PCOS Pain: Why is PCOS so painful?

Symptom management is a crucial aspect of living with polycystic ovary syndrome (PCOS), a common hormonal disorder that affects as much as 10% of reproductive-aged women. Each person will experience PCOS differently, but often irregular periods, issues with fertility, facial and body acne and unwanted hair growth are cited as symptoms. Another common symptom is pain–nearly 30% of people with PCOS reported pain as one of their symptoms. While there is no cure for PCOS, there are still ways to manage PCOS-related pain. Understanding the root causes of this pain is the first step toward finding effective ways to manage it and improve your overall quality of life.

Does Polycystic Ovary Syndrome (PCOS) Cause Pain?

Yes, pain is one of the signs of PCOS. In research, nearly 30% of people with PCOS report pain as a symptom. PCOS pain often manifests as period pain, pelvic discomfort, cramps, or lower back pain. This pain occurs because hormonal irregularities in PCOS can lead to enlarged ovaries, irregular menstruation, and other symptoms that trigger discomfort. There are several reasons PCOS may cause pain, which can make it challenging to manage. It could be:

• Ovarian cysts: Many people with PCOS also have ovarian cysts, which are fluid-filled sacs in or on the ovary. Though many cysts are small and harmless, they can grow in size and cause issues like bloating, swelling and pain in the pelvis and lower abdomen.
• Hormonal imbalances: Hormonal fluctuations during your menstrual cycle, such as estrogen and progesterone, can lead to painful, heavy periods.
• Inflammation: Research indicates that people with PCOS have higher levels of inflammatory biomarkers, which may mean chronic inflammation occurs somewhere in the body. Inflammation is often associated with body pain and heightened sensitivity.

Menstrual pain

Heavy and painful periods are often a symptom of PCOS. In women with PCOS, the ovaries may produce excess androgens (male hormones), which can interfere with ovulation, leading to irregular or absent periods. When there is a period, the lining of the uterus (endometrium) has thickened due to prolonged periods without shedding. The thicker lining can result in heavier, more painful periods as the body works to expel the thickened uterine lining. Additionally, pelvic and lower stomach pain can intensify menstrual cramps.

Painful sexual intercourse

Dyspareunia, the medical term for painful intercourse, is an issue that many women face, including those with PCOS. While there are various reasons for dyspareunia, women with PCOS may experience pain during or after sex due to a combination of physical and emotional factors. These may include reduced sex drive, decreased lubrication, and lowered sexual confidence, all of which can contribute to painful sex. Additionally, common PCOS symptoms like weight gain, acne, and unwanted facial hair can impact self-esteem and sexual interest, further exacerbating discomfort during intimacy. 

Can PCOS cause joint pain?

Inflammatory PCOS can cause joint pain. People with PCOS are at an increased risk of having Psoriatic arthritis (PsA), a painful, progressive, inflammatory autoimmune disease that affects the skin, nails, joints, and spine. The connection is inflammation, which, in PsA, causes pain and swelling in the joints. Though there are no studies that directly link PCOS and PsA, there is research linking psoriasis (an inflammatory skin condition) and PCOS, and people with psoriasis have higher incidences of PsA. 

Managing PCOS Pain

PCOS-related pain may not be as common as other symptoms, but it can be debilitating and disruptive. While there is no cure for PCOS, working with your Genesis provider and adopting a few lifestyle changes can help lessen the pain.

Medication

Hormonal contraceptives are one of the primary methods of “treating” PCOS. Hormonal contraceptives can help regulate the menstrual cycle, balance estrogen and progesterone levels, and reduce the severity of PCOS symptoms, including pain. Other treatments, like progesterone therapy, may also be beneficial in managing discomfort by lowering the production of prostaglandins, which cause painful contractions. 

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), like Ibuprofen, are easily accessible methods of pain management, though they are not recommended for long-term daily use. Always follow dosage instructions and consult with your healthcare provider prior to starting any medication.

Surgery

In some severe cases, people may opt for laparoscopic surgery for PCOS. One surgical option is Laparoscopic ovarian drilling. The procedure uses a laser or electrocautery to destroy small areas of ovarian tissue, which may help restore ovulation and reduce some PCOS symptoms. The minimally invasive surgery is primarily used in people trying to get pregnant. 

Heat Therapy

For quick, medication-free relief, you can opt for the tried and true heat therapy method. Soaking in a warm bath or using a heated pad can temporarily soothe pelvic and lower abdomen pain. Heat helps naturally relax pelvic and uterine muscles, and there aren’t any limits on how long you can use a hot water bottle; just be sure you use a towel or something else to cover your skin so you don’t get burned.

Eat a balanced diet

Making changes that address the underlying reason for the pain, i.e., the hormonal imbalances caused by PCOS, can help manage pain. A well-rounded diet can play a key role in alleviating both the physical and emotional discomfort associated with PCOS. Omega-3 fatty acids (found in walnuts and salmon), vitamin D (in egg yolks and cheese), and high-fiber foods (like kale and quinoa) are particularly beneficial for reducing inflammation and improving insulin sensitivity.

Exercise regularly and stretch for relief

Staying active can help manage a healthy weight and reduce insulin sensitivity issues, another common PCOS symptom. Aim to exercise 3 to 5 times a week, combining aerobic activities like brisk walking, running, or cycling with strength training, such as lifting weights or using resistance bands. You can also incorporate practices like yoga and pilates, which can help reduce muscle tension and alleviate stress, anxiety, and depression. Focus on gentle stretches and poses that feel good for your body, and remember to build up slowly over time to avoid injury.

Work with your Genesis provider for PCOS pain relief

Managing PCOS pain involves a combination of lifestyle changes and other remedies. Every woman’s experience is unique, so it can be helpful to work with your Genesis provider, who can discuss all of your available options and provide guidance. If you’re struggling with PCOS pain and need personalized support, don’t hesitate to contact us to request an appointment today. We can help you explore treatment options tailored to your specific needs and ensure you’re on the path to better health and comfort.

PCOS Pain FAQs

Does PCOS cause pain?

Yes, PCOS can cause pain, often as period cramps, pelvic discomfort, or lower back pain. This may be due to ovarian cysts, hormonal imbalances, or chronic inflammation linked to the condition.

Can PCOS cause painful sex?

Yes, PCOS can cause painful sex, often due to a mix of physical and emotional factors like reduced lubrication, lower sex drive, and decreased self-confidence. Symptoms such as weight gain, acne, and unwanted hair can also affect self-esteem and contribute to discomfort during intimacy.

Does PCOS cause painful periods?

Yes, PCOS can lead to heavy and painful periods caused by hormonal imbalances that thicken the uterine lining, making menstrual cramps more intense.

What does PCOS pain feel like​?

PCOS pain can feel like a dull ache or shooting pains, mainly in the pelvis and lower back.