Bloating commonly occurs as a result of eating or drinking a large amount, having trapped gas, or retaining fluid. However, it can also be a symptom of PCOS.

Bloating is an uncomfortable feeling of tightness or fullness in the abdomen. Some people with bloating may also experience distention, in which the abdomen becomes physically larger alongside the bloated feeling. The most common cause of bloating is excess gas.

Polycystic ovary syndrome (PCOS) is a condition that causes symptoms throughout the body. Research suggests a link between the gut and PCOS development — specifically, changes in gut bacteria and decreased gut bacteria diversity. This may relate to the occurrence of bloating in PCOS.

This article will explore the prevalence of bloating in PCOS, possible causes, and relief options.

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A 2021 study found that bloating was the most commonly reported symptom among participants with PCOS. In the study, 73.8% of participants from the United States reported bloating as their most common symptom, along with 78.6% of U.K. participants and 80.4% of Australian participants.

Additionally, in a 2017 study, one of the most frequently expressed individual symptoms of PCOS was bloating. Participants reported it frequently enough for researchers to call it an important PCOS symptom.

In a typical cycle, a person has more progesterone than estrogen in their body after ovulation. Progesterone is a natural hormonal diuretic, meaning it helps the body release excess fluids.

A common symptom of PCOS is anovulation, or lack of ovulation. If ovulation does not occur, the body may not produce enough progesterone. This may lead to water retention, which is a common cause of bloating.

A 2022 study suggests that hormonal changes may cause bloating in people with PCOS. Researchers theorize that these hormonal changes may affect gut flora and bile acids associated with digestion.

Certain medications commonly prescribed to treat PCOS symptoms can cause bloating as a side effect.

For example, metformin is a medication that doctors commonly prescribe to manage PCOS symptoms, particularly insulin resistance. However, metformin can cause bloating, nausea, and flatulence.

Clomiphene is a medication that doctors prescribe to induce ovulation in women with anovulation. According to 2016 research, clinical trials found bloating to be a common side effect of the medication.

Doctors commonly recommend hormonal contraceptives to treat PCOS symptoms. However, hormonal birth control can cause side effects, one of which may be bloating.

For example, research notes that combined oral contraceptives (those containing more than one hormone) can cause gastrointestinal discomfort, and progestin-only contraceptives can cause bloating specifically.

Around 10–20% of the general population has irritable bowel syndrome (IBS). A common symptom of IBS is bloating, which can range from mild to severe. Multiple studies have found that people with PCOS have a higher prevalence of IBS.

A study from 2020 found that 29.7% of people with PCOS also had IBS, compared with 11% of people without PCOS. The researchers suggest that stress and anxiety associated with PCOS may cause IBS to occur more commonly in people with PCOS, as stress can affect gastrointestinal functioning.

There is no single treatment that can alleviate all types of bloating. However, there are certain at-home tips that may help ease the discomfort associated with it.

It is important to note that a person should talk with a doctor before starting a diet or trying a new supplement or medication.

Low-FODMAP diet

FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.” It is a method for identifying foods in a person’s diet that trigger uncomfortable gastrointestinal symptoms, such as bloating, diarrhea, and constipation.

Experts recommend following a plan that limits FODMAP-containing foods for 4–6 weeks, gradually introducing foods back to the diet, and taking note of which cause symptoms.

Research from 2017 concluded that a low-FODMAP diet is an effective method for easing symptoms associated with IBS.

Medications and supplements

Simethicone is one medication a doctor may recommend to help reduce symptoms of gas, such as bloating, abdominal pressure, and a feeling of fullness. It does not typically cause side effects and comes in multiple forms.

Antispasmodics help reduce muscle spasms. Research also suggests that they may help ease bloating. For example, in a 2019 study, the antispasmodic pinaverium bromide significantly eased bloating, and people who took the antispasmodic otilonium bromide experienced less bloating than people who took a placebo.

Prebiotics are a type of fiber that act as food for helpful bacteria in the gut. Probiotics are live microorganisms that come from certain foods and supplements. Research from 2022 found that prebiotics and probiotics can reduce bloating by reducing gas production.

A supplement that may help ease bloating is peppermint oil. However, as with all supplements, peppermint oil can cause side effects, and it is not suitable for use by all people.

Lifestyle changes

Gently massaging the abdomen from right to left may help move trapped gas through the gastrointestinal tract.

Physical activity may also help reduce bloating that occurs after eating. Research from 2021 found that a 10–15 minute walk after eating eased abdominal bloating more effectively than medications prescribed to help gastrointestinal processing.

A person may also wish to avoid certain foods and drinks that have associations with gas and bloating. These include:

  • fizzy drinks
  • heavily processed foods
  • cabbage
  • beans
  • lentils

Bloating is a common occurrence in people with and without PCOS. It may occur as a symptom of hormonal changes associated with PCOS, or it may be the result of medications used to treat PCOS. In most cases, it is the result of excess gas.

A person who experiences prolonged or bothersome bloating may wish to talk with a doctor about medical interventions and lifestyle changes. These can be effective for people with and without PCOS.