Polycystic Ovarian Syndrome (PCOS) is a complex metabolic-endocrine condition. If you have PCOS, you may have tried several things to manage this frustrating condition and its symptoms. I have highlighted many strategies for managing PCOS in my other blog posts, but this article focuses on the connection between PCOS and gut health.
I am a Halifax dietitian specialized in women’s health. After reading this blog post you will understand:
How PCOS and gut health are connected
What the best probiotic for PCOS gut health is
How to improve gut health in PCOS
How to manage PCOS and gut issues, such as SIBO and PCOS & leaky gut and PCOS
Let’s jump in and talk more about how your gut health may be playing a role in your PCOS symptoms.
What is PCOS?
Polycystic Ovarian Syndrome (PCOS) is a complex hormonal disorder that affects approximately 5-10% of women of reproductive age. It is characterized by a combination of symptoms such as irregular periods, weight gain, acne, excess hair growth on the face and body, thinning hair on the scalp, and infertility. PCOS is the leading cause of infertility in women and can also lead to health conditions like type 2 diabetes, heart disease, and hypertension.
Because there is no cure for PCOS, the symptoms are managed through diet, physical activity, medication, and dietary supplements. Most people with PCOS are followed by a team that includes a medical doctor (often an endocrinologist) and a dietitian.
Reach out to me if you are looking for a nutritionist in Halifax or a Canada dietitian. I can point you in the right direction.
What causes PCOS?
There is no one cause for PCOS. Instead, many factors contribute to its development.
PCOS is believed to be influenced by a combination of genetic, environmental, and lifestyle factors. Insulin resistance and hormonal imbalances, including elevated levels of androgens such as testosterone, are considered primary contributors to the development of PCOS.
A relatively new hypothesis in the world of PCOS research is that an imbalance of microbes in the gut can trigger the onset of PCOS.
What is the gut microbiome?
There are approximately as many bacterial cells in the human body as there are human cells. These bacteria live on our skin, in our digestive tract, in the vagina, and in the respiratory tract. Together, these bacteria are referred to as the microbiota, or microbiome.
The gut microbiome refers to the complex community of microorganisms that lives within our digestive system, most often the colon. Most of these microorganisms live in symbiosis with us and play a crucial role in digestion, immune function, and the production of essential vitamins and neurotransmitters. In PCOS, the gut microbiome is important for balancing insulin, managing inflammation, and regulating appetite.
When there is an imbalance between good and harmful bacteria, this is referred to as dysbiosis. Dysbiosis can be characterized by any combination of:
Overgrowth of certain bacteria (SIBO)
Low amounts of ‘good’ bacteria
Low diversity of bacterial species in the gut microbiome
How are PCOS and gut health related?
Studies have shown that women with PCOS have dysbiosis and less diverse gut bacteria than women without PCOS. Increased intestinal permeability (leaky gut) and small intestinal bacterial overgrowth (SIBO) have also been observed in women with PCOS.
This is bad news, as dysbiosis of the gut microbiome in PCOS is related to the development of insulin resistance, acne, hair loss, weight gain, chronic inflammation, and metabolic syndrome.
Interestingly, it has been shown that good gut health can actually regulate androgens and help with symptoms of hyperandrogenism, such as acne and weight gain.
How to improve PCOS gut health
Your gut health is heavily influenced by what you eat, what medications you take, and your lifestyle habits.
Here are some gut friendly foods and tips on how to improve gut health with PCOS:
1. Eat gut friendly foods: Focus on consuming a variety of whole foods, including fruits, veggies, whole grains, lean proteins, and healthy fats. A combination of all these foods promotes a diverse gut microbiome.
2. Fiber, fiber, fiber: The bacteria in your gut looooove fiber. In this context, fiber is also known as ‘prebiotic’ because it serves as foods for the microbiome organisms. Include prebiotic-rich foods like whole grains, fruits, and veggies, which serve as fuel for your beneficial gut bacteria.
3. Eat probiotic-rich foods daily: Incorporate fermented foods into your diet, such as yogurt, kefir, sauerkraut, kimchi, and kombucha. These foods contain beneficial live bacteria that can help restore and maintain a healthy gut microbiome. Probiotics and PCOS should go hand-in-hand!
4. Consider probiotic supplementation: Consult with a healthcare professional (like a registered dietitian) about the use of probiotic supplements. Certain strains, such as Lactobacillus acidophilus, Bifidobacterium lactis, and Lactobacillus rhamnosus, have shown potential benefits for individuals with PCOS.
5. Minimize processed and high-sugar foods: Highly processed foods and excessive sugar intake can disrupt the balance of gut bacteria and contribute to inflammation. Limit your consumption of refined carbohydrates, sugary beverages, and artificial additives as much as you can, while also fostering a healthy relationship with food.
6. Manage stress: Chronic stress can negatively impact gut health in PCOS. Incorporate stress management techniques such as regular exercise, mindfulness practices, and sufficient sleep to support a healthy gut.
7. Stay hydrated: Drinking an adequate amount of water is essential for maintaining good gut health. Water helps to maintain healthy bowel movements and supports digestion.
8. Exercise regularly: Regular physical activity has been shown to positively influence gut health. Engaging in moderate-intensity exercise can help improve digestion, promote bowel regularity, and support overall gut function. See my blog post on exercise in PCOS.
9. Avoid unnecessary antibiotic use: This is a major tip that dietitians often forget to mention. Antibiotics disrupt the balance of gut bacteria. Use antibiotics only when necessary and work with your healthcare provider to explore alternatives or strategies to minimize the impact on the gut microbiome.
10. Seek professional guidance: Consult with a healthcare professional or a registered dietitian with experience in gut health and PCOS to create an individualized plan that suits your specific needs. Contact me if you need a dietician[SLB1] in Halifax.
Best probiotics for PCOS
Probiotics are live and active bacteria found in fermented foods. They can be found in some foods such as yogurt, kefir, sauerkraut, kimchi, and kombucha, and are also available in supplement form.
There are many kinds of probiotics with varying degrees of trustworthiness. When choosing probiotics for PCOS, pay close attention to the dose, colony-forming units (CFUs), storage information (most need to be refrigerated), and species. My general recommendation is to choose probiotic products with at least 1 billion (or, 109) colony-forming units of Lactobacillus, Bifidobacterium, Bacillus or Saccharomyces boulardii, species.
For example, regular Activia yogurt contains 109 CFUs of Bifidobacterium per serving, making it a great probiotic for PCOS. Overall, the best probiotic for PCOS is one that is trustworthy, that you enjoy, and that you can have every day.
Leaky gut and PCOS
Leaky gut is a condition that is not officially recognized as a medical diagnosis. It is derived from the idea of increased intestinal permeability, which is observed in certain gastrointestinal disorders. The concept suggests that in leaky gut, bacteria and undigested food particles may pass through the intestinal lining into the bloodstream, potentially leading to inflammation and playing a role in hormonal imbalances.
Studies have shown that markers of gut permeability are not any different in PCOS. Nonetheless, recommendations to support PCOS gut health remain the same. It’s essential to consume a nutrient-rich diet and minimize processed foods.
SIBO and PCOS
Small Intestinal Bacterial Overgrowth (SIBO) occurs when there is an overgrowth of bacteria in the small intestine, leading to digestive symptoms and nutrient malabsorption. Symptoms of SIBO range from mild to severe, with chronic diarrhea, weight loss, and malabsorption. The only way to know if you have SIBO is to be tested and diagnosed by a medical doctor.
SIBO is connected to irritable bowel syndrome but has also been observed in people with other conditions like PCOS. Managing SIBO involves working with a medical professional to address underlying gut dysbiosis through targeted antimicrobial therapy, followed by dietary modifications, such as reducing fermentable carbohydrates (FODMAPs) that can feed the overgrowth.
As a general guideline, most people with PCOS do not need to be concerned with SIBO.
How do you fix PCOS gut health?
Your PCOS gut health is heavily influenced by what you eat, what medications you take, and your lifestyle habits. Eat gut friendly foods, have a daily source of probiotics, minimize processed and high-sugar foods, and manage your stress.
Does poor gut health cause PCOS?
There is no one cause for PCOS. Instead, many factors contribute to its development. A relatively new hypothesis in the world of PCOS research is that an imbalance of microbes in the gut can trigger the onset of PCOS.
Which probiotic is best for PCOS?
The best probiotic for PCOS is one that is trustworthy, that you enjoy, and that you can have every day. My general recommendation is to choose probiotic products (whether it be foods or supplements) with at least 1 billion (or, 109) colony-forming units of Lactobacillus, Bifidobacterium, Bacillus or Saccharomyces boulardii, species.
How should I manage PCOS and gut issues?
PCOS gut problems like diarrhea, constipation, and bloating, are really frustrating. If you live in Nova Scotia Canada, work with a Halifax dietitian specialized in women’s health to solve your PCOS and gut issues.