PCOS And The Gut

“All disease begins in the gut”. Hippocrates made this statement nearly 2000 years ago and more and more research these days is only proving that the man can’t be more right. As a matter of fact, the basic foundation of good health is a healthy gut.

But does gut health have anything to do with Polycystic Ovarian Syndrome (PCOS)? Well, PCOS is caused by hormonal imbalance and insulin resistance and it infact does have everything to do with gut health.

Did you know over 100 trillion bacteria live in our gut? Yes, you heard that right. These bacteria are responsible for breaking down the food that goes down the way. This provides us with nutrition and also protects us from germs and infections. This inner ecosystem that interacts with us in intense ways is called the gut microbiome. Several factors like a sedentary lifestyle, chronic stress, a poor diet that lacks nutrition, etc. can cause damaging effects on our gut health. The major factors that lead to PCOS, hormonal imbalance and insulin resistance, are just two of them. 

Is your gut making your PCOS worse?

Several studies show that low-grade inflammation is a common cause of PCOS and this chronic inflammation can lead to weight gain, especially in the abdomen area and cause insulin resistance. An imbalance in good and bad bacteria in the gut, commonly known as Dybosis, is also a result of this chronic inflammation. According to many studies, live microbes or healthy-gut bacteria called probiotics have threatening effects on fat accumulated in the belly and overall body weight. 

Moreover, leaky gut is a common problem experienced by many women diagnosed with PCOS. The tight junction lining of our gut walls begins widening in such cases which, in turn, let large food particles and toxins to leak into the bloodstream worsening the low-grade inflammatory condition. This is exactly the reason why most of the women who are diagnosed with PCOS are also diagnosed with a leaky gut

HPA Axis Dysfunction and PCOS

According to many studies, patients with PCOS also have a hyper-responsive HPA or Hypothalamus-Pituitary-Adrenal axis. The hypothalamus and pituitary gland, which controls the adrenal glands, are located in the brain. The adrenal glands are responsible for producing male hormones, called androgens, and the stress hormone, called cortisol. Any disturbance caused in the HPA axis can result in excess androgen production, stress, increase in abdominal fat, impaired glucose sensitivity, and insulin imbalance. This state where the women who are neither overweight nor have cystic ovaries are diagnosed with PCOS is called Adrenal PCOS. This is a usual scenario when the women have elevated androgenic hormone levels, also known as, male sex hormones. 

According to several studies, 20-30% of women with PCOS have excess adrenal androgen, i.e. in such situations, adrenals cause elevated androgenic hormones and not ovaries. Recent research also reveals that the development and regulation of the hypothalamic-pituitary-adrenal axis and behaviour are caused by the gut microbe.

Managing PCOS with better gut health

As mentioned, improving your gut health plays an important role in managing PCOS symptoms. If you are still wondering how your gut health will have a negative impact on PCOS, here’s your answer in brief:

  • Imbalance in the gut microbiome can be responsible for chronic inflammation
  • Systemic inflammation will have important implications on cystic acne  
  • Obesity and metabolic dysfunction can be a result of out-of-whack gut flora
  • An unbalanced gut microbiome can cause insulin resistance
  • Gut microbes might also affect the HPA axis which, in turn, stimulates excess androgens. 
  • Last, but not least, the symptoms that are seen as the heart and soul of PCOS, i.e, insulin resistance, low-grade systemic inflammation, and elevated androgenic hormones, can be results of poor gut health. 

Now you know why gut health plays a major role in managing PCOS. However, improving gut health is, in fact, easier than you think. One of the best-recommended ways is to include probiotics in your diet. They are live microbes and have the power to heal the gut by having a positive impact on the PH of the intestine. They are also capable of creating healthy microbiomes. These ‘good’ bacteria can take over the ‘bad’ disease-causing bacteria. After all, it is always good that wins over the bad! 


If you suffer from any kind of gut problems or conditions, visit SMILES Gastroenterology and consult the leading gastroenterologists who are experts in providing effective treatment for all gut-related problems. Book your appointment today.