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Bloating is something that most people (men and women) will experience at some point in their lives. It is regularly associated with the digestive system and its emergence can be attributed to things such as constipation, eating too much or an underlying health condition that is linked to digestion.

Displaying symptoms of bloating is harmless enough in itself, providing that these disappear after a few days and follow a clear pattern. There are times, however, that this seemingly innocuous symptom is caused by something that is developing within the body which could be an indication of something more serious that requires medical intervention, particularly in women. 

What is bloating? 

Bloating can describe the phenomenon of the stomach appearing swollen and a general feeling of fullness or discomfort after eating. This can also be accompanied by moderate to severe abdominal pain. Often, women feel their clothes have become tighter around the waist. 

Non-gynaecological reasons for bloating

The most frequent causes of bloating are said to be things such as trapped gas, indigestion and incomplete bowel movements (constipation) – and these are symptoms commonly experienced by those with irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). Change of diet, international travel and viral illness can all cause these symptoms transiently resolving in most cases after only a few days.  

Gynaecological reasons for bloating

Bloating may also be associated with hormonal changes. Progesterone and progestogen (a manufactured type of progesterone) hormones cause the muscle of both the womb (in preparation for a potential pregnancy) and the bowel to relax. The consequence of this is that the contents of the bowel move significantly more slowly, allowing it to ferment and creating gas which distends the bowel. This causes swelling and bloating in the abdomen and can often result in constipation. In the majority of cases, this is temporary and resolves after menstruation. Progesterone contraceptives can sometimes be associated with low-grade chronic bloating. 

In some instances, persistent bloating cannot be explained by issues of digestion or hormonal change and may be a sign of an underlying gynaecological problem. 

For instance, women suffering from endometriosis frequently report bloating as a symptom of their illness. Endometriosis is a condition which is associated with tissue from the lining of the womb growing in other areas of the body, most commonly in the pelvic tissues such as on the ovaries or pelvic coverings (peritoneum). It can also directly affect the bowel. When a woman menstruates, these tissues also break down and bleed which is associated with inflammation and varying degrees of pain.

Ovarian cysts may also be associated with bloating. The majority of ovarian cysts are benign, however, ovarian cancer may cause the ovaries to enlarge and symptoms of bloating. Ovarian cancer most commonly affects women over the age of 50 and has been known to demonstrate a host of stomach-based symptoms, including bloating, feeling full more quickly and abdominal swelling and altered bowel habits.

Advice from an expert

Persistent bloating can be a cause for concern and requires further investigation in order to rule out something serious or to determine the existence of another underlying medical condition. As an expert in gynaecology, Mr Francis Gardner has dedicated his career to gaining an enormous knowledge in the assessment and treatment of both benign and cancerous gynaecological conditions, so he is able to help women of all ages to gain a better understanding of the issues affecting them.

Book your consultation or a One Stop See and Treat assessment with Mr Gardner today to identify the underlying cause of your problems. In the majority of cases, he will be able to reassure you and put your mind at ease. If you are suffering from a serious underlying problem, he can perform all the necessary investigations and treatments in a timely manner in order to ensure you return to good health at the earliest opportunity.



Bloating is a physical reaction commonly experienced by people of all genders and ages. Bloating can often be harmless enough, but medical attention should be sought if this is progressive or persistent or occurring with increased regularity or causing you substantial pain.

Those who bloat regularly can prevent this by working out which foods have this effect on them. This can reduce discomfort and pain if the reason for your bloating is linked to your digestive system. A review of any medication you take, particularly contraception or hormone replacement therapy (HRT), may lead to significant improvement in symptoms.


Those with endometriosis often suffer from significant pelvic pain both during and outside of their normal monthly menstrual period. Women suffering with ovarian cancer may have these symptoms but may also have loss of appetite or needing to go to the toilet more often, periods of nausea, back pain and regularly feeling tired.

A consultation with a thorough assessment of the symptoms presented is essential. Further investigation may be required, and these can include pelvic and abdominal examinations, ultrasound assessments, blood tests and biopsies. In some cases, initial investigations may lead to further assessments such as with MRI or CT scans and in a minority of cases a laparoscopic assessment with the support of a general anaesthetic. If these tests are required, Mr Gardner will explain these to you in detail and guide you through these assessments each step of the way. 

In rare cases where cancer is suspected, this will be discussed at a gynaecological cancer multidisciplinary meeting to ensure the best possible and most appropriate treatment is offered.