PCOS and gas: Exploring the link, strategies for control, and additional insights

In people with Polycystic Ovary Syndrome (PCOS), bloating is a common and bothersome symptom. A 2022 study suggests that hormonal changes in PCOS may cause bloating, particularly due to insulin resistance, altered gut microbiome composition, and the metabolic overlap of PCOS [1][3][5].

Women with PCOS often have a less diverse gut microbiome and dysbiosis that impact estrogen recirculation, inflammation, and insulin resistance — all of which contribute to gastrointestinal discomfort and post-meal distension [1][3]. Medications used to manage PCOS and hormonal fluctuations across the menstrual cycle can also alter gut transit time, causing trapped gas and a sensation of fullness [1].

Effective relief options for bloating in PCOS focus on improving gut health and managing underlying metabolic factors. Probiotics and fermented foods, such as yogurt and kefir, can help restore healthy gut flora diversity [2][3]. Fiber-rich diets including oats, fruits, and vegetables support digestion without exacerbating bloating [2]. Magnesium-rich foods like spinach, almonds, and sunflower seeds may help muscle relaxation in the gut and reduce stress-related digestive symptoms [2]. Vitamin D supplementation supports insulin sensitivity and overall hormonal balance, indirectly benefiting gut health [2].

It's important to avoid diets that impair gut function, such as very low-fiber plans like some keto variants, which can worsen constipation and bloating [4]. Managing insulin resistance through diet and lifestyle, as improved metabolic control reduces gut inflammation and bloating [1][3].

Certain foods and drinks, such as fizzy drinks, heavily processed foods, cabbage, beans, and lentils, have associations with gas and bloating. A study from 2021 found that a walk after eating eased abdominal bloating more effectively than medications prescribed to help gastrointestinal processing [6]. Gently massaging the abdomen from right to left may help move trapped gas through the gastrointestinal tract.

Some medications, like Clomiphene, Metformin, hormonal birth control, and Simethicone, can also cause bloating as a side effect [2][3][4][7]. Peppermint oil may help ease bloating, but it can cause side effects and is not suitable for use by all people.

In summary, altered gut bacteria in PCOS disrupt hormonal and digestive balance, causing bloating; restoring gut flora and improving metabolism with diet, probiotics, magnesium, and vitamin D are key strategies for relief. Regular physical activity, avoiding bloat-inducing foods, and gentle abdominal massage may also provide additional relief.