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The surprising link between PCOS and gut health — and how to fix it

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PCOS is a complex hormonal condition, but by prioritising gut health through nutrition, movement, sleep and stress management, you can dramatically improve some symptoms.

Polycystic ovary syndrome (PCOS) affects one in 10 women globally, yet many sufferers remain undiagnosed and unaware of the impact it has on their health.

Beyond the well-known symptoms of irregular periods and fertility struggles, emerging research has shed light on a surprising connection between PCOS and gut health.

A staggering 94% of PCOS patients face gut health problems, with 64% experiencing gut health symptoms more than once a week, according to a study by hormonal health company Mira.

As more women struggle with inflammation, insulin resistance and hormonal imbalances, the role of our gut microbiome has never been more crucial.

According to experts, nurturing your gut with the right diet, exercise and lifestyle changes could hold the key to managing — and potentially easing — the often-debilitating symptoms of PCOS.

L360 spoke to experts about why your gut health could be the missing piece to your PCOS puzzle, and how to fix it.

Read more: PCOS misdiagnosis: What happens when symptoms are misunderstood
Nurturing your gut with the right diet, exercise and lifestyle changes could hold the key to managing the often-debilitating symptoms of PCOS (Picture: Freepik)

How gut health and PCOS are connected

Your gut is home to a delicate ecosystem of bacteria that influence everything from digestion to immunity. But in women with PCOS, this balance is often disrupted, leading to a condition called gut dysbiosis — an imbalance of good and bad bacteria.

“Women with PCOS often experience gut-related symptoms that signal an underlying connection between hormonal issues and digestive health,” says Rohini Bajekal, a nutritionist specialising in PCOS. “Studies show that women with PCOS have lower bacterial diversity and higher numbers of bacterial colonies like Prevotella, which promote androgen excess and insulin resistance while worsening lipid levels.”

Similarly, Alexandria Smith, a fertility and hormone integrative nutrition coach, explains that PCOS is also linked to specific bacterial imbalances. “Women with PCOS who experience mood issues tend to have lower levels of Butyricicoccus, beneficial bacteria that help reduce inflammation, and higher levels of Sutterella, which is linked to metabolic issues like insulin resistance and weight gain.”

The gut and hormones are deeply connected, and when gut health is compromised, PCOS symptoms — like irregular periods, acne, weight gain and mood swings — can worsen.

Signs your gut may be affecting your PCOS

Many women with PCOS experience digestive symptoms that could indicate an unhealthy gut, including:

  • Bloating and gas
  • Constipation or diarrhoea
  • Brain fog and fatigue
  • Food sensitivities
  • Increased sugar cravings
  • Mood swings and anxiety

The link between gut health and mental wellbeing is especially important. Research shows that inflammation caused by gut imbalances may contribute to anxiety and depression, both of which are more common in women with PCOS.

Read more: Stories of women who went through early menopause in their 30s
Woman suffering with a headache
Brain fog and fatigue are common symptoms of PCOS (Picture: Freepik)

How to heal your gut and improve PCOS symptoms

The good news? “Our gut is very forgiving,” says Rohini. “By making simple, nourishing changes, we can restore balance and take control of our health.”

Eat for gut health

A diverse, fibre-rich, plant-based diet is one of the most effective ways to support a healthy gut microbiome. Rohini recommends aiming for at least 30 different types of plants per week, which has been shown to improve gut diversity.

Here are some easy ways to get more gut-loving foods into your diet:

  • Eat the rainbow: load up on fruits, vegetables, legumes, nuts, seeds, herbs and spices.
  • Swap meat for beans or tofu: research shows that reducing red meat intake and replacing it with plant proteins like lentils and chickpeas lowers inflammation and supports gut health.
  • Batch-cook meals: soups, stews and grain bowls packed with a variety of vegetables and herbs are an easy way to increase diversity in your diet.
  • Switch up your grains: instead of always eating rice or bread, try quinoa, barley or millet for extra fibre and nutrients.
  • Enjoy dark chocolate: rich in polyphenols, dark chocolate feeds beneficial gut bacteria and fights inflammation.

Prebiotics, probiotics and polyphenols

Alexandria recommends focusing on three key elements to rebuild a healthy gut microbiome: prebiotics, probiotics and polyphenols.

Prebiotics, found in foods like garlic, onions, leeks, asparagus, chickpeas and kidney beans, help nourish good bacteria.

Probiotics, which are abundant in fermented foods such as kimchi, sauerkraut and kefir, help replenish beneficial gut bacteria. Probiotic supplements may also support insulin sensitivity and hormone balance.

Lastly, polyphenols, present in foods like broccoli, olives, cinnamon, oregano and dark chocolate, create an environment in the gut where healthy microbes can thrive.

Read more: The truth about premenstrual dysphoric disorder (PMDD)
Variety of beans in jars
Consider adding key foods to your diet (Picture: Freepik)

Move your body

Exercise isn’t just for fitness — it’s essential for gut health. Studies show that resistance training helps reduce androgen excess, a key issue in PCOS.

Even a 15-minute brisk walk after meals can improve blood sugar control and support a healthier gut microbiome.

Prioritise sleep and stress management

Chronic stress and poor sleep can worsen gut health and PCOS symptoms. The experts recommend to:

  • Get seven to nine hours of quality sleep each night
  • Practice mindfulness, yoga or meditation
  • Spend time with supportive friends and family

Minimise alcohol, caffeine and tobacco

Excess alcohol and caffeine can disrupt gut bacteria and increase inflammation, making PCOS symptoms worse. If you drink coffee, opt for decaf, or go for green tea, which is rich in gut-supporting polyphenols.

Feature image credit: Freepik

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