It was over 2000 years ago that Hippocrates stated “all disease begins in the gut”. The man was seriously onto something! Today more and more research points us in one direction: A healthy gut is the very foundation of good health and wellbeing.
But wait, why are we talking about gut health? Isn’t Polycystic Ovarian Syndrome (PCOS) caused by hormonal imbalance and insulin resistance? What does gut health have to do with PCOS? In short – EVERYTHING.
Our gut is home to over 100 trillion bacteria. These bacteria help us break down the food we eat and get nutrition from it. These bacteria also help in defending against germs and infection too. This inner ecosystem, known as gut microbiome, interacts with us in profound ways. A poor diet lacking in nutrition, chronic stress and a sedentary lifestyle negatively impact our gut health. Hormonal imbalance and insulin resistance, which lead to PCOS, is one of them.
PCOS is associated with low-grade inflammation. This has been seen in various research studies. This chronic inflammation leads to weight gain (particularly around the abdomen) and insulin resistance. It also leads to Dysbiosis, which is an imbalance of good and bad bacteria in the gut. Studies have shown that probiotics (which are live microbes or healthy-gut bacteria) have lowering effects on belly fat and body weight.
Additionally, many women diagnosed with PCOS suffer from a Leaky Gut. In such a state, the tight junctions lining our gut wall begin to widen. This allows larger food particles and toxins to leak into the bloodstream. This again stimulates a systemic, low-grade inflammatory response. And that is probably the reason why a lot of women suffering from PCOS also get diagnosed with a Leaky Gut.
There’s a growing evidence that shows PCOS patients have a hyper-responsive HPA or Hypothalamus-Pituitary-Adrenal axis. The hypothalamus and pituitary gland is located in the brain. It controls the adrenal glands, which produce male hormones (androgens) like DHEA as well as the stress hormone named cortisol. Disturbances in the HPA axis leads to excess androgen production, stress, increased abdominal fat, impaired glucose sensitivity, and insulin resistance. This is also known as Adrenal PCOS. In this condition, women who are neither overweight nor have cystic ovaries, are diagnosed with PCOS. And this happens because they have elevated androgenic hormones, a.k.a. male sex hormones.
Research has now shown that 20%-30% women with PCOS have adrenal androgen excess. In other words, it’s not the ovaries that are responsible for the elevated androgenic hormones but the adrenals. Recent evidence indicates that the gut microbiome can affect the development and regulation of the hypothalamic-pituitary-adrenal axis and behavior.
As you can see, improving your gut health will go a long way towards finding relief from a variety of PCOS symptoms. Here’s a quick look at some of the ways your gut health may impact PCOS:
Insulin resistance, low-grade systemic inflammation, and elevated androgenic hormones lie at the heart of PCOS. This is why I started this article by stating that your gut health has EVERYTHING to do with PCOS.
One of the best ways to improve gut health is to incorporate probiotics into your diet. These are live microbes that can positively affect the PH of the intestine to heal the gut. They can also create a healthy microbiome where the ‘good’ bacteria overpower the ‘bad’ disease-causing bacteria.
There are various formulations of probiotics available that can be extremely helpful for women with PCOS. In fact, a clinical trial from 2015 revealed that multi-species probiotic supplements helped lower blood sugars as well as improve insulin sensitivity in PCOS patients.
Some of the most popular probiotic strains are
Also, a prebiotic like Trans-Galactooligosaccharides (TOS) can be very beneficial. Because prebiotics promote the growth of therapeutic bacteria, such as Bifidobacteria and Lactobacilli.
Multi-species probiotic supplements can be very helpful. Especially if you pick a supplement with high CFU (colony forming units) per capsule. Talk to your doctor and ask for recommendations if you’re overwhelmed by the choices available in the market.
While probiotic supplements are an easy way to ensure gut health, you can also add natural probiotics to your diet. One of the easiest available all-natural probiotic is yogurt. Buttermilk (chaas) is another good option. Cream-cheese and cottage cheese are other options worth trying.
However, it is possible that your doctor may have advised you to cut back on dairy. Because it contains IGF-1 which mimics the function of insulin. IGF-1 may also lead to increased testosterone levels which can worsen PCOS symptoms. In that case, there are plenty of other all-natural diary-free probiotic foods you can try.
Most probiotic foods are also really healthy. They don’t cause a sudden spike in blood sugar levels upon ingestion, which makes them an excellent addition to your PCOS diet.
So go ahead, try out probiotics for PCOS treatment and begin your gut-healing journey right away!
Is PCOS an inflammatory process? – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3245829/
Regulation of abdominal adiposity by probiotics (Lactobacillus gasseriSBT2055) in adults with obese tendencies in a randomized controlled trial – http://www.nature.com/ejcn/journal/v64/n6/abs/ejcn201019a.html?foxtrotcallback=true
Stability of adrenocortical steroidogenesis over time in healthy women and women with polycystic ovary syndrome – https://www.ncbi.nlm.nih.gov/pubmed/15531511
Evidence of a disturbance of the hypothalamic-pituitary-adrenal axis in polycystic ovary syndrome: effect of naloxone – https://www.ncbi.nlm.nih.gov/pubmed/8796141
Adrenal Androgen Excess in the Polycystic Ovary Syndrome: Sensitivity and Responsivity of the Hypothalamic-Pituitary-Adrenal Axis – https://academic.oup.com/jcem/article/83/7/2317/2865285/Adrenal-Androgen-Excess-in-the-Polycystic-Ovary
Microbiome, HPA Axis and Production of Endocrine Hormones in the Gut – https://link.springer.com/chapter/10.1007/978-1-4939-0897-4_8
The role of HPA axis in metabolic derangements in PCOS – http://www.endocrine-abstracts.org/ea/0020/ea0020s1.3.htm
Association between Polycystic Ovary Syndrome and Gut Microbiota – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836746/
Gut microbiome, obesity, and metabolic dysfunction – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104783/
Gut microbiota interactions with obesity, insulin resistance and type 2 diabetes: did gut microbiote co-evolve with insulin resistance? – http://journals.lww.com/co-clinicalnutrition/Abstract/2011/09000/Gut_microbiota_interactions_with_obesity,_insulin.13.aspx
The gut microbiome shapes intestinal immune responses during health and disease – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095778/
Richness of human gut microbiome correlates with metabolic markers – https://www.nature.com/nature/journal/v500/n7464/full/nature12506.html
Effects of Probiotic Supplementation on Pancreatic β-cell Function and C-reactive Protein in Women with Polycystic Ovary Syndrome: A Randomized Double-blind Placebo-controlled Clinical Trial – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4387688/
Acne vulgaris, probiotics and the gut-brain-skin axis – back to the future? – https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-3-1