PCOS Bloating: The Causes and How To Beat It
Do you suffer from PCOS bloating? I understand the PCOS bloat may feel like a daily struggle and a real pain to manage. You may feel heavy, uncomfortable and embarrassed of your bloated stomach.
But you don't have to feel this way.
Bloating is a common concern for women with PCOS. I frequently get asked what causes it and what to do about it. So, in this post, you will find out the possible causes of PCOS bloating and what you can do to beat the bloat.
Let's get started.
Can polycystic ovaries cause bloating?
Bloating is a common symptom of PCOS. The increase in stomach size may feel tight and painful. It may even make you think you have gained weight. Not knowing the cause of the bloat may leave you feeling confused and frustrated. But PCOS bloating can occur for various reasons including hormone imbalance, an unhealthy gut, IBS, food intolerances and more.
Now that you know PCOS bloating is a common symptom and that you are not alone in this struggle. Let’s talk about the possible causes in more detail.
What Causes PCOS Bloating?
PCOS bloating can happen for various reasons, so let's get into them.
PCOS Bloating Caused by the Hormone Imbalance
PCOS is a common hormonal condition that affects 10-20% of reproductive-age women. Women with PCOS produce too many male hormones. The high male hormones interrupt the production of female hormones (estrogen and progesterone) and the natural ovulation cycle. In turn causing PCOS symptoms, like irregular periods and polycystic ovaries.
So, here’s the thing.
Both estrogen and progesterone influence fluid levels in the body.
Estrogen, Progesterone and the Menstrual Cycle
During a healthy menstrual cycle, estrogen and progesterone levels rise and fall. Before ovulation (mid follicular phase), estrogen is high and progesterone levels are low. During this time women tend to retain more water.
However, after ovulation (during the luteal phase of menstruation), progesterone is dominant and estrogen levels are low. Now here's the thing, because progesterone is a natural diuretic, it helps flush out the retained water and reduce the bloat.
Now, because women with PCOS have an irregular period and often do not ovulate, the ovary does not produce progesterone. As a result, estrogen levels remain high. This causes you to retain water and feel bloated.
So, one possible reason for the constant and severe bloating is high estrogen.
Balance your Hormones
To beat the PCOS bloat you must balance your hormones. I recommend reading my 'Types of PCOS: Ultimate Guide' to educate yourself of the different types of PCOS. But I suggest working with a medical professional who will help you get to the root cause of your hormonal imbalance. Once you have identified your root cause, the next step is to make dietary and lifestyle changes to support the rebalancing of your hormones.
An Unhealthy Gut causes PCOS Bloating
Our gut houses both good and bad bacteria. We need a balance of both for digestion and optimal gut health. Having too much bad and not enough good gut bacteria can affect the breakdown and digestion of food resulting in bloating, gas and discomfort.
A possible reason for the imbalance in gut bacteria is the Birth Control Pill (BCP). The BCP is the first line of treatment for PCOS. But, researchers have found risks to taking the pill, including changes to the bacteria found in the gut.
You might be wondering, 'what can I do to heal my gut?'
Here's the thing.
While I am not suggesting that you come off the pill (this is a decision you need to make with your doctor), there are several natural ways you can improve the health of your gut.
Eat more Fiber and Add Probiotics
Soluble fiber dissolves in water to form a liquid gel which helps slow down digestion. This type of fiber also softens the stool to allow easy movement through the gastrointestinal tract (GI tract).
Insoluble fiber does not dissolve in water. Instead, it absorbs water which allows the stool to remain in solid form and pass more easily through the intestines. Because of this, insoluble fiber is often recommended to help with constipation.
Aim to eat 25g of fiber day. Fiber-rich foods include fruits, vegetables, seeds, oats, beans.
But make sure you increase your fiber intake slowly as a sudden increase may cause you to feel bloated and experience stomach cramps.
Probiotics are good live bacteria and yeast that keep your gut healthy.
Foods that contain probiotics include yogurt, sauerkraut, kimchi, miso, kombucha, pickled cucumbers and kefir.
You might be wondering why I said yogurt seen as women with PCOS are often told to avoid it. Well, research shows the fermentation process significantly reduces the level of IGF-1 in milk (a hormone which increases testosterone). So, you can include yogurt with live cultures in your PCOS diet.
The next cause of PCOS bloating on the list is IBS.
The Link Between PCOS and Irritable Bowel Syndrome (IBS)
Now, you might be wondering, “what’s the link between IBS and PCOS?”
Well, a study found 42% of PCOS women also have IBS compared to only 10% of the healthy women.
Reasons for the IBS bloat can include a fructose or lactose intolerance, an imbalance in gut bacteria, small intestinal bacterial overgrowth (SIBO). It may also occur because of changes to the muscles in the digestive system, causing the organs involved in digestion to alter in speed, strength and coordination.
There are several ways you can alleviate the painful symptoms of IBS. They include avoiding FODMAPs and using peppermint oil.
Let me explain.
Avoid FODMAPs to Help with Bloating
An intolerance to FODMAPs are common in IBS patients. FODMAP is an acronym for "fermentable oligo-, di-, mono-saccharides and polyols". They are short-chain carbs which are not easily broken down or absorbed by the blood. They make their way into the large intestine where our gut bacteria uses it as energy and then releases them as gas. This causes bloating and pain.
Now, you might be wondering, 'what foods are FODMAPs?'
FODMAP foods include:
- Fructose: A simple sugar found in fruits and vegetables. It is also one of the components found in table sugar and most added sugars.
- Lactose: A type of sugar found in dairy products like milk, yogurt, cheese.
- Fructans: A type of carbohydrate made up of fructose molecules. Fructans are found in foods like ripe bananas, artichokes, broccoli, cabbage, garlic, onion, wheat, barley, rye and spelt.
- Galactans: Are a complex carbohydrate which means they are digested and absorbed slowly by the body. They can be found in legumes like kidney beans, chickpeas, oat milk and soy products.
- Polyols: Also known as sugar alcohols, they are carbs but not sugar. Examples of polyols include xylitol, sorbitol, maltitol and mannitol. They are commonly used as sugar-free sweeteners and can be found in certain fruits like apples, apricots, peaches and pears.
Follow a Low FODMAP diet
IBS patients see improvements in symptoms like cramping, bloating, gas and diarrhea when following a low FODMAP diet. A low FODMAP diet involves avoiding all high FODMAPs, for a few weeks, to find out which food(s) are causing digestive discomfort. If you would like to find out what which foods you must avoid and which you can eat, here is a full list of both high and low FODMAP foods.
Keep in mind, however, this is a short-term treatment diet because FODMAP foods contain healthy bacteria that supports and protects your digestive system. Ideally, IBS symptoms will improve during the restriction period and patients will slowly be able to reintroduce some of the foods.
To find out what foods you are sensitive or intolerant to, buy your EverlyWell at-home food sensitivity test kit which measures your body’s IgG response to 96 foods. This can help guide you on what foods you may have to eliminate.
Use Peppermint Oil
Peppermint may help reduce symptoms of bloating because it helps relax the abdominal muscles and digestive system.
Studies have been done to see the impact peppermint has on IBS. Results from a 2019 review study found peppermint oil was a safe and effective remedy for abdominal pain and IBS symptoms.
Peppermint oil can be taken in liquid or capsule form. But it is best to consult a medical professional before you include this remedy into your diet.
Around 70% of women with PCOS suffer from high blood sugar and insulin levels. In an attempt to lower them, they avoid sugar and instead opt for artificial sweeteners. However, studies have found that artificial sweeteners like sorbitol and aspartame can cause bloating. The reason for this is because the body does not completely absorb them.
Also, research shows artificial sweeteners such as saccharin and sucralose can alter the bacteria found in your gut. Which means they can cause an imbalance in your good and bad gut bacteria.
To help reduce the bloat, here's what I recommend.
Drink More Water
Swap your diet drinks, which contain artificial sweeteners, for water.
Also, drinking plenty of water can reduce any water you are retaining which may be causing your bloating. Because here’s the thing, your body retains water when it is dehydrated. So, providing your body with plenty of water will prevent it from holding onto it.
Eating Too Many Beans Can Cause PCOS Bloating
Diet plays a key role in reversing PCOS and balancing your hormones. So, including plenty of nutrient-dense whole foods like beans, which are high in fiber and protein, are a great PCOS friendly food. But here’s the thing, eating too many beans can cause bloating.
Beans contain a type of carbohydrate called oligosaccharide that cannot be fully broken down in the body. This is because the body does not produce the enzyme that can break it down. As a result, bloating can occur.
But this doesn’t mean you have to stop eating beans.
Soak Your Beans
To help reduce the amount of oligosaccharides in them, soak the dried beans overnight and cook them in fresh water (not the water you soaked them in). This is because the oligosaccharides can seep into the water.
You can also cook beans with kombu which is a type of seaweed. This can also reduce the oligosaccharides because it contains an enzyme that breaks the carb down.
Vegetables are essential to any PCOS diet. They are a source of vitamins, minerals, antioxidants and fiber. Because of their nutrient content, many women with PCOS create smoothies containing tons of raw vegetables to help them quickly and effortlessly drink their greens.
Unfortunately, these smoothies can cause bloating.
Well, cruciferous vegetables like kale and broccoli contain a sugar called raffinose which isn’t easily broken down by the body. Instead, it is broken down by gut bacteria in the small intestine and they turn it into gas. This is what can cause bloating.
Here's what you can do to beat the bloat.
Watch the Raw Vegetables
Because raw produce can be difficult for your body to break down, cook them instead to make it easier for your body to digest. You will still get the nutrients, it just helps soften the fibre so it doesn't cause the bloat and discomfort.
You have now found out what may be causing your PCOS bloating and how to beat it. But as a bonus, I have provided you with some extra tips.
Here are an extra 5 tips and remedies that can help you beat the PCOS bloat.
Salt is a mineral needed for fluid balance, nerve and muscle function. So, in moderate amounts, salt isn’t bad. Unfortunately, more than 80% of our salt intake is hidden in processed food. As a result, too much salt is consumed on a daily basis.
Eating too much salt causes your body to retain fluid and can, therefore, make you feel bloated.
This tip follows on from the point above about salt. Potassium is a mineral and electrolyte involved in many essential processes in the body.
Including potassium in your diet helps to balance the negative effects of salt. So, the more potassium you eat, the more salt you will excrete from the body. As a result, the water retained will be reduced and this will help decrease the bloating.
Potassium-rich foods include- avocado, spinach, coconut water, sweet potato, white beans, asparagus, citrus fruits, tomatoes.
Exercise helps gas pass through the digestive system and reduce symptoms of bloating. So, if you suffer from bloating and constipation, exercise may help stimulate muscle contraction in the digestive tract.
Yoga poses can position your abdominal muscles in a certain way that soothes the digestive system and allows excess gas to pass through, therefore alleviating discomfort and bloat.
From personal experience, I have noticed improvements in both my digestion and bowel movements. I highly recommend trying yoga and the poses mentioned below for abdominal relief.
Yoga poses for bloating include child’s pose, apanasana, happy baby, spinal twist, one-legged seated spinal twist, seated forward bend and bridge pose.
Our gut bacteria, hormones, food sensitivities and PCOS differ from person to person. We are all different. Therefore, to identify what is causing your bloating I suggest you keep a food diary.
Every day write down the foods you eat and make a note of how you feel after eating them. If you experience symptoms such as bloating, gas, or discomfort, try to identify the level of pain and the severity. It can be normal to experience some bloating and gas after eating. So it is important to determine whether these are the symptoms of a food intolerance, IBS or just a normal part of healthy digestion.
To sum up, PCOS bloating occurs for various reasons including imbalanced hormones, an unhealthy gut and IBS. As well as eating artificial sweeteners, too many beans and raw veg.
But, while PCOS bloating may be a nightmare to live with, what with the stomach pain and protruding belly. There are ways you can beat the PCOS bloat.
They include dietary and lifestyle changes. As discussed eating more fiber and probiotics to improve gut bacteria. Following a low FODMAP diet to overcome food intolerances and IBS. Exercising regularly and drinking lots of water as well as taking peppermint oil. Depending on what is causing your bloat these changes may alleviate the pain and discomfort of PCOS bloating.
Don’t let PCOS dictate how you should feel or what you should wear because you have to cover up the bloat. It’s time to take back control!
Hey there! I am Despina Pavlou, founder of PCOS Oracle and online coach. I want to share with you the diet and lifestyle changes I made to naturally reverse my PCOS and achieve hormonal balance. I believe using my holistic approach you too can take back control from PCOS.