The Hidden Link Between PCOS & Bloating

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If you’re anything like me, I know you’ve struggled with that post-food bloat and experience bloating. The feeling like you could either float away or pop altogether, but somehow feeling like an uncomfortable rock-solid lump at the same time. We can all feel like that after a big holiday dinner, or maybe if you’ve just eaten something that your gut bacteria doesn’t love. But there’s also another reason why so many women are struggling with PCOS & bloating, and it’s so overlooked by many professionals that the real cause can be misdiagnosed or dismissed for years.

Of course, there are pills you can take to banish the bloat (but do you really want to do that!?), and there’s exercises you can do after every meal to help the bloat move through you (I personally don’t want to do that either). But the real treatment is getting to the root cause of the issue so you can stop just dealing with the symptoms and finally be bloat-free. There are many different causes of bloating, but most of the time it is just put down to being a gastrointestinal issue, when really there could be other influences at play. For example our hormones! Being a Naturopath who specialises in hormones, I’m especially passionate about this, and here’s why.

Bloating is a common symptom of  polycystic ovarian syndrome, which is often referred to as PCOS. But being a women’s health issue, this condition (despite being incredibly common), is still a little bit taboo. Many practitioners overlook the signs and symptoms of this common condition and sadly, women everywhere are suffering in silence as it can take much longer than it should to get a clear diagnosis. Bloating is one symptom that has only recently been recognised as a common occurrence for women with PCOS.

What is Polycystic Ovarian Syndrome?

PCOS is one of the leading endocrine disorders, commonly identified among younger women, and it’s thought to affect as many as 20% of women worldwide. Women living with this condition produce excessive amounts of androgens (often thought of as male hormones) and may not ovulate regularly. If left untreated, it can lead to unpleasant symptoms and fertility problems, but if picked up early, symptoms can be managed and the fallout can be less severe.

A recent study conducted by the women’s health app, Flo, found that bloating was the most common symptom reported, affecting 77% of users living with PCOS. But bloating isn’t the only symptom you might experience. Here are some of the more easily-identifiable symptoms of PCOS:

  • Irregular menstrual cycles, long menstrual cycles or no periods at all.
  • Difficulty getting pregnant (because of irregular ovulation or failure to ovulate).
  • Excessive hair growth (hirsutism) – usually on the face, chin, chest, back or buttocks.
  • Weight gain despite no changes in activity or diet.
  • Thinning head hair in a male pattern (temples and crown) and hair loss from the head.
  • Oily skin with or without acne.
  • Issues controlling blood sugar

That’s not to say that these symptoms will always be caused by PCOS, but if you’re struggling with any combination of these issues, it’s a good time to check in with your GP or Naturopath.

So, How is PCOS Linked to Bloating?

According to Anna Klepchukova, Flo’s chief medical officer, “Studies have shown that developing PCOS impacts the biological composition of our guts, making it more difficult for the body to digest food and altering bowel function.”

PCOS is responsible for so many hormonal changes outside what we see as the norm. Some of these can reduce beneficial gut flora and bile acids that help the process of digestion, so it changes the natural process of metabolism (how the human body turns what we eat and drink into energy). Because of these changes, imbalance and inflammation can occur in the digestive tract, leaving you with a bloated belly.

It is also thought that the insulin dysregulation that often accompanies PCOS may be a contributing factor to gastrointestinal changes.

Watch Your Diet

You may find that some foods trigger bloating more than others. People living with PCOS can have their bloating triggered by foods that contain the carbohydrate raffinose, which contributes to more gas production. Examples of these include asparagus, beans, broccoli, Brussels sprouts, cabbage and cauliflower, which is why many Naturopaths and Nutritionists will advise you to take a closer look at your diet.

Looking more holistically, it’s also important to consider the psychological impacts of living with this condition, and the chronic stress that some people face, which may also contribute to an imbalance in the brain-gut axis, which can be another cause of bloating.

Treat PCOS & Bloating Naturally

It’s important to say this honestly; there is no known ‘cure’ for PCOS, as the condition isn’t so black and white and there are multiple ‘types’ of PCOS that require slightly different support (a topic for another blog). But there are a number of ways that people living with the condition can work alongside practitioners to manage their symptoms. Treatment protocols are highly individualised, but to give you some more in-depth understanding, here are some areas that I explore one-on-one with clients in the clinic:

  • Dietary Modification: A modified diet is the first step and one of the most powerful interventions in managing PCOS for the rest of your life. Generally we need to look closely at the carbohydrate content of the diet and create an individualised plan for success. This is especially important if bloating is a common occurrence.
  • Herbal Medicine & Natural Supplementation: This is a key pillar in any PCOS treatment plan, but the particular herbs and supplements may differ slightly from individual to individual depending on their unique driving factors. This is where working with a qualified Naturopath will help to support you and your specific needs. 
  • Daily Exercise: Exercise helps your muscles to be more sensitive to insulin resulting in greater insulin uptake and lower fasting insulin levels. Together we will find a daily exercise program that supports you and brings you joy.
  • Stress Management: High cortisol can drive insulin production and can worsen PCOS symptoms. Adopting a natural stress-management protocol is an essential part of any treatment protocol.
  • Weight Management: Research suggests that as little as a 2-5% body weight reduction can improve metabolic and reproductive outcomes in PCOS. This is not about appearances or vanity in any way, and when it comes to PCOS, excessive and quick weight loss is definitely not the answer, but losing weight can definitely support the body and help reduce PCOS bloating.

All treatment plans for PCOS do need to be highly individualised, as most importantly, they need to work for you. There is no one-size-fits-all solution, and that’s why I always recommend working with an experienced holistic practitioner. As a hormone-specialising Naturopath, I often find myself working with and helping women experiencing PCOS.

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