Exploring the Relationship Between PCOS and IBS

Coping with multiple conditions can be challenging. 

You may be wondering if there is a connection between your conditions.

IBS affects approximately 10-15% of people in the United States and is the most common functional gastrointestinal disorder. It’s also highly unpredictable, so those with IBS may experience a multitude of symptoms, including bloating, abdominal pain, and alterations in bowel habits (diarrhea, constipation). IBS does not have an identified structural cause. The pain experienced is likely a result of visceral hypersensitivity, and can be so debilitating that it is one of the leading causes of work absenteeism.

Well, I live with IBS every day. What does that have to do with PCOS?

Let’s define PCOS first for those who may not be as familiar with it.

PCOS, or polycystic ovary syndrome, has some of the same features as IBS. According to Kalunza et al., PCOS is a complex phenomenon of reproductive, endocrine, and metabolic disturbances that causes inflammation, abdominal pain, and bowel movement dysfunction. It affects approximately 5-10% of reproductive-age women, and unfortunately, can lead to infertility.  You can learn more about the PCOS & Gut Dysbiosis Connection in this article.

Here are several ways PCOS and IBS are related:

1) Hormones

While PCOS occurs exclusively in women, IBS disproportionately affects twice as many women as men. In PCOS, irregular menses occurs due to excessive follicle-stimulating hormone (FSH) and luteinizing hormone (LH) which prohibit ovulation. This same study revealed these hormones may be related to IBS since excess FSH and LH can cause constipation by delaying the movement of food in the digestive system. Higher perceptions of pain may result from female sex hormones.

2) Inflammation and Quality of Life

Both PCOS and IBS affect the quality of life for those who have it. Additionally, they both share symptoms of bloating, abdominal pain, and changes in bowel habits from inflammation. Chronic inflammation is a hallmark of both and leads to stress – both internal at the cellular level and external (environmental). With PCOS, you are at increased risk of the following inflammatory issues: insulin resistance, type 2 diabetes mellitus, obesity, cholesterol, and heart problems. Symptoms of depression and anxiety may also be found in those with IBS and PCOS due to the gut-brain axis.

3) Intestinal Permeability

There are studies that now link PCOS to intestinal permeability and alterations in gut bacteria. Enhanced intestinal permeability (leaky gut) is a well-studied contributor to IBS. As a quick refresher, this means that the protective mucosal barrier in the intestines starts to degrade over time and causes “holes” to form. Like a water hose, when holes start forming, toxins and inflammatory substances begin to leak out into the bloodstream and wreak havoc, and that’s when symptoms really start to appear.

What can I do to treat PCOS and IBS?

Reducing and managing symptoms is the goal, as the literature shows there is no known cure for either of these. However, there are steps you can take

#1- The single most important factor in managing both involve lifestyle changes.

• Diet – A well-balanced, nutrient-rich diet is essential. A Low FODMAP diet may help manage the inflammation from foods.
• Stress reduction – While this may sound simple, many people struggle with what to do. Gentle exercises like yoga, therapy sessions, adequate sleep, and other relaxation techniques are examples.
• Medications – Your gastroenterologist or gynecologist may prescribe medications targeted to achieving symptom relief.

#2- Probiotics and/or prebiotics may be beneficial to the gut bacteria (microbiome), and this is discussed in the PCOS/Dysbiosis article, mostly as it relates to insulin resistance.

My tips if you suffer from either or both IBS & PCOS:

Whether you have both or just one of these, I encourage you to start paying attention to the triggers. There’s no one-size fits all approach to the symptoms or management, so it’s important to start listening to the cues your body provides.

1- Journaling. Writing down the foods you eat, how you feel after eating them, and any symptoms will be helpful in identifying triggers. Once you identify your triggers, you can make plans to avoid them.

2- Figure out what makes you happy and less stressed. Incorporate more of this in your life. Your hormones (and body) will thank you for it.

3- Move more. While it can be exhausting to deal with your symptoms, movement/exercise can help boost your mood and increase your quality of life. Tiny steps matter….

1. _{American College of Gastroenterology. (n.d.). Low-FODMAP Diet.}
2. _{Bazarganipour, F., Taghavi, SA., Asemi, Z. et al. The impact of irritable bowel syndrome on health-related quality of life in women with polycystic ovary syndrome. Health Qual Life Outcomes, 18, 226 (2020).}
3. _{Centers for Disease Control and Prevention. (2022). PCOS (Polycystic Ovary Syndrome) and Diabetes.}
4. _{Irritable bowel syndrome (IBS): ACG. American College of Gastroenterology. (2024, March 28).}
5. _{Kałużna, M., Kompf, P., Wachowiak-Ochmańska, K., Moczko, J., Królczyk, A., Janicki, A., Szapel, K., Grzymisławski, M., Ruchała, M., & Ziemnicka, K. (2022). Are patients with polycystic ovary syndrome more prone to irritable bowel syndrome?. Endocrine Connections, 11(4), e210309.}
6. _{Pusceddu, M. M. & Gareau, M. G. (2018). Visceral pain: gut microbiota, a new hope?. Journal of Biomedical Science, 25, 73.}
7. _{Weaver, K. R., Melkus, G. D., & Henderson, W. A. (2017). Irritable Bowel Syndrome. The American Journal of Nursing, 117(6), 48–55.}