The Link Between PCOS and IBS

PCOS is an endocrine (or hormonal) disorder, whereas IBS or Irritable Bowel Syndrome is a gastrointestinal disorder meaning it affects our gut health and digestion. It is generally given as a diagnosis of exclusion, where conditions like Crohn’s disease, ulcerative colitis and coeliac disease have been eliminated.  It is thought to affect 1 in 5 people in the UK. Symptoms include Typical IBS symptoms include abdominal pain, diarrhoea and/or constipation, bloating, wind, indigestion, mucous.

If you have PCOS, you may also experience symptoms of IBS. Here are potential reasons behind the association, according to research:

High levels of hormones

PCOS is marked by overly high levels of luteinising hormone (LH) and follicle-stimulating hormone (FSH), which are there to stimulate ovulation. Not only are excess levels of these hormones indicative of PCOS, but they can also lead to symptoms of IBS. Research shows that high levels of LH and FSH can cause slow transit of food in the digestive tract, leading to constipation.

Being female

Studies show that far more women suffer with IBS than men. Therefore, being a woman may increase your chance for having both conditions.

Although it isn’t entirely clear why IBS is more common in women, it’s thought to be related to sex hormones. Oestrogen and progesterone may slow down intestinal muscle contractions leading to constipation. Plus, hormone fluctuations during menstruation can lead to fast transit, which can cause diarrhoea. 

Inflammation

Inflammation is a common driver of PCOS symptoms – and it is a common driver of IBS.

Inflammation plays a role in the development of IBS. This includes inflammation of the mucosal gut lining, as well as neuroinflammation via the gut-brain axis The gut-brain axis is the neuronal system that connects your brain and gut.

Stress

Stress is another drive of PCOS, as we have seen. 

Strong emotions like stress, anxiety, and depression trigger chemicals in the brain that turn on pain signals in your gut that may cause your colon to react. Stress and anxiety may make the mind more aware of spasms in the colon. IBS may be triggered by the immune system, which is affected by stress.

Alterations to the gut microbiome

We have around 2kgs of bacteria in our large intestine called our gut microbiome. These bacteria help with our immune tolerance, create special chemicals to feed our gut lining, help make vitamins and many other important jobs. Research shows that women with PCOS have far less diverse microbiomes than women without PCOS. 

But why do we get IBS? As a syndrome it’s really an umbrella name for a variety of different digestive disruptions, such as: 

• Poor digestion - the right amount of stomach acid is needed to break down proteins, as well as for the absorption of minerals, such as iron or zinc. Enzymes helps us to break down fats, carbohydrates and proteins allowing them to be properly absorbed. So, any issues with stomach acid or enzyme production can cause symptoms. If our digestion is impaired for any reason, it can lead to bloating, wind, diarrhoea or feeling full when we’ve not actually eaten that much.
• Food sensitivities or intolerances – these are different from true food allergies which are life-threatening and can cause anaphylaxis. Food intolerances, such as lactose intolerance, is where we don’t produce enough of the correct enzyme to break down a type of food, which can lead to upset stomachs and inflammation. Food sensitivities are thought to be caused by an immune response generating symptoms such as stomach pain and irritation, joint pain, fatigue, and rashes.
• Small intestine bacterial overgrowth (SIBO) – normally very few bacteria live in the small intestine, so an overgrowth here can alter the shape and function of it. It can interfere with digestion of food and absorption of nutrients. SIBO is often characterised by bloating and distension, diarrhoea and/or constipation, belching, and nutrient deficiencies.
• Microbiome disruption or dysbiosis - Dysbiosis is an imbalance of the numbers of beneficial (‘good’) and pathogenic (‘bad’) bacteria in the large intestine which may cause discomfort, bloating and constipation and/or diarrhoea.  This is becoming more common due to overuse of antibiotics, stress, alcohol, and high sugar diets.

Working with a qualified health practitioner, like our team here at PCOS Clinics, can help you get to the root cause of your digestive discomfort. Fully trained practitioners can organise testing such as:

• Food intolerance and sensitivity testing.
• Comprehensive stool analysis for dysbiosis, candida or pancreatic enzyme sufficiency.
• Breath test for SIBO.

If you’re suffering from symptoms of IBS, why not get in touch? We can help you determine the root cause of what’s going on for you. Tackling your IBS may be one of the main steps to getting your PCOS symptoms under control, especially as IBS can be a major trigger for inflammation. Why not book a call?