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PCOS and gut health

Up to five million women in the U.S. have Polycystic Ovary Syndrome (PCOS), and yet this condition remains frustratingly difficult to diagnose and treat. One study found that 70% of women with PCOS haven’t been diagnosed, so they continue to experience debilitating symptoms.

With a wide range of symptoms, PCOS can have a profound influence on a woman’s life. In fact, studies have found a high incidence of anxiety and depression among women with PCOS.

The health of our gut microbiome — the trillions of living organisms found in the intestine — plays a large role in overall health. This is especially true for women dealing with PCOS. Conventional treatments often fall short in treating PCOS and any treatment plan for PCOS must take gut health into consideration among many other hormone-balancing solutions.

Let’s take a look at the connection between PCOS and gut health and ways to manage and treat this condition naturally to get back to feeling your best.

What is PCOS?

PCOS is a complicated hormonal condition that affects women’s ovaries, causing them to produce an excess of androgens, or male hormones. This can lead to a variety of symptoms such as:

  • Cysts in the ovaries
  • Irregular menstrual cycles
  • Infertility
  • Acne
  • Insulin resistance
  • Thinning hair on the scalp
  • Excess face and body hair
  • Chronic inflammation
  • Obesity and weight gain

PCOS is the leading cause of infertility in women and can lead to additional health problems including diabetes, heart disease, and high blood pressure.

Traditional treatment for PCOS often involves oral contraceptives or the birth control pill; however, this does not get to the root problem of the condition and overlooks the role of gut health. Additionally, when women stop taking their birth control, symptoms can reappear and oftentimes worse than before.

In regard to gut health, studies have found that women with PCOS have a different gut microbiome composition than those without PCOS. Making changes to improve your gut health can have a large impact on PCOS symptoms, as well as physical and mental well-being.

What causes PCOS?

There is no clear answer as to why some women develop PCOS. Many factors can contribute — including your genetics, environment, and even your gut microbiome.

What is the gut microbiome?

There are many types of bacteria living in our gut. Most are beneficial strains of bacteria that help produce essential vitamins, regulate our immune system, impact metabolism, alter hormone levels, muscle strength, and even regulate our mood.

A diverse gut microbiome with the proper balance of good and bad bacteria is optimal for health; however, when there is an imbalance of good and bad bacteria, this is referred to as dysbiosis.

How is gut dysbiosis linked to PCOS?

Women with PCOS are shown to have higher rates of dysbiosis and less diversity in their gut microbiome than those without PCOS. The higher levels of harmful bacteria can contribute to inflammation, metabolic dysfunction, and increased insulin. Excess insulin triggers an increase in androgen production from the cells of the ovaries.

Restoring the gut microbiome to treat symptoms of PCOS

Now that we have explored the link between the gut microbiome and PCOS, let’s focus on small steps to promote gut health and hormone balance including:

  1. Eat more fiber. A diet rich in fiber is highly beneficial for supporting the good bacteria in the gut. The recommended amount of fiber for women is 30-40 grams per day, which can be found in plant foods like beans, lentils, vegetables, and whole grains.
  2. Increase prebiotics & probiotics in the diet. Prebiotics are non-digestible, fermentable components of foods that help kick-start digestion and promote beneficial gut bacteria. They have also been shown to help reduce insulin resistance and lower androgens. They are found in foods like garlic, onion, bananas, and apples.
    Probiotics are found in fermented foods. They contain live bacteria that help your gut microbiome flourish. They can be found in foods like tempeh, kimchi, sauerkraut, and yogurt, and are also available in supplement form. There are many different kinds of probiotic supplements, with varying degrees of effectiveness, so it’s important to work with a practitioner to determine the best one for you.
  3. Avoid artificial sweeteners. Artificial sweeteners have been shown to have a harmful effect on the gut microbiome and can worsen insulin resistance. Instead, choose natural forms of sweeteners such as honey, monk fruit, stevia, or maple syrup.
  4. Prioritize sleep. Lack of sleep causes a great deal of stress in the body, which can in turn promote inflammation and gut dysregulation. Sleep also factors in how our body is able to handle blood sugars by altering insulin levels. You should aim to get at least seven to nine hours of sleep per night. This might mean adjusting your sleep hygiene by avoiding caffeine and limiting screen time before bed.
  5. Manage stress. Researchers have found a link between psychological stress and dysbiosis. While reducing stress in your life can feel sometimes like an impossible task, develop ways to manage it. For example, you could take a close look at the stressors surrounding you and work to create boundaries to protect your peace of mind. Relaxing activities like yoga, meditation, and walks in nature may also help.
  6. Exercise regularly. Exercise helps with sleep and stress, and studies show it can improve the state of your microbiome. Moderate exercise can reduce inflammation and improve biodiversity in your gut; however, it’s important not to overtax your body, which can lead to harmful cortisol production. Steady state cardio, strength training, and mobility training can be the foundations to a good routine, but don’t hesitate to get some guidance if you’re not sure where to start.

Many areas of health, including your hormonal health, begin in the gut. For women with PCOS, maintaining gut health is especially important and can help alleviate unwanted symptoms and prevent serious health issues.

Eating a variety of whole foods, avoiding artificial sweeteners, and prioritizing sleep are a few simple steps women with PCOS can take to optimize the diversity of their gut microbiome and overall health. If you have any questions on the best treatments for PCOS, schedule an appointment today for your personalized treatment plan.


Dr. Alyssa Burnham is a licensed Naturopathic Doctor (ND) specializing in Integrative Women’s Health across the lifespan and offers naturopathic medicine services virtually at Wise Woman Wellness LLC, an innovative wellness and hormone center at 1480 Swan Road, De Pere, WI. She earned her four-year medical degree from the National University of Natural Medicine and completed two years of residency training at the University of California Irvine. With special interest in gut health, PCOS, menstrual disorders, and autoimmune diseases, she offers women the best of conventional and holistic, naturopathic therapies including functional medicine testing, botanical medicine, clinical nutrition, mind–body techniques, lifestyle practices, and nutraceuticals. Her approach to health is to identify the root cause and treat with the least invasive therapies. Schedule a FREE 15-minute Discovery Call with her at or call 920-339-5252 to schedule your initial visit!

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