PCOS causes a ripple effect in the body which causes various physiological changes. Which of these changes are responsible for the bloating you suffer from. 

Sex hormones and water retention: 

One of the most important reasons for bloating is water retention. You might feel heavier than usual and feel lethargic throughout the day when bloating sets in. We know PCOS causes a hormonal imbalance in the body, what we are unaware of is the repercussions the hormones have on water retention. In PCOS, there is an imbalance of sex hormones which are progesterone and estrogen. With an increase in estrogen, you see an increase in water retention in the body which becomes a major cause for bloating to occur.

Imbalance in Gut Flora: 

There is a colony of bacteria living in the stomach that pretty much controls the overall quality of our life. There are two types, one is a predominant microflora which brings good benefits to the body and there is a subdominant type that behaves as the troublemakers. Studies have shown that there is an alteration in this colony for one living with PCOS. Due to the reduction of good bacteria in the gut, the digestion process is hampered, as a result, food sits in the stomach for more time, ferments and causes bloating. Therefore when the gut bacteria is compromised there is a proinflammatory reaction that happens which causes a range of gut-related symptoms including bloating, nausea, vomiting, diarrhea, constipation and more.

Ovarian Hyperstimulation Syndrome (OHSS):

If you are suffering from PCOS-related infertility and you are going through a fertility treatment then you might be at risk of OHSS induced bloating. There are several hormone injections involved in a fertility treatment that gets the ovaries to make the egg required for fertilization. Since the ovaries are overstimulated there is a chain reaction of increase in the estrogen leading to water retention and bloating. So, expect a certain amount of bloating if you are trying to conceive through hormone treatments.

Food Intolerances:

There are certain foods that can trigger worsening of your PCOS symptoms like gluten, dairy, mushrooms, soy, peanuts, among others. In these cases, the gut lining gets inflamed by the intake of these food items because of which there is discomfort leading to bloating in the gut. Even certain raffinose (a type of carbohydrate) containing food like beans, broccoli, cabbage, cauliflower, etc., can cause fermentation in the gut leading to bloating. Going on an elimination diet will help remove the allergens from the diet and reintroduce them later at a slow pace to ensure as little damage to the stomach lining as possible.