PCOS and Inflammation: What the Research is Telling Us

When we think about polycystic ovary syndrome (PCOS), most people picture irregular periods, extra androgens (male hormones), or trouble with fertility. However, research over the past decade reveals another piece of the puzzle: PCOS and inflammation are closely linked.

What do we mean by inflammation?

Inflammation is part of your body’s natural defence system. It helps fight infections and aid in healing injuries. That’s good and normal inflammation.

But in PCOS, many women have low-grade, long-term inflammation, the kind that doesn’t heal you, but instead keeps your immune system slightly “switched on.” This can make maintaining hormone balance, insulin function, and even having good egg quality more challenging.

How Women with PCOS Might “Feel” This Kind of Inflammation

1. Fatigue that doesn’t match the activity level
   • Feeling tired even after adequate sleep or low physical exertion.
   • PCOS and inflammation can increase inflammatory chemicals that blunt energy metabolism and mitochondrial function.
2. “Brain fog” and low motivation
   • Difficulty focusing, slower thinking, or low drive.
   • Inflammatory cytokines can affect neurotransmitters like serotonin and dopamine, altering mood and cognition.
3. Aches, bloating, or puffiness
   • Joint or muscle stiffness, especially in the morning, or a general feeling of “heaviness.”
   • Some also notice bloating or fluid retention related to inflammatory pathways.
4. Heightened stress reactivity
   • Feeling on edge, anxious, or easily fatigued under stress.
   • Inflammation activates the stress response (HPA axis), which can create that “wired but tired” state.
5. Worsening skin or hair symptoms
   • PCOS and inflammation can exacerbate acne, scalp inflammation, or hair thinning, as inflammatory cytokines can impact hair follicles and oil glands.
6. Slower recovery from exercise or illness
   • Taking longer to bounce back from workouts, colds, or minor infections.
   • Chronic inflammation can delay tissue repair and lower immune efficiency.
7. Weight changes despite good habits
   • Inflammatory molecules (like TNF-α and IL-6) can make insulin resistance worse, leading to stubborn weight around the middle despite a healthy diet and exercise.
8. Menstrual irregularities or painful periods
   • Inflammation in the ovaries and uterine lining can alter hormone signalling and prostaglandin balance, contributing to cramps or irregular bleeding.

What studies are finding about PCOS and inflammation

Researchers have looked at thousands of women with PCOS, and here’s what they’ve noticed:

• Higher blood markers of inflammation, like C-reactive protein (CRP) and specific cytokines (chemical messengers of the immune system).
• Inflammation isn’t only about weight. Fat cells can secrete more of these inflammatory chemicals (cytokines). But even women with PCOS who are not overweight sometimes show signs of higher inflammation.
• Ovarian effects. Inflammation is often found inside the ovary and follicular fluid (the fluid around developing eggs), which may affect egg quality and ovulation.
• Stress on cells. PCOS is linked with oxidative stress. Oxidation or oxidative stress is the process that makes metal rust or an apple turn brown after you bite into it and leave it. It is an aging, damaging process. Within certain limits, it is also normal; in excess, it adds more strain on the ovaries and metabolism.

Why does this matter?

Inflammation can feed into the main problems of PCOS:

• It exacerbates insulin resistance, resulting in elevated blood sugar and insulin levels.
• High insulin levels can increase androgen (male hormone) production, leading to acne, hair changes, and irregular menstrual cycles.
• Over time, chronic inflammation raises the risk of heart disease, diabetes, and high blood pressure.

It’s a cycle: hormones can drive inflammation, and inflammation can drive hormone imbalance.

What you can do to calm inflammation

The good news? Inflammation is something you can influence. Here are some research-supported strategies:

1. Food choices matter. Diets rich in vegetables, fruits, lean proteins, nuts, seeds, olive oil, and fish (similar to a Mediterranean-style diet) are linked to lower inflammation. Ultra-processed and sugary foods can exacerbate inflammation. Food sensitivities like dairy and gluten, and others, will increase inflammation.
2. Movement helps. Regular physical activity helps lower inflammation and improve insulin sensitivity.
3. Stress management. Chronic stress keeps the immune system activated. Mind-body practices (yoga, meditation, walking outdoors) can help.
4. Sleep. Poor sleep worsens inflammation and insulin resistance. Good sleep hygiene makes a difference.
5. Targeted supplements and herbs. Some evidence suggests that omega-3 fatty acids, vitamin D, curcumin, and certain herbs may help regulate inflammation; however, these should be personalized and monitored by a healthcare professional.

What’s still unclear about PCOS and Inflammation

Scientists are still figuring out:

• Is inflammation the cause of PCOS, or a result of it?
• Which women with PCOS are most affected, and how can we test for it easily in the clinic?
• Do anti-inflammatory diets or supplements reliably improve fertility outcomes?

More research is forthcoming, but the trend about PCOS and inflammation is clear: inflammation plays a significant role in PCOS.

PCOS and Inflammation Takeaway

PCOS is more than a hormone condition. It’s also an inflammatory one. Supporting your body with anti-inflammatory foods, regular physical activity, adequate sleep, and effective stress management may not only improve your PCOS symptoms but also protect your long-term health.

PCOS and Inflammation References

Aboeldalyl S, James C, Seyam E, Ibrahim EM, Shawki HE, Amer S. The Role of Chronic Inflammation in Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis. Int J Mol Sci. 2021 Mar 8;22(5):2734. doi: 10.3390/ijms22052734. PMID: 33800490; PMCID: PMC7962967.

Su, P., Chen, C. & Sun, Y. Physiopathology of polycystic ovary syndrome in endocrinology, metabolism and inflammation. J Ovarian Res 18, 34 (2025). https://doi.org/10.1186/s13048-025-01621-6

Shang, J., Wang, S., Wang, A. et al. Intra-ovarian inflammatory states and their associations with embryo quality in normal-BMI PCOS patients undergoing IVF treatment. Reprod Biol Endocrinol 22, 11 (2024). https://doi.org/10.1186/s12958-023-01183-6

Padder, K.A., Jahan, N., Yousuf, M.A. et al. Deciphering the interplay between oxidative stress and inflammation in polycystic ovary syndrome: outcome of a case-control study. J Ovarian Res 18, 196 (2025). https://doi.org/10.1186/s13048-025-01734-y