Every time I discuss gut health and Polycystic Ovarian Syndrome with my patients, I get some funny looks.

Is there a connection between PCOS and gut health?

Well, yes. To start off, scientific studies show that our gut microbiota can give us some important answers regarding our PCOS symptoms. More specifically, gut health has many answers for those wanting to lose weight.

As perplexing as it may seem, weight loss is not just about taking in fewer calories than the ones you consume. That’s a very reductionist view of not just weight loss but also our overall health.

Anyway, lest I digress from the topic for today, let’s just cut to the chase.

Today, I want to talk to you about one of the most neglected organs in the human body: the gut.

Contemporary research is bringing new insights to the fore with regards our gut’s relationship with common ailments like diabetes, obesity, depression and even autoimmune diseases like Hashimoto’s thyroiditis.

There’s actually a saying in the medical community that the study of bacteria in the gut today is just like how the study of antibiotics in the 20^th century was such a monumental discovery.

Therefore, it shouldn’t surprise you to know that your battle with PCOS is inextricably linked with your gut health.

Understanding PCOS and Gut Health: What Is The Microbiome?

Do you know how many microorganisms reside in our bodies? 100 trillion.

You can find them anywhere from the gut, throat, skin, nose and urogenital tract. To give you a perspective of how magnanimous that number is, it’s actually 10 times more than the total number of cells in our body!

The microbiome is an umbrella term used to refer to all the fungi, bacteria, protozoa and viruses that live in our body.

These microbiomes are responsible for regulating a wide range of functions in our body. This includes digestive processes like how our food is absorbed into the bloodstream and about 75 percent of all activities taking place in the immune system.

I’m hoping all this new information is helping you let go of any presumptions regarding bacteria being bad for our health. Our health depends on bacteria—just that they should be the right kind.

The trouble with gut health in PCOS is that the number of good bacteria becomes less in comparison to the bad bacteria.

How does this happen? My objective in this article is to explain to you exactly how and why the gut microbiome balance is disrupted during PCOS and what you can do to augment this balance.

What Causes The Gut Microbiome To Fall Out Of Balance?

Consider the microbiome in your gut as a community of good citizens and some not-so-good ones. When there are too many delinquents and deviants in your community—more so than the number of peaceful dwellers in the area—there’s bound to be problems.

This is kind of how the imbalance between good and bad bacteria forms in your gut. There are many factors for this change.

Maternal Obesity at the Time of Birth:

Studies show that children whose mothers were overweight when they were born are left prone to alterations in their gut microbiome.

Birth via Caesarean Section:

A baby’s gut is basically non-existent while it lives in the mother’s womb. When the child is born, it passes through the mother’s vaginal tract and inherits the microbiome present to formulate its own gut flora. However, children who are born through C-section do not pass through the vaginal tract and therefore are prone to having serious alterations in their microbiomes as they grow older.

Not Being Breastfed as an Infant:

There has been some fascinating research in recent years that explains how infants who had almost exclusively been breastfed were the ones who had the best gut microbiome of all.

This means that those babies who were fed a combination of formula milk with breast milk or were only fed formula milk have less healthy microbiomes. Perhaps this is an indication that formula milk can disrupt the balance of good and bad bacteria.

Frequent Use of Antibiotics, Especially During Childhood:
If you have to take antibiotics for whatever reasons, know that long term use can have negative effects on your gut microbiome.

Taking Inflammatory Medication for PCOS Symptoms:

Many women choose to take birth control pills as convenient ways to regulate their menstrual cycle and promote ovulation health. However, contraceptive pills can be inflammatory and can disrupt the microbiome in your gut.

Consuming a Low Starch Resistant Diet:

Resistant starch behaves pretty much like soluble fiber and is not digested in the stomach or small intestine. This means the good bacteria in your gut starves and causes disruptions in the microbiome.

What Is the Connection between PCOS and the Gut Microbiome?

Studies show that women with PCOS have a greater number of bad bacteria and a lesser number of good bacteria. Now the real question is what triggered what; is the microbiome disrupted because of PCOS or is PCOS caused by the poor gut?

Personally, I think that it’s cyclical. You hold a greater likelihood of developing PCOS if you have a bad gut. That’s because an imbalance of bacteria causes the gut to become inflamed and prone to insulin resistance. Now we know from my previous articles that inflammation exacerbates PCOS symptoms, so we can decipher that poor gut bacteria does negatively affect PCOS.

Additionally, excess production of androgens is also known to throw the gut bacteria out of balance and that’s a key symptom of PCOS.

By the way, if you’re taking the Pill to treat your PCOS condition, let me tell you that it will not work and is only making your symptoms worse than they are.

Understanding the Link between PCOS, The Microbiome and Weight Gain

Okay, let me make this clear; the microbiome affects pretty much all of your PCOS symptoms. I’m not going to pick and choose here but since we’re on the topic of weight loss, let’s just keep our focus at that.

Studies show that the health of our microbiome directly affects our weight.

There was one study that showed how mice that were unable to keep their bad bacteria in control, had a greater appetite and were also prone to getting obese and developing insulin resistance. More interestingly, when these bad bacteria were transferred to a thin mouse, that mouse also developed obesity and was at risk of Type-2 diabetes! So it’s a really good indicator of how diabetes can emerge due to poor gut flora.

Now you might be thinking how the situation of these experimental mice applies to us humans—more specifically PCOS patients. Well, there have been plenty of such similar studies performed on humans. You can read them here and here.

The point that I’m trying to make here is that your body is extremely complex and it’s unfair to assume that weight gain has to do with calories in versus calories out. The PCOS and gut bacteria are all intertwined and stubborn weight gain is just a core symptom.

How Does Bad Bacteria Contribute To PCOS and Weight Gain?

There are 3 main ways that bad bacteria influences your PCOS related weight gain.

1. Bad Bacteria Affects the Number of Calories You Absorb From Food

Bad bacteria in the gut can significantly increase the speed at which we absorb carbohydrates and fatty acids from our food. So in a way, this is only causing you to store your food as fat.

2. Bad Bacteria Makes You Resistant to Insulin

Any time you eat, insulin is released to help break down the glucose molecules and have them absorbed into the bloodstream. However, when there’s an excess of bad bacteria in your system, the production of insulin is increased. This causes the cells to become resistant to the excess insulin hormones, eventually causing a communication breakdown and leading all glucose to become stored as fat. Nearly 70 percent of women with PCOS are diagnosed with an insulin resistance problem.

3. Bad Bacteria Makes You Leptin-Resistant

Consider leptin the opposite of insulin. Its function is to regulate the storage of fat in our bodies, distribute energy from food and ensure that we’re able to survive starvation mode.

The hormone is secreted via our fat cells and informs the hypothalamus region in the brain about our fat storage situation. According to this information, the body then speeds up or reduces the pace of our metabolic processes.

Proper functioning of the leptin hormone is important to ensure we don’t put on excess weight. The trouble is that just as how too much insulin makes our blood cells resistant to it, similarly too much bad bacteria make the hypothalamus resistant to leptin. In such a scenario, the hypothalamus can no longer detect the amount of leptin present in our blood. Hence, our metabolism slows down thinking we’re in starvation mode and increases our appetite.

Studies show that women with PCOS are prone to developing leptin resistance.

 Natural Ways to Improve Your Gut Microbiome

Dealing with PCOS can be frustrating, especially if stubborn weight gain is your core symptom. However, there is light at the end of the tunnel. I have successfully helped many women regain control of their bodies by rebalancing their gut microbiome.

Now, this is obviously easier said than done, especially if you’ve got insulin resistance. Nonetheless, here are three things I always recommend to my patients:

1. Avoid Foods and Drugs That Are Damaging Your Microbiome

As outlined above, antibiotics are bad for your gut. If you’re taking any medication to cope with inflammation (like ibuprofen) then you’re actively killing the good bacteria and making your symptoms worse. You’re also damaging the inner walls of your intestines and inducing a leaky gut.

Now, I understand that in some serious conditions, you will be required to take antibiotics but you have to learn to avoid them as much as you can. Don’t pop a pill just because you’re looking for a quick solution for your acne. Try to mold a diet where you don’t put your body on fire to begin with. Say no to gluten and dairy. For more details on how to keep a gut and PCOS friendly diet, you can read my power post article here.

2. Enjoy Probiotics and Fermented Foods

Since the problem in your gut lies in the imbalance of good and bad bacteria, you need to take up foods that improve the number of good bacteria. This rebalancing act can be accomplished if you take up some good quality probiotics or eat fermented foods (like kombucha or kimchi). Studies show that women with PCOS who regularly take probiotics are able to reduce their blood sugar levels and cope with insulin resistance. Plus, fermented foods make it easier for you to digest carbohydrates so that also keeps your blood sugar from spiking.

3. Feed Your Good Bacteria with Prebiotics

You’ve probably heard of resistant starch? It’s a prebiotic. That means it’s a carbohydrate that helps improve the good bacteria in your gut. Prebiotics are similar to probiotics in their function, but it helps to have them both be present in your gut for a maximum positive effect.

What you need to understand here is that all of your gut bacteria either lives in the colon or in the large intestine. Whenever you eat food, it goes through the stomach where it’s only partially digested. Then the food passes through the small intestine where all the vitamins and nutrients are absorbed. Whatever molecules that cannot be digested are then passed over to the large intestine.

Prebiotics are such substances that are not digested or absorbed by the small intestine. This means they’ll go straight to your large intestine and help rebalance the good bacteria levels. Some starch resistant foods you can take up include potatoes, rice and beets.

Final Word

Weight gain from PCOS might seem like an uphill battle but as research shows, the root of the problem may reside in your gut. Just follow my tips to help find the balance between your good and bad bacteria and naturally heal any inflammation, insulin or leptin resistance.

If you’re interested in working with my office, please complete these health questionnaires.

Let me know about your health condition and your personal goals so I can get to know you a bit better. Once you’ve submitted the questionnaires, my office will be sending you an email on how to get started on your path to better health, naturally.

I look forward to working with you!