ASSOCIATION BETWEEN INSULIN RESISTANCE STATUS AND PERSISTENT ABDOMINAL BLOATING IN WOMEN WITH POLYCYSTIC OVARY SYNDROME

Abstract

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age worldwide. It is linked to reproductive, endocrine and metabolic changes such as hyperandrogenism, ovulatory dysfunction, obesity and insulin resistance. One of these manifestations has been postulated to be attributable to insulin resistance as a shared pathogenic mechanism. Whereas abdominal bloating and constipation are undoubtedly a common complaint among women with polycystic ovary syndrome (PCOS), they have received far less attention. Recent data suggests intestinal dysbiosis, inflammation and/or hormonal secretion may also be involved in the gastrointestinal dysfunction seen in this population. Objective: Perform systematic review of recent evidence on insulin resistance and chronic abdominal bloating among women with PCOS - potential associated patho-physiological mechanisms. Methods: A narrative review was performed based on published literature derived from PubMed, Scopus, Web of Science and Google Scholar covering the years 2020 to 2026. Inclusion criteria were restricted to studies on: insulin resistance; gut microbiota; metabolic syndrome; gastrointestinal symptoms in women with PCOS; obesity and inflammatory markers. Results: We had enough evidence that insulin resistance keeps supporting the below states (hyperinsulinemia, visceral adiposity, chronic low-grade inflammatory state, gut microbiota composition and intestinal permeability changes). All of these should have an effect on gut motility but also lead to things like abdominal distension. Although studies directly assessing the role of insulin resistance in sustained abdominal distension phenomena among women with PCOS are still lacking, there is supporting biologically plausible evidence. Conclusion: Several integrated metabolic and gastrointestinal pathways may underlie sustained abdominal distention in women with PCOS, a major contributing factor being insulin resistance. Causality and which therapeutic targets act effectively requires future prospective mechanistic studies. Conclusion Therefore, the core factors of abdominal bloating in women with PCOS are early screening to prevent metabolic syndrome and improved preventive measures for gut dysbiosis, hyperinsulinemia and insulin resistance leading to a fuller consideration of women's health.