, medication and supplementation, and ongoing, expert support to heal your body.