The Link Between PCOS and Gut Health

As a gut health Dietitian, I’ve worked with many women who struggle with Polycystic Ovary Syndrome (PCOS), a hormonal disorder that affects approximately 1 in 10 women of childbearing age. 

Managing PCOS can be a challenging experience (if you know, you know), and you may have tried various approaches to deal with this frustrating condition. However, an important topic that often gets overlooked is the connection between PCOS and gut health.

That’s why in today’s blog, I will be exploring the connection between PCOS and gut health, including how gut health impacts PCOS and tips for supporting gut health in women with PCOS. Whether you have been diagnosed with PCOS or are simply interested in improving your gut health, this post will provide you with valuable information and practical strategies to support your overall health and well-being. Let’s dive in!

What is PCOS? 

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that affects many women of reproductive age. It is a complex condition that involves the endocrine system, which is responsible for producing hormones that regulate various bodily functions. 

PCOS can cause a range of symptoms including: 

• Infertility
• Irregular or absent menstrual cycles
• High levels of androgens or “male” hormones, which may cause symptoms like acne, facial hair growth and head hair loss
• Insulin resistance (thought to be a primary driver or “root cause” in PCOS)
• Vitamin and mineral deficiencies
• Chronic low grade inflammation
• Pregnancy complications like gestational diabetes or high blood pressure 
• Obesity
• Sleep apnea
• Elevated cholesterol levels and heart disease

While the exact causes of PCOS are not fully understood, research suggests that it may be related to insulin resistance, inflammation, and genetic factors. Additionally, a new theory is currently being explored by scientists and researchers across the globe —is the theory that an imbalance of microbes in the gut can trigger the development of PCOS.

How are PCOS and gut health related?

The gut microbiome is made up of trillions of microorganisms that live in our digestive tract, and it plays a crucial role in maintaining our overall health and well-being. When the balance of microbes in the gut is thrown off, this can lead to a range of health problems, including inflammation, immune dysfunction, and hormonal imbalances. And as we now know, these are all hallmarks of PCOS. This imbalance between the ratio of good and harmful bacteria, is referred to as dysbiosis.

Studies have shown that women with PCOS have an altered gut microbiome compared to women without PCOS.[1] Specifically, women with PCOS tend to have higher levels of harmful bacteria and lower levels of beneficial bacteria in their gut. This dysbiosis can trigger the development of PCOS by altering the production and metabolism of hormones, such as estrogen and androgens, in the body.[2] In addition, the complications associated with PCOS (obesity, insulin resistance, etc.) may lead to worsening dysbiosis, further complicating things.

Tips for supporting gut health and PCOS

While all the talk about poor gut health may seem a little scary, there is good news! There are plenty of simple steps you can take to promote a healthy gut, restore balance to your microbiome, and ultimately support the management of your PCOS. Here are some tips to start with:

1. Consume more fiber. The human body can’t digest fiber, but rather it passes through the digestive system, carrying with it harmful bacteria and cholesterol for elimination. Consuming fiber can be beneficial for gut health as it can ferment into short-chain fatty acids, promoting the growth of beneficial microbes and reducing inflammation. By including fiber in your diet, you can support the growth of healthy gut microbes and improve your overall health!
2. Add more probiotics to your diet. Probiotics are "friendly bacteria" that can assist in restoring balance and maintaining a healthy gut microbiome, thereby preventing or addressing dysbiosis. Additionally, probiotics aid in proper digestion and nutrient absorption, boost the immune system, and potentially reduce inflammation in the digestive tract. You can find probiotics from natural food sources, such as yogurt with live and active cultures, kefir, kombucha, as well as a variety of fermented vegetables like kimchi, miso, pickles, and sauerkraut.
3. Add more prebiotics to your diet. Prebiotics are foods that feed these beneficial bacteria. These special types of fiber are not easily broken down by digestive enzymes and pass through the small intestine to reach the colon, where they help to stimulate the growth and activity of beneficial gut bacteria. Garlic, onion, asparagus, artichokes, under-ripe bananas, and apples are all great sources of prebiotics. For optimal gut health, it's recommended to incorporate a combination of prebiotics and probiotics into your daily diet.
4. Reduce inflammatory foods. Certain foods can increase inflammation in the body and worsen gut health, including processed foods, refined sugar, and saturated fats. Try to limit or avoid these foods as much as possible.
5. Choose anti-inflammatory foods instead. Since PCOS is linked to chronic low-grade inflammation, incorporating foods that help reduce inflammation into your diet can be beneficial. Some examples of anti-inflammatory foods include turmeric, berries, green tea, red grapes, tomatoes, and cruciferous veggies like broccoli, cauliflower, and brussels sprouts. Fatty fish such as salmon, sardines, and tuna are also a great source of omega-3 fatty acids, which can help reduce inflammation as well.

Bottom Line: The gut microbiome plays a crucial role in the development and management of PCOS. By taking steps to support our gut health through diet and lifestyle changes, we can take an active role in managing our symptoms and improving our overall health and well-being. Remember, you are not alone, and if you need extra support, apply to work with me here! 

References: 

1. Rizk, M. G. (2020, November 16). Intersection of Polycystic Ovary Syndrome and the Gut Microbiome. Nih.gov.
2. Torres, P. J., Siakowska, M., Banaszewska, B., Pawelczyk, L., Duleba, A. J., Kelley, S. T., & Thackray, V. G. (2018). Gut microbial diversity in women with polycystic ovary syndrome correlates with hyperandrogenism. The Journal of Clinical Endocrinology and Metabolism, 103(4), 1502–1511.