The Connection Between IBS and PCOS

The connection between irritable bowel syndrome (IBS) and polycystic ovary syndrome (PCOS) is REAL! ⠀

IBS is the most common GI disorder among women with PCOS. One study found that 20% PCOS women had IBS symptoms and that these symptoms were related to poor quality of life scores along with worries about health and food avoidance. ⠀

Another study found that up to 42% of women with PCOS had IBS! Yikes! That’s a lot of tummy trouble. ⠀

If this is you, here are some ways to get relief.

Signs and symptoms of IBS include:








Anxiety & depression⠀


The Link Between PCOS and IBS

There are several possible reasons for the increased link between IBS in the PCOS population.

Gut Microbiome
A connection exists with women with PCOS having less diverse gut bacteria and higher testosterone levels. Keep in mind, about 80% of your immune system is regulated in your gut. Having a healthy gut microbiome may be key to managing PCOS. For more tips on gut health and PCOS, click here:

READ PCOS and Microbiome: 5 Easy Ways to Improve Gut Health

Hormone Imbalances
Sex hormones play a role in the regulatory mechanisms of the brain and gut-microbiotica involved in the pathophysiology of IBS. Increased levels LH may also contribute to IBS symptoms in women with PCOS. Increased levels of ovarian hormones have been shown to decrease gastrointestinal transit, causing symptoms.

Medication or Supplement Use
Of course, medications and certain supplements can cause GI problems too. The popular diabetes medication Metformin could make IBS symptoms worse for some people with PCOS. Metformin works to block carbohydrates from raising blood glucose and insulin levels. In doing so, metformin can cause diarrhea and nausea. Taking metformin with food and starting at a low dose and gradually increasing the dose, can help minimize these effects.

READ What to Know About Taking Metformin for PCOS

While side effects from nutritional supplements are rare, they may be more common in people with IBS. Inositols can be very helpful for managing PCOS symptoms yet are sugar alcohols. People with IBS who take inositols (like Ovasitol) may find starting slow with a low dose each day for several weeks helpful before adding a second or higher dose. Taking supplements with food can also help reduce the risk of any potential side effects.

Stress and IBS
There is a connection with increased stress and worsening of IBS symptoms. The hypothalamic–pituitary–adrenal axis response to stress affects the GI system. Studies have shown that women with PCOS experience more anxiety and stress which may cause a higher prevalence of IBS in these patients.

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PCOS Lifestyle Tips for IBS Relief

While having IBS can affect everything from your social life to you mood, there is some good news: You don’t have to live with IBS symptoms! Here are some lifestyle tips to help you get relief from IBS symptoms if you have PCOS: ⠀

Stress relief (yoga and mindfulness in particular)

Regular exercise⠀

Drinking plenty of water⠀

Pre and Probiotics⠀

Limiting caffeine and alcohol

Gentle nutrition with a balanced plate (carbs, proteins, and fat)

Consider Berberine to help improve gut health

Eating low-FODMAPs foods

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FODMAPS is an acronym for foods that are difficult for most people to digest. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols, which are groups of short chain carbohydrates, fibers and sugar alcohols that can cause GI distress. There are numerous foods in each of these categories ranging from gluten to beans to apples and onions.

Five Things Women with PCOS Should Know about FODMAPs

A low FODMAPs approach is an evidence-based food trial that can help up to 75% of IBS-sufferers get symptom relief.

Identifying trigger foods can be difficult, as these are different for each person. Keeping a food diary of meals and ingredients along with symptoms, can help identify triggers. Eating a balanced plate which includes low GI or high fiber carbs, proteins, and fats can also be helpful.

One approach that is more restrictive and not for everyone, especially anyone with or with a history of an eating disorder, is eliminating high FODMAPS foods for a short period of time (4 to 6 weeks) and slowly reintroducing them back in to check for symptoms. This break also helps the gut to rest.

Sample Low FODMAP Eating Plan for PCOS


2 eggs


1 cup berries

Lunch: (bowl)

¼ cup lentils

½ cup quinoa

Salad greens

¼ avocado


Tahini dressing


Almonds, clementine

Dinner: Chicken stir fry


Avocado oil

Green beans




¾ cup brown rice


2 cups popcorn

Following a low FODMAP trial can be complicated and difficult. I do recommend working with a nutrition expert trained in FODMAPs.

An easier way I have found to take the stress out of avoiding FODMAPS is incorporating premade low FODMAP meals. Yes, there is such a thing!

I have been loving the low FODMAP friendly prepared meal service by ModifyHealth. They taste great (really fresh) and are generous portions. Best of all, they take the guesswork and stress out of following a low FODMAP approach so you can focus on feeling better. At ModifyHealth, you can select your favorite meals and all orders include free shipping across the US.

ModifyHealth makes it simple to experience fresh, fully-prepared Monash Low-FODMAP Certified™ and gluten-free meals made with non-GMO ingredients. And, delivery is free!

Interested in giving ModifyHealth meals a try? Use coupon code PCOSNUTRITION for $60 off when you place your order.

Full disclosure: this is an affiliate link and I will get a very small commission from each sale.


What questions do have about PCOS and IBS?



PMID: 32660493⠀PMID: 19697132

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