Tired, Run-down and Inflamed? Is Inflammation Driving your PCOS?

What is inflammation?

Inflammation is the body’s natural defence mechanism. When you injure yourself or catch an infection, your immune system releases chemical messengers to repair tissue and fight off pathogens. This short-term, or acute inflammation, is essential for healing.

However, when the immune system stays slightly switched on over time, a state of chronic low-grade inflammation develops. It’s subtle, often without clear symptoms, but measurable in the body through elevated inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6), or tumour necrosis factor-alpha (TNF-α).

Unlike acute inflammation, this persistent “background” inflammation can quietly affect many systems, including metabolism, hormones, fertility, gut health, and immune resilience. In other words, even though you may not feel overtly unwell, your body may still be under a gentle but ongoing immune strain.

The link between PCOS and chronic low-grade inflammation

Many studies show that women with Polycystic Ovary Syndrome (PCOS) tend to have higher levels of inflammatory markers compared to women without PCOS. This suggests that inflammation is part of the underlying physiology of the condition rather than just a by-product.

Researchers describe PCOS as a metabolic–endocrine–immune disorder, where factors like insulin resistance, excess androgens, and oxidative stress contribute to immune activation. The picture is complex: insulin resistance can increase inflammation, while inflammation itself can worsen insulin resistance, creating a vicious cycle.

Obesity and central fat accumulation often amplify this process because adipose tissue releases inflammatory cytokines. However, even lean women with PCOS can show signs of immune dysregulation, suggesting that the inflammation is not simply weight-related.

This persistent low-level inflammation may also influence how the ovaries function, affect egg quality, and disrupt normal ovulation. For many clients, this explains why symptoms such as fatigue, sluggish recovery from illness, acne, and irregular cycles tend to flare during times of increased stress or poor immune health.

How inflammation affects hormones 

Inflammation has wide-reaching effects on hormone balance:

1. Hormone production and clearance.
Pro-inflammatory molecules can disrupt ovarian function, reducing the ability of follicles to mature properly and affecting ovulation. Chronic inflammation also alters the way hormones are processed in the liver, which can lead to higher circulating androgens.

2. Insulin resistance and androgen excess.
Inflammation reduces insulin sensitivity, which in turn raises insulin levels. Elevated insulin drives the ovaries to produce more androgens (such as testosterone), worsening typical PCOS symptoms like acne, hair growth, and irregular periods.

3. Egg quality and implantation.
Within the ovaries, inflammatory cytokines and oxidative stress can damage developing follicles and reduce oocyte quality. This can make conception more difficult and may increase miscarriage risk.

4. Metabolic and cardiovascular risk.
Long-term inflammation contributes to higher risk of metabolic syndrome, type 2 diabetes, and cardiovascular disease, all conditions that are more prevalent in women with PCOS.

When clients describe being “constantly run down” or “taking ages to recover from colds,” it may reflect immune system overactivity and low resilience driven by this chronic inflammatory state.

Signs of inflammation in PCOS

Low-grade inflammation often goes unnoticed because it doesn’t cause the typical redness, swelling, or pain associated with acute inflammation. Still, there are patterns and symptoms that suggest it may be at play:

• Feeling constantly tired or taking longer to recover from illness
• Frequent colds or infections
• Worsening PCOS symptoms in times of stress or fatigue
• Irregular cycles, acne, or oily skin that flare around winter or illness
• Raised inflammatory markers such as CRP or white blood cell count (if tested)
• Digestive issues or gut dysbiosis, which can contribute to immune imbalance

Feeling “drained and exhausted by December” can often reflect a combination of immune strain, nutrient depletion, and chronic inflammation.

Steps to reduce inflammation

While inflammation is part of the body’s natural defence, long-term low-grade inflammation can be influenced by lifestyle and nutrition. The goal isn’t to “switch it off”, but to bring the body back into balance.

1. Improve insulin sensitivity and body composition.
Because insulin resistance drives inflammation, improving metabolic health is key. Regular movement, strength training, balanced meals, and reducing visceral fat all help reduce inflammatory signals. See more details here.

2. Eat an anti-inflammatory diet.
A Mediterranean-style pattern, one rich in vegetables, herbs, olive oil, oily fish, nuts, seeds, legumes (if tolerated), and colourful plant foods, is linked with lower inflammatory markers. Reducing refined sugars and ultra-processed foods helps stabilise blood glucose and reduce oxidative stress.

3. Support gut health.
Around 70% of the immune system sits within the gut. A disrupted microbiome or increased intestinal permeability (“leaky gut”) can promote systemic inflammation. Include diverse fibres, fermented foods, and prebiotic vegetables while avoiding excessive alcohol or ultra-processed foods that irritate the gut lining. Or get in touch if you’d like to investigate the root cause of your gut issues.

4. Optimise key nutrients.
Certain nutrients have been shown to help regulate inflammation, including omega-3 fatty acids, vitamin D, magnesium, selenium, and antioxidants such as polyphenols. While these can come from food, clients may wish to discuss testing or supplementation with their practitioner.

5. Manage stress and prioritise rest.
Chronic stress keeps cortisol high and the immune system on alert. Techniques such as yoga, walking, breathwork, journalling, or meditation can help regulate the body’s stress response and reduce inflammatory signalling.

6. Focus on winter resilience.
During the colder months, clients often experience more colds and fatigue. I encourage them to maintain vitamin D levels, eat adequate protein, include immune-supportive foods like garlic, mushrooms, and zinc-rich seeds, and make space for recovery instead of pushing through fatigue.

7. Support hormone balance through the cycle.
Because inflammation can vary with hormonal changes, I recommend balanced meals with protein, fibre and healthy fats throughout the month. Regular sleep, exercise, and stress management help buffer the hormonal impact of inflammation.

Have a go at tracking your energy, mood, cycle regularity, and immune resilience over time to identify improvements and patterns.

And if you’re interested in working with one of our practitioners on your gut health, looking to see if that or food sensitivities or intolerances may be driving your symptoms, please get in touch. We offer a range of testing options that we can discuss further with you.