Polycystic Ovarian Syndrome (PCOS) is an endocrine-based disorder that affects many women. Today, we want to walk through the connection between PCOS and gut health to help understand how to use a holistic approach to addressing this multifaceted condition.
So, let’s understand what PCOS is. A hormonal imbalance, insulin resistance, and ovarian dysfunction characterize PCOS. With that said, many common symptoms include:
- Irregular menstrual cycles
- Cystic ovaries
- Acne
- Hirsutism
- Weight gain
- Fertility issues
The Gut-PCOS Connection
Now that we understand PCOS let’s understand the gut microbiome connection. Our gut microbiome comprises trillions of microorganisms that regulate metabolism, inflammation, and hormone production. Alterations in the gut microbiota composition and function can increase the development and progression of PCOS (1). Let’s take a deeper dive into this connection.
- Inflammation:
Chronic low-grade inflammation is a feature of both PCOS and gut dysbiosis. An imbalance in gut microbiota can lead to increased intestinal permeability, also known as a leaky gut. This allows toxins, bacterial fragments, and inflammatory molecules to enter the bloodstream and trigger systemic inflammation.
Once these substances breach the intestinal barrier, they enter the bloodstream and trigger an immune-based response. Systemic Inflammation exacerbates insulin resistance, disrupts ovarian function, and worsens overall PCOS-based symptoms.
- Insulin Resistance
As mentioned previously, insulin resistance is a known driver of PCOS pathology. However, the lesser-known connection is the gut microbiome’s role in modulating insulin sensitivity by influencing glucose metabolism and inflammatory pathways. Dysbiosis is defined as an overgrowth of harmful bacteria and reduced diversity of beneficial microbes, which can disrupt insulin signaling, making insulin resistance in women with PCOS a core issue.
Elevated levels of circulating inflammatory molecules impair insulin signaling pathways, leading to decreased insulin sensitivity in tissues from skeletal muscle, liver, and adipose tissue. This creates a compounding cycle of blood sugar-related issues, making insulin resistance worse and promoting the development of metabolic disturbances associated with PCOS.
- Hormonal Imbalance
Another interesting aspect of the gut microbiota is that it influences hormone metabolism and synthesis that impact sex hormone levels in women with PCOS. Imbalances in estrogen, progesterone, and androgens disrupt ovarian function, menstrual regularity, and fertility. Dysbiotic gut microbiota promotes excessive production of androgens, allowing for common symptoms like hirsutism and acne to become more prevalent in individuals with PCOS.
A Functional Medicine-Based Approach
In helping women with PCOS-based symptoms, all underlying factors that are related to PCOS must be addressed. This includes looking at and understanding the function of our gut microbiome. Taking a deeper look at the microbiome helps avoid symptoms and allows the body to restore itself to its natural state of balance.
In doing this, we take a multifaceted approach to care by identifying diet and nutrition-related concerns. We ensure a PCOS-friendly diet rich in whole foods, fiber, and anti-inflammatory nutrients.
Next, we encourage lifestyle modifications. Believe it or not, stress-management techniques and adequate sleep are important for hormonal and gut health. The modifications that we help clients make modulate the gut-brain axis to alleviate inflammation and improve insulin sensitivity. The truth is that when our body is not under a constant state of stress, our ability to use insulin appropriately is optimized.
Finally, as needed, there are targeted interventions to repair the gut lining and restore microbial balance. Unfortunately, it is not as simple as using a probiotic because addressing the correct underlying gut infection is key. Each gut infection requires a different approach to ensure that the stress is gone and that you can repair the gut lining so that the chances of recurring are minimal.
Adopting a holistic and functional medicine approach to understanding PCOS helps manage this condition. Remember that the body works together at all times. Ensuring that underlying gut imbalances, inflammation, and insulin resistance are addressed allows women to finally see improvements in hormonal balance. Are you curious to learn more about our proven approach that has helped thousands of women get better? Click here to learn more.
Reference:
- He, Y., Jin, X., Wang, H., Dai, H., Lu, X., Zhao, J., Zhang, H., Chen, W., & Wang, G. (2021). The emerging role of the gut microbiome in polycystic ovary syndrome. F&S Reviews, 2(3), 214-226. https://doi.org/10.1016/j.xfnr.2021.03.003