This article has been compiled by Vaibhavi Kodnani, a content writer at Proactive For Her.

What is PCOS?

Polycystic ovary syndrome (PCOS) is a hormonal disorder that can occur in menstruators. You may have PCOS if you qualify for any two of the following three diagnostic criteria:

• Having irregular periods: Your periods will be considered irregular if you do not have a fixed period cycle.
• Having excess androgens: The symptoms of excess masculinizing hormones include acne, excessive body hair growth, especially on the chin, face or upper part of the body, and hair loss.
• Having cysts on your ovaries: The doctor will perform an ultrasound to check if you have cysts on your ovaries.

Apart from these criteria, the other PCOS symptoms include:

• Fatigue
• Bloating
• Feeling moody, anxious or depressed
• Dark, velvety patches on the neck
• Difficulty in losing weight

We will be focusing on understanding the relationship between PCOS and bloating.

What is bloating?

Bloating means when your gut gets filled with air or gas. You may experience the following symptoms during bloating:

• Belly pain
• Feeling full easily
• Tightness in the belly
• A little belly bulge

How are PCOS and bloating related? 

PCOS, bloating and gas are interrelated. Inflammation and stress in the body ultimately become key contributors to PCOS. The various symptoms of inflammation and stress are:

• Bloating
• Migraines
• Constipation or diarrhoea
• Indigestion
• Rapid weight fluctuations
• Acne
• Brain fog
• Thinning of hair
• IBS (if you haven’t had it before)
• Irregular periods

Various reasons are contributing to inflammation and stress in the body that can cause PCOS bloating.

Diet

Your diet can be a reason behind your poor gut health, stomach pain after eating and PCOS abdominal bloating. The below-mentioned categories of foods cause an imbalance between healthy and unhealthy bacteria in the gut.

• Dairy foods and beverages
• Foods containing gluten
• Foods high in sugar
• This unhealthy bacteria can increase the production of gases, ultimately causing PCOS stomach bloating. Thus, poor gut health causes inflammation in the body, thus becoming a contributory factor to PCOS. However, not all of the mentioned foods need to be triggers for bloating in people with PCOS. It will vary from person to person depending on various factors.

Other diet-related triggers for bloating include:

• Too many processed foods
• Low fibre diet
• High fat intake

PCOS medication

Some PCOS medications such as metformin and birth control pills are extremely helpful in managing PCOS, but they may also lead to bloating in some people.

1. Slow metabolism- If you have a slower metabolism due to a lack of exercise or thyroid abnormalities, your gut can also take time to process food and cause bloating.
2. Inadequate sleep- Lack of sleep can raise cortisol, your stress hormone that can affect your gut health, resulting in bloating and constipation.

Will all people with PCOS have bloating?

No, not all people with PCOS will experience bloating. Even those who get bloating may not have it for the entire duration of their menstrual cycle; it may only occur during a specific period of the cycle. Also, it may not be a persistent problem throughout their PCOS journey.

What are the ways to treat PCOS bloating?

The first and foremost tip to remember is to treat your overall gut health, which will eventually help manage PCOS and bloating.

Identify the food triggers causing bloating

Gluten foods, dairy products or sugar are known to cause inflammation, elevate your cortisol levels, and lead to bloating. If you are a consumer of these foods, try eliminating all of them from your diet or one at a time. Then after a while, try adding them back one by one to identify the real trigger behind the bloating. You do not need to completely stop the foods that are not suiting you. However, once you identify them, you can reduce their consumption to avoid inflammation and its symptoms.

Consume more fibre

Add lots of fibre-rich foods to your diet to ensure a healthy digestive system and excrete the excess hormones and toxins out of your body. All whole grains, vegetables, fruits are good sources of fibre.

Add natural probiotics to your diet

Probiotic foods provide healthy bacteria in the gut to improve the digestive system and reduce symptoms of bloating. Fermented foods, kombucha, and homemade yoghurt are some natural probiotics that you can consume. You can even have a probiotic supplement if needed.

Cut down the sugar intake

Even though this point has been mentioned before, it needs to be highlighted again. Sugar in various forms can cause gas and bloating. Hence, cut down on the amount of sugar, artificial sweeteners, and processed foods you have all day.

Plan a sustainable lifestyle

Adopting a healthy lifestyle can help you manage various PCOS symptoms. Hence, incorporate sustainable lifestyle changes that you can follow consistently.

Exercise

Exercising for around 30 mins a day is ideal for a healthy gut. It will help your digestion, speed up your gut metabolism, and restore the healthy bacteria balance in your gut. All of this will manage your bloating symptoms. As a beginner, you can start with general exercises such as walking, cycling, strength training, yoga and swimming. Slowly, as you build confidence, you can amp up your workouts.

Give importance to sleep

When it comes to sleep, there are three important rules to follow.

• The time you go to sleep: Go to bed at a specific time every day, preferably early.
• The number of hours you sleep: Deep sleep cycles are crucial. Hence you must get at least 7-8 hours of night sleep every day.
• The quality of your sleep: Make sure to sleep in a clean space and don’t use your screens before sleeping.

Get a thyroid hormone test done

If you experience constipation and sensitivity to cold, go for a thyroid hormone test. It is to ensure that the thyroid is not the reason behind your low metabolism.

Talk to your doctor about PCOS medications

PCOS medications such as birth control pills or metformin can cause bloating too. You can consult your doctor for their alternatives.

The last point is for people with PCOS experiencing irritable bowel syndrome (IBS).

1. Low FODMAP diet for IBS
   
   Many people may have IBS, an intestinal disorder that shows inconsistent patterns of diarrhoea, constipation, and bloating. They get a PCOS belly bloat. In such a case, you may want to consider a low FODMAP diet. To explain further, FODMAP represents fermentable oligosaccharides, disaccharides, monosaccharides and polyols. These are certain types of carbohydrates. For those having IBS, FODMAPs are poorly absorbed by their gut and is also the reason behind bloating. Therefore, having a low FODMAP diet can significantly reduce their PCOS bloated stomach.

When following a low FODMAP diet, here is a list of foods that you must avoid or reduce:

• Gluten
• Dairy
• Onion
• Garlic
• Sugar
• Fruit juices
• High fructose corn syrup or artificial sweetener products
• You can benefit from this diet and reduce bloating and other IBS symptoms. However, you need not adopt this diet for a lifetime. You can slowly add these foods back into your diet one by one and identify the triggers to avoid them later on. 

Disclaimer: This information is educational and should not be construed as medical advice. Please consult your doctor before making any dietary changes or adding supplements. 

Proactive For Her is a digital clinic for women, offering accessible, personalised, and confidential healthcare solutions. We offer out-patient care, diagnostic services and programs for various health concerns of Indian women, across their lifetime - from puberty to pregnancy to menopause.