Abdominal Pain In PCOS: What’s Normal and When to Be Concerned

Polycystic ovary syndrome (PCOS) is a hormonal condition that affects women of reproductive age. Because it involves hormonal imbalances, PCOS can impact SO many systems in the body, triggering a long list of symptoms that can really decrease a Cyster’s quality of life. This is why many Cysters are searching for ways to manage common symptoms of PCOS including weight gain, irregular periods, excess hair growth, acne, mood swings, fatigue, and even abdominal pain. 

Are you surprised to hear abdominal pain or pelvic pain could be caused by PCOS? It’s true! There are a few ways PCOS can trigger abdominal pain, so today I’m going to talk about why it happens and what you can do about it. 

Abdominal Pain In PCOS: What’s Normal and When to Be Concerned

Though there’s no direct treatment for PCOS, you don’t need to jump straight to medications like metformin or hormonal birth control for your symptom management if you don’t want to (those aren’t your only options). There are so many ways to naturally ease symptoms like abdominal pain and even reverse your PCOS! 

Here’s what you need to know about this common PCOS symptom: 

How Does PCOS Cause Abdominal Pain?

There are lots of reasons women with PCOS may experience abdominal pain, but most of them trace back to the same root causes: inflammation, insulin resistance, and hormonal imbalances. These underlying issues are key to improving symptoms, but first, let’s break down the specific ways they can lead to abdominal pain:

Ovarian Cysts: 

Ovarian cysts are small, fluid-filled sacs that can form on or inside the ovaries. With PCOS, the body’s hormone levels, especially excessive androgens, can mess with ovulation. That means the follicles (which normally release an egg) don’t mature properly, so they just stick around on the ovary. While many cysts go away on their own, some can cause symptoms like bloating, pelvic pain, or cramping. (For more on cysts, listen to this episode of A Cyster and Her Mister.)

Period Pain: 

Periods aren’t just irregular with PCOS they can be super heavy and painful, too. That’s partly because sex hormone imbalances (like too much estrogen or not enough progesterone) can lead to a thicker buildup of the uterine lining. When your body finally sheds that lining, it can make cramps a lot more intense. Plus, PCOS is linked to higher levels of inflammation, which can amplify period discomfort and abdominal pain even more. (Here’s more on what periods are like with PCOS.)

Gut Issues: 

Hormonal imbalances, especially elevated androgen and insulin levels, can disrupt the gut microbiome (the balance of good and bad bacteria in your digestive system). PCOS is also linked to higher levels of inflammation, which can affect how your gut functions and lead to symptoms like bloating, gas, constipation, or diarrhea. All of this can make your digestive system more sensitive, causing pain or cramping in the lower abdomen. 

Endometriosis:

Endometriosis can cause abdominal pain because tissue similar to the uterine lining grows outside the uterus on places like the ovaries, fallopian tubes, or even the intestines. This tissue still responds to your monthly hormones, so it bleeds and gets inflamed during your cycle, but since it has nowhere to go, it can lead to swelling, scarring, and intense pain. 

PCOS and endometriosis are sometimes confused because both can cause irregular menstrual cycles, pelvic pain, and fertility issues, but they’re very different: PCOS is driven by hormonal imbalances and lack of ovulation, while endometriosis is caused by displaced tissue and inflammation. Some people even have both, which can make getting an accurate diagnosis and a good treatment plan super difficult, so it’s important to get checked if you’re dealing with ongoing pain. Here’s more on PCOS vs. endometriosis.

How To Manage Abdominal Pain In PCOS

Try an anti-inflammatory gluten- and dairy-free diet. 

Diets aren’t just about weight loss—they’re about giving your body the tools it needs to function and heal. For many women with PCOS, abdominal pain can be triggered by underlying inflammation, gut imbalances, and hormone fluctuations. That’s why I recommend trying a gluten- and dairy-free anti-inflammatory diet.

This approach has helped many Cysters reduce inflammation, improve insulin resistance, and bring hormones into better balance—all key factors that contribute to bloating, cramping, and pelvic pain. As your gut and metabolism begin to heal, you might be surprised at how much better your body feels. Real food, real relief.

If you’re ready to manage PCOS symptoms naturally through diet, download The Cysterhood app. It’s full of PCOS-friendly recipes and meal plans you’ll love what you’re eating and how you’re feeling! 

Do regular slow-weighted workouts. 

Exercise can also make a big difference when it comes to the root issues of PCOS! But I completely understand if those crunches and sit-ups you thought you needed to do to lose belly fat are causing more discomfort than progress (and PSA, there are more effective ways to target PCOS belly). Slow, weighted workouts help reduce inflammation, improve insulin sensitivity, balance hormones, support digestion, and relieve stress, all of which give your dysregulated body the support it needs. As these areas improve, there’s a good chance you’ll notice your abdominal pain improving, too. You’ll find slow-weighted workout routines on the app along with those PCOS-friendly recipes!

Use heating pads or take a warm bath. 

While you work on addressing the root causes of your abdominal pain to get lasting relief, heat therapy can be a great way to manage the pain in the moment. A heating pad or warm bath can help relax muscles, boost circulation, calm nerve sensitivity, support digestion, and reduce stress, making it easier to cope when the pain flares up.

Practice stress management. 

Stress management is another important step for relieving abdominal pain with PCOS because stress increases inflammation, disrupts hormone balance, and can cause muscles in the abdomen and pelvis to tense up leading to more pain. It also affects digestion and makes your body more sensitive to discomfort. 

So, try calming your mind and body with things like yoga, meditation, nature walks, journaling, better sleep, or your favorite hobbies. You’ll not only feel mentally better, but physically too. 

Stay hydrated. 

Want a really easy way to ease abdominal pain? Drink more water! Proper hydration helps flush out toxins, reduce bloating, support digestion, and lower inflammation, all of which can contribute to less cramping and discomfort. Water also keeps your hormones and metabolism functioning more smoothly, giving your body the support it needs to manage pain more effectively.

I also recommend drinking Testosterone Relief Tea. Elevated androgens can contribute to inflammation, irregular ovulation, and ovarian cyst formation…all of which may lead to cramping, bloating, or discomfort in your lower belly. The science-backed herbal blend in this tea was created to help naturally lower testosterone levels and support hormonal balance. Ingredients like spearmint, chamomile, and nettle are known for their anti-inflammatory and hormone-regulating properties, making this tea a gentle but effective option for supporting pain relief and easing uncomfortable symptoms tied to PCOS.

It’s not just soothing to sip…it’s part of a consistent routine that supports your healing from the inside out. Many Cysters find that enjoying the tea once or twice a day helps reduce bloating, lessen pelvic pain, and promote more regular cycles over time.

Relieve pressure by resting in the fetal position. 

Here’s another one that won’t cure abdominal pain, but can help you get through it as you work through healing! Try sleeping in the fetal position, which can relax the abdominal muscles to reduce cramping and tension. For some, it even has a bonus relaxing effect! 

Take supplements that relieve inflammation, insulin resistance, and hormonal imbalance. 

There are so many supplements that can kick-start your PCOS healing by providing tons of extra support with essential vitamins and minerals. Here are my must-have list for getting to the root issues of PCOS:

Getting these specifically from OvaFit ensures that you get NSF-certified and high-quality supplements at the carefully selected dosages suggested by research on women with PCOS. Talk to your doctor before starting any new supplements to make sure they’re right for you. 

Consider acupuncture. 

Acupuncture for PCOS works by stimulating specific points on the body to promote better blood flow, reduce inflammation, and calm the nervous system. This means it’s great for easing pain! Acupuncture may also support hormone regulation and improve insulin sensitivity, making it a holistic option for addressing both the pain and the underlying causes of PCOS. Many Cysters find it especially helpful during painful flare-ups or as part of an ongoing healing plan!

Try a TENS (Transcutaneous Electrical Nerve Stimulation) machine. 

For people really struggling with chronic pain, TENS machines can be a natural, drug-free way to get some immediate relief. The machine sends mild electrical impulses through the skin to stimulate the nerves, blocking pain signals from reaching the brain. You can find discrete options like Livia that allow you to go about your day even while dealing with your abdominal or pelvic pain. 

Get a consultation with a pelvic floor physical therapist. 

Ongoing abdominal or pelvic pain is not uncommon, but it doesn’t have to be your “normal.” If you’re doing what I’ve recommended on this list and just aren’t seeing relief (or not enough relief), get a consultation with a pelvic floor physical therapist. There could be an undiagnosed injury or other problem that a specialized healthcare provider could help address. It never hurts to dig deeper, you deserve the full picture when it comes to your pelvic health!

Get to the root of your chronic pain to find long-term PCOS healing! 

It’s true that PCOS doesn’t have a “cure,” but that does NOT mean you’re just stuck with your symptoms. No way! A holistic, natural approach to PCOS management can actually get to the root of your body’s dysfunction to reverse the condition, allowing you to finally live symptom-free! 

For more on how to tackle polycystic ovarian syndrome, browse the PCOS Weight Loss blog and tune in weekly to the A Cyster and Her Mister podcast! It’s time to say goodbye to pain and difficult PCOS symptoms with a lifestyle that allows you to thrive with PCOS.