Up to five million women in the U.S. have Polycystic Ovary Syndrome (PCOS), but this condition remains frustratingly difficult to diagnose and treat. One study found that 70% of women with PCOS haven’t been diagnosed, so they continue to experience debilitating symptoms.
With a wide range of symptoms, PCOS can have a profound influence on a woman’s life. In fact, studies have found a high incidence of anxiety and depression among women with PCOS.
The health of our gut microbiome– the trillions of living organisms found in the intestine– plays a large role in overall health. This is especially true for women dealing with Polycystic Ovary Syndrome. Conventional treatments often fall short in treating PCOS and any treatment plan for PCOS must take into consideration gut health among many other hormone-balancing solutions.
Let’s take a look at the connection between PCOS and gut health and ways to manage and treat this condition naturally to get back to feeling your best.
What Is PCOS?
PCOS is a complicated hormonal condition that affects women’s ovaries, causing them to produce an excess of androgens, or male hormones. This can lead to a variety of symptoms such as:
- Cysts in the ovaries
- Irregular menstrual cycles
- Insulin resistance
- Thinning hair on the scalp
- Excess face & body hair
- Chronic inflammation
- Obesity & weight gain
PCOS is the leading cause of infertility in women. It can also lead to numerous serious health problems like diabetes, heart disease, and high blood pressure.
Traditional treatment usually involves starting hormonal birth control to “balance” hormonal levels. However, this tends only to mask the condition and overlooks the crucial importance of gut health. As soon as women stop taking the pill, symptoms can reappear worse than before.
Studies have found that women with PCOS have a different gut microbiome composition than those without the condition. Making changes to improve your gut health can therefore have a huge impact on PCOS symptoms and your physical and mental well-being.
What Causes PCOS?
There is no clear cut answer as to why some women develop PCOS. Many factors can contribute – including your genetics and your environment. One of the leading theories is that PCOS can be caused by an imbalance in the gut microbiome.
What is the gut microbiome?
There are many types of bacteria living in our gut. Most are beneficial strains of bacteria that help produce essential vitamins, regulate our immune system, impact metabolism, alter hormone levels, muscle strength and even regulate our mood.
A diverse gut microbiome with the proper balance of good and bad bacteria is optimal for health. However, when there is an imbalance of good and bad bacteria, this is referred to as dysbiosis.
How is gut dysbiosis linked to PCOS?
Women with PCOS are shown to have higher rates of dysbiosis and less diversity in the gut microbiome than those without the condition. They present higher levels of harmful bacteria which contribute to inflammation and metabolic dysfunction.
An excess of bad bacteria leads to inflammation in the body, which can then increase insulin levels in the blood. Excess insulin then triggers an increase in androgen production from the cells of the ovaries.
Restoring The Gut Microbiome To Treat Symptoms Of PCOS
Now that we have explored the link between gut imbalance and PCOS, it is time to focus on some of the ways you can promote gut health. The good news is that small tweaks to your diet and lifestyle can improve the functioning of your gut in as little as 24 hours. Some simple steps include:
1 – Eat more fiber.
A diet rich in fiber is highly beneficial for supporting the good bacteria in the gut. The recommended amount of fiber for women is 25 grams per day, which can be found in plant foods like beans, lentils, vegetables, and whole grains.
2 – Increase prebiotics + probiotics in the diet.
Prebiotics are non-digestible, fermentable components of foods that help kick start digestion and promote beneficial gut bacteria. They have also been shown to help reduce insulin resistance and lower androgens. They are found in foods like garlic, onion, bananas, and apples.
Probiotics are found in fermented foods. They contain live bacterias that help your gut microbiome flourish. They can be found in foods like tempeh, kimchi, sauerkraut, and yogurt, and are also available in supplement form. There are many different kinds of probiotic supplements, with varying degrees of effectiveness, so it’s important to work with a practitioner to determine the best one for you.
3 – Avoid artificial sweeteners.
Artificial sweeteners are known to have a harmful effect on the gut microbiome and can worsen insulin resistance. Opt for natural forms of sweeteners such as raw honey, maple, or date syrup.
4 – Sleep more.
Lack of sleep causes a great deal of stress to the body, which can in turn promote inflammation and gut dysregulation. Sleep also factors in how our body is able to handle blood sugars by altering insulin levels. You should aim to get at least 7-9 hours of sleep per night. This might mean adjusting your sleep hygiene, by avoiding caffeine and limiting screen time before bed.
5 – Manage stress.
Researchers have found a link between psychological stress and dysbiosis. While reducing stress in your life can feel sometimes like an impossible task, develop ways to manage it. For example, you could take a close look at the stressors surrounding you, and work to create boundaries to protect your peace of mind. Relaxing activities like yoga, meditation, and walks in nature also help.
6 – Exercise regularly.
Exercise helps with sleep and stress, and studies show it can actually improve the state of your microbiome. Moderate exercise can reduce inflammation and improve biodiversity in your gut. However, it’s important not to overtax your body, which can lead to harmful cortisol production. Steady state cardio, strength training, and mobility training can be the foundations to a good routine, but don’t hesitate to get some guidance if you’re not sure where to start.
Many areas of health, including your hormonal health, begin in the gut. For women with PCOS, maintaining gut health is especially important and can help alleviate unwanted symptoms and prevent serious health issues.
Eating a variety of whole foods, avoiding artificial sweeteners, and prioritizing sleep are a few simple steps women with PCOS can take to optimize the diversity of their gut microbiome and overall health. If you have any questions on the best treatments for PCOS, please give me a call!
Centers for Disease Control and Prevention, “PCOS and Diabetes” https://www.cdc.gov/diabetes/basics/pcos.html
Balikci A, Erdem M, Keskin U, Bozkurt Zincir S, Gülsün M, Özçelik F, Akgül EÖ, Akarsu S, Öztosun M, Ergün A. Depression, Anxiety, and Anger in Patients with Polycystic Ovary Syndrome. Noro Psikiyatr Ars. 2014 Dec;51(4):328-333. doi: 10.5152/npa.2014.6898. Epub 2014 Dec 1. PMID: 28360650; PMCID: PMC5353166.
Guo Y, Qi Y, Yang X, Zhao L, Wen S, Liu Y, Tang L. Association between Polycystic Ovary Syndrome and Gut Microbiota. PLoS One. 2016 Apr 19;11(4):e0153196. doi: 10.1371/journal.pone.0153196. PMID: 27093642; PMCID: PMC4836746.
González F. Inflammation in Polycystic Ovary Syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids. 2012 Mar 10;77(4):300-5. doi: 10.1016/j.steroids.2011.12.003. Epub 2011 Dec 8. PMID: 22178787; PMCID: PMC3309040.
Ojo O, Feng QQ, Ojo OO, Wang XH. The Role of Dietary Fiber in Modulating Gut Microbiota Dysbiosis in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Nutrients. 2020 Oct 23;12(11):3239. doi: 10.3390/nu12113239. PMID: 33113929; PMCID: PMC7690692.
Harvard Health, Should I be eating more fiber? https://www.health.harvard.edu/blog/should-i-be-eating-more-fiber-2019022115927
Dana Withrow, Samuel J. Bowers, Christopher M. Depner, Antonio González, Amy C. Reynolds, Kenneth P. Wright, Sleep and circadian disruption and the gut microbiome-possible links to dysregulated metabolism, Current Opinion in Endocrine and Metabolic Research, Volume 17, 2021 Pages 26-37, ISSN 2451-9650,
Qin HY, Cheng CW, Tang XD, Bian ZX. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol. 2014 Oct 21;20(39):14126-31. doi: 10.3748/wjg.v20.i39.14126. PMID: 25339801; PMCID: PMC4202343.
Clauss M, Gérard P, Mosca A, Leclerc M. Interplay Between Exercise and Gut Microbiome in the Context of Human Health and Performance. Front Nutr. 2021 Jun 10;8:637010. doi: 10.3389/fnut.2021.637010. PMID: 34179053; PMCID: PMC8222532.