PCOS and constipation: Tips for avoiding and preventing constipation

Polycystic ovary syndrome (PCOS) is a common metabolic condition affecting up to 20% of women of reproductive age. Not all women have symptoms, though it is a leading cause of fertility problems and is often diagnosed during fertility testing.

Not many people realize PCOS can harm your digestive system, though many sufferers report experiencing digestive symptoms. The dysbiosis of gut bacteria associated with PCOS may be to blame, though other contributing factors exist. Stress, obesity, and medication side effects can also cause constipation in women with PCOS.

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In a nutshell

For women with polycystic ovary syndrome (PCOS), constipation is an unpleasant but common symptom. Lifestyle changes can alleviate digestive symptoms, including PCOS constipation. Increasing your fiber intake, staying hydrated, and daily exercise can help to keep your bowel movements regular

PCOS and constipation

The link between PCOS and the digestive system is still being explored, so we don’t yet fully understand why digestive issues are a common symptom associated with this condition. However, scientists are currently exploring the link between PCOS and gut bacteria, which may cause digestive symptoms such as bloating and constipation.

Common symptoms of PCOS include:

• Irregular or missed periods
• Weight gain
• Infertility
• Excessive hair growth on the face and body
• Thinning hair on the scalp
• Acne and oily skin

Many women also report digestive symptoms, including bloating and constipation. These symptoms can be particularly unpleasant as they interfere with your daily life. You might be relieved to hear there are lifestyle changes you can make to reduce their impact.

Constipation occurs when you poo less frequently or find it difficult to pass a bowel movement. Most people experience constipation at some point in their lives, but the impact of this condition shouldn’t be underestimated. You might be constipated if:

• You’re pooing less often than usual
• Your poo is unusually large
• Your poo is small, dry, hard lumps
• It hurts when you have a poo
• You feel like you still need to go after having a poo

Other symptoms associated with constipation include stomach ache, bloating, and nausea.

Can PCOS cause constipation?

Many PCOS sufferers complain of regular constipation, so we know it is linked with PCOS. There is no research examining whether PCOS causes constipation; however, we know that PCOS impacts gut health. A 2022 study published in Endocrine Connections found that women with PCOS have an increased risk of experiencing symptoms of Irritable Bowel Syndrome (IBS).

Why does PCOS cause constipation?

Though the exact reasons behind how and why PCOS affects the body are still being explored, there are several theories as to why PCOS may impact the digestive system:

Dysbiosis of the gut bacteria

Experts believe gut bacteria may be one reason why women with PCOS suffer from constipation. Dysbiosis of the gut microbiome means an imbalance of the bacteria in your gut, which can impact the digestive system, causing symptoms like bloating and constipation. A 2017 study published in PLOS One found that women with PCOS had a low diversity of gut bacteria.

Hormonal imbalances

The hormonal imbalances of PCOS could be to blame for your slow-moving digestive system. A 2020 article in Health and Quality of Life Outcomes stated that the higher hormone levels of women with PCOS are thought to interfere with bowel function and cause constipation.

Obesity

Obesity and weight gain are symptoms of PCOS, though not everybody experiences them. Obesity is a risk factor for constipation, so that it could be this PCOS symptom messing with your digestive health. A 2024 review published in Open Access found that losing weight reduced the risk of constipation.

Stress

PCOS is linked with higher levels of stress and anxiety. Stress affects the gut and can cause inflammation in the digestive tract. If you are experiencing stress as a symptom of PCOS, this could be partly to blame for your constipation.  

Medication

For some women, constipation is a side effect of the medication used to treat other symptoms of PCOS. For example, metformin is a medication commonly used to manage insulin levels in women with PCOS, but it could be causing constipation. Speak to your doctor if you think this could be the case.  

6 tips for avoiding PCOS constipation

The following lifestyle changes may help to treat and prevent constipation: ‍

‍1. Eat plenty of fiber

Most people don’t eat enough fiber, so constipation is a common complaint. According to a 2014 article published in the American Journal of Lifestyle Medicine, 95% of Americans aren’t getting enough dietary fiber. A 2020 article published in Nutrients found that dietary fiber could be used to treat and prevent constipation.

A 2024 study published in Clinical Nutrition found that increased dietary fiber reduces mortality risk for various health conditions, so it’s worth increasing your fiber intake. The following foods are high in dietary fiber:

• Porridge oats and high-fiber breakfast cereals
• Whole grain breads
• Lentils and beans
• Fresh vegetables
• Fresh and dried fruits
• Nuts and seeds
  

2. Avoid trigger foods

Some foods can trigger constipation, though you may overlook which ones when you’re busy living your life. It’s worth keeping a food and symptom diary for a couple of weeks to identify any food triggers causing constipation. Potential triggers include dairy, refined grains, fatty junk foods, and processed foods.

3. Stay hydrated

Dehydration is linked with constipation. Fiber soaks up water, which helps keep your stools soft. Without enough fiber and water, your bowel movements might be dry and hard, making them difficult to pass. You should drink around 2.7 liters of fluid each day. Try to avoid sodas and caffeinated drinks, which can irritate the gut.

4. Take a probiotic

If your gut microbiome is unbalanced, a probiotic could help restore order. Look for a daily probiotic that contains healthy gut bacteria. A 2023 study published in Nutrients found that probiotics can help to manage PCOS symptoms.

5. Take regular exercise

Exercise can stimulate the bowels and help to get your digestive system moving. Rather than waiting for constipation to strike before exercising, you should ensure daily exercise to prevent constipation.

If you suffer from PCOS fatigue, you may struggle with your energy levels. It’s essential to plan exercise that works for you. If you know you’re exhausted in the evenings, schedule an early morning workout to make it an achievable goal.

A 2019 research review published in the Scandinavian Journal of Gastroenterology found that exercise was an effective treatment for constipation, though more research was needed to confirm the results.

6. Reduce stress

Many women with PCOS report high stress and anxiety levels, and this could be impacting their digestive health. Getting your stress levels under control could alleviate your digestive symptoms and prevent constipation. Daily stress-relieving practices, such as mindfulness and yoga, can reduce stress and mitigate its impact on the body.

When to seek medical help

Constipation is an awful symptom that can leave you feeling bloating, nauseous, and uncomfortable. You don’t need to suffer in silence. If the above lifestyle changes haven’t helped, make an appointment to see your doctor. It’s worth highlighting the link between PCOS and constipation so your doctor can develop a treatment plan that works for you. Your doctor may suggest a stool softener to use in the short term to provide relief.

Final verict

You’re not alone if you’re suffering from PCOS constipation. Unfortunately, this is a common complaint from women with PCOS. It’s thought that an imbalance of gut bacteria causes digestive symptoms for PCOS sufferers. Luckily, there are things you can do to help.

Improving your fiber intake could make a huge difference. Fresh fruits and veggies, whole grains, nuts, seeds, and legumes are all great sources of fiber. Staying hydrated, exercising regularly, and avoiding your food triggers help alleviate your symptoms. To tackle the root cause of the problem, try taking a daily probiotic to improve your gut bacteria.

If the above changes aren’t helping, it’s time to bring in the professionals. Your doctor will be able to offer tailored medical advice taking into account your PCOS diagnosis.