PCOS and gut health

PCOS has 4 root causes, insulin resistance, inflammation, gut health, and hormonal. Unfortunately doctors always ignore gut health. Whereas, new research is showing us it could actually be the key of getting your PCOS under control.

We know for a fact that women with PCOS have a different gut microbiome to women without PCOS. So much so that recent studies have shown that the gut microbiome may actually be responsible for many of the symptoms that go hand in hand with PCOS.

Gut microbiome and PCOS

What is PCOS?

Polycystic Ovarian Syndrome or “PCOS” is a metabolic disorder that affects the whole body and is estimated to affect 15% of women worldwide.

Some symptoms of PCOS include:

  • Irregular or absent menstrual cycles

  • No ovulation
  • High levels of “male” hormones (androgens) cause the typical PCOS symptoms of acne, hirsutism, and male pattern baldness.

  • Insulin resistance

  • Several vitamin and mineral deficiencies

  • Chronic inflammation

  • Joint pain
  • Eczema and psoriasis
  • Obesity

  • hearing loss
  • Sleep apnea

  • Elevated cholesterol levels and heart disease

  • Increased risk of endometrial cancer

How are PCOS and gut health-related?

Let’s start with understanding what gut health is.

The gut microbiome

Our gut is the home to billions of microbes ranging from bacteria to viruses, fungi, and also parasites.  The more diverse your microbiome the healthier your gut is.

Just like a football team, the most successful team isn’t the one with 12 great goalkeepers but the team with a range of skills to provide balance. Having a more diverse microbiome increases our resilience to infection. This is similar to a large garden: if you have all the same flowers planted and a virus comes along that affects that flower it can literally wipe out the entire garden. On the other hand, if you have different varieties of flowers, it is much less likely that one disease has enough ‘weapons’ to kill them all. The same goes for your microbiome.

Some of the roles of the microbiome include:

  • Digestion of food

  • Absorption of nutrients
  • Training our immune system.
  • Producing important molecules that strengthen the gut barrier and may help balance blood sugar, lower blood fats, regulate appetite, facilitate communication with the brain and ultimately help prevent many diseases.
  • Communicates with our other vital organs, including our brain, liver, and heart.
  • Managing inflammation

  • Producing vitamins

  • Metabolizes medication and deactivates toxins
  • Balancing hormones

  • Producing neurotransmitters that impact mental health

When there is an imbalance between the ratio of good and harmful bacteria, this is referred to as dysbiosis. This can lead to a variety of health complications. Studies have shown that, in fact, women with PCOS have gut dysbiosis and less diverse gut bacteria than women without PCOS, which may contribute to symptoms and disease progression.

Intestinal permeability

This is a fancy term that refers to how intact the gut barrier lining. Imagine that a healthy gut lining is like a closed fist with almost no gaps in it. This lining protects our body against harmful toxins. When the gut lining becomes damaged, it becomes like an open hand with spread-out fingers. There are many gaps in the lining now which allow these harmful products to enter.

Both dysbiosis and increased intestinal permeability are known to be present in PCOS. The oral contraceptive pill and metformin have been shown to make the gut microbiome worse and contribute to this permeability. Yet most conventional doctors make use of them in PCOS.


  • Constipation
  • Bloating
  • Diarrhoea
  • Skin issues like eczema, acne, and rosacea

  • Irregular bowel movements

  • Food sensitivities and intolerances

  • Nutrient deficiencies, which can be diagnosed by lab work.

  • Mood disorders like anxiety and depression

Tips for supporting gut health in PCOS

There are actually many things you can do to help improve your gut health and ultimately help manage your PCOS.

Add more fibre to your daily diet.

We find fibre in vegetables, fruits, grains and legumes. Including enough fibre in your daily meals is essential for supporting your gut microbiome.

Add Probiotic-rich food into your diet

I like to think of probiotics as “friendly bacteria”. They can help improve the balance of your gut microbiome. You can find probiotics in natural and fermented food. Yoghurt is one of my favourite ways of adding live bacteria into my days. Fermented foods like kefir, kombucha, kimchi, miso, and nato are all great sources of these friendly bacteria. A probiotic supplementation is also an option, but it’s best to talk to a trusted healthcare provider to help determine which supplement is best for you.


Antioxidants and anti-inflammatory foods.

We know that poor gut health leads to inflammation. Because PCOS is associated with chronic low-grade inflammation, eating foods that help reduce inflammation can be extremely helpful. This includes herbs and spices like turmeric. As well as colourful fruit and vegetables.

Be mindful of added sugar

Excessive added sugar intake can promote inflammation in the body and contribute to dysbiosis. Many times we don’t realise how much-added sugar we are actually consuming. So make sure to read labels especially of drinks, yoghurts, sauces and salad dressings.

Stress management.

We have all experienced effects in our tummy coming from stress. Studies show that stress can alter the gut microbiome, cause the gut to become more permeable, and impact gut sensitivity. Stress management looks different for everyone but some ideas include gentle exercise, meditation, breathwork, journaling, reading, and setting boundaries so you have time for this self-care daily.


Incorporate more sleep.

Not sleeping enough is a significant stressor on the body, which also harms the gut.  Therefore making sure you get at least 7-9 hours of sleep each night is essential. You can do this by setting a consistent bedtime, avoiding caffeine after 4 pm, and setting up your bedroom to support a comfortable sleep environment.

If you want to learn more about gut health and PCOS my 10 week PCOS Blueprint group program.

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