Gut Health and PCOS

Dr. Gayathri
October 11, 2023
5 minutes

PCOS is widely known as an endocrine (hormonal) disorder whereas it should primarily be considered as a metabolic syndrome. OK! But why?

PCOS is something commonly seen in women of reproductive age group, but it is something which stays within and transforms into various conditions in various stages of life. The Commonest being Diabetes Mellitus and the rarest could be Endometrial Cancer. So it’s high time we shift the focus from PCOS being just a hormonal disorder and look at the broader canvas.

What is a metabolic syndrome?

They are a cluster of conditions that can increase your risk of developing heart diseases, diabetes mellitus and stroke. PCOS already shows certain symptoms of metabolic syndrome such as features of insulin resistance, obesity etc.

Apart from features of sub fertility, some complications of PCOS includes:

  • Irregular menstrual cycles (delayed, heavy, absence)
  • Acne, Facial Hair Growth, Visceral Obesity, baldness (excess androgen features)
  • Insulin resistance
  • Vitamin and mineral deficiencies
  • Sleep Apnea
  • Chronic inflammatory state
  • Pregnancy Complications - Gestational Diabetes, PIH
  • Elevated Cholesterol levels and high risk of heart disease

We all know that PCOS is caused due to certain genetic factors which is supported by environmental factors.

Apart from that one less explored area but something very relevant in this scenario is your gut health.

Recent studies have proven that Human body is an ecosystem in itself, which means it is home for varied communities of microbes including viruses, protists, bacteria, archaea and fungi. Gut is the most important area which carries most varied microbiome. These microbiome has different purposes, they can be essential to maintain optimum health whereas some of it can also cause diseases.

This microbiome flora (micro-organisms that live in the gut) is something which develops in the first 3 years of life and is unique for each individual. The imbalance or maladaptation of this microbiome in the gut is know as dysbiosis. Dysbiosis leads to an impaired gut or leaky gut syndrome.

Common reasons for dysbiosis are -

  • Junk food or food cooked in low quality vegetable oil
  • Daily use of gluten
  • Having dairy when your gut is sensitive to it (most people suffer from this!)
  • Over consumptions of refined sugar
  • Alcohol consumption
  • Frequent infections - bacterial or virus
  • Having fishes with high metal content
  • Constant stress or no enough time to relax

When you indulge in poor quality food for a longer period, ratio of good to bad bacteria decreases to such an extent that bad bacteria starts compromising the integrity of gut lining which allows the permeability of larger molecules into the blood stream creating various disease response.

Relation between leaky gut and PCOS

There are studies which shows that in comparison to women without PCOS, women with PCOS have dysbiosis in the gut, they have less diverse species innately which makes it favourable for disease progression. Another study claims higher level of androgens, lower the gut bacterial diversity in PCOS. Insulin resistance and obesity associated with PCOS worsens the gut dysbiosis and cause further complications. 2 biochemical factors seen in almost all women with PCOS is insulin resistance (metabolic syndrome) and chronic state of inflammation. Many studies agree that gut microbiome and metabolic syndrome has a connection.

However, Bad bacteria causes chronic inflammatory response, and when these inflammatory promoting factors enters the blood stream, they inactivate insulin binding receptors. Increased blood insulin and inflammatory promoting factors secrete more androgens. High insulin levels also allows more bioavailable testosterone to freely move in the body. All these can cause PCOS or aggravate PCOS symptoms.

What can women with PCOS do?

A proper lifestyle and diet is what helps the most, latter being the most important one, as it helps in balancing the gut microbiome. A healthy diet by including more wholesome plant based diet, avoid alcohol, high fibre diet. Gut microbiome has the ability to ferment fibre rich food and thus flourishing the microbiome.

Including fermented vegetables, butter milk etc helps as they are good source of probiotic. Probiotic enhance digestion and absorption of nutrients, reduce inflammation in digestive tract and boosts the immune system.

PCOS and gut health can equally be managed by doing stress management effectively, stop consuming refined sugar and sufficient sleep.

Imbalance in the gut microbiome is closely associated with PCOS, therefore improving the gut health is vital in the management of PCOS and increasing fertility.