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Happy Gut: Happy Hormones. Why Gut Health REALLY Matters in PCOS

What Is The Gut Microbiome?

Let’s get nerdy—your gut microbiome is a complex community of trillions of microorganisms (also called microbiota or microbes), including bacteria, viruses, and fungi, that live in your digestive system. These tiny organisms play a crucial role in various areas of your body, from your digestion to your immune system regulation, and even your mood.

The bacteria in your gut microbiome should orchestrate a fine balance of beneficial and harmful bacteria to stop various health problems.

The Link Between Your Gut microbiome and PCOS

Polycystic ovary syndrome (PCOS) is a health condition that affects the ovaries. It affects about 1 in every 10 women in the UK. Its exact cause isn’t known but it’s connected to abnormal hormone levels in your body. Symptoms can include irregular periods, infertility, and weight gain.

Research shows that there are differences in the gut microbiome of women who have PCOS and women that don’t. A study found that women with higher amounts of male hormones (known as hyperandrogenism) had fewer species of bacteria in their gut. This causes an unhealthy microbiome which is linked to insulin resistance and inflammation, which may lead to PCOS.

Insulin resistance can cause hormonal imbalances such as:

● It can stop your sex hormone-binding globulin (SHBG) from working. Your SHBG picks up the free testosterone in your body. So if you have less SHBG then it can’t pick up as much and, therefore, your testosterone levels will be higher.

● Higher levels of luteinising hormone (LH) which is in control of stimulating ovulation. If this is too high then you may not ovulate regularly.

The Link Between Leaky Gut and PCOS

No need to call a plumber! A leaky gut, also known as intestinal permeability, is often seen in women with PCOS.

Barrier cells, called epithelial cells, coat the lining of your gut. They carry around the nutrients from the food you’ve eaten into your bloodstream.

Imagine healthy epithelial cells like a closed fist. As there are no gaps, digested food particles, digestive waste, or toxins can’t ‘fall’ into your blood.

If you have inflammation due to PCOS, the epithelial cells can become weak. So your tight fist now loosens and this creates gaps. Undigested food, particles, and waste can fall through the gaps and leak out of your intestines and into your bloodstream.

This can cause your insulin levels to rise, which produces higher levels of male hormones and can cause difficulties with ovulation.

Symptoms of poor gut health

It’s important to remember that we’re all different, our symptoms won’t look the same as someone else with poor gut health.

Below are some of the common symptoms you may have with poor gut health:

● bloating

● gas

● constipation

● diarrhoea

But there are also some other signs that you may not be so familiar with, such as:

● difficulties sleeping

● tiredness

● low mood

● anxiety

● often experiencing a cold

● skin conditions such as acne, atopic dermatitis, and psoriasis

● allergies

● sugar cravings

What can our poo tell us about our gut health?!

Well, first of all, we have to remember that we’re all unique, so what’s normal for one person may not be for you. However, changes in our bowel habits may be a sign that our gut health is a little off.

So, what exactly is ’normal’? Let’s find out…

● You go for a poo every day (possibly twice a day)

● You have a poo every 2–3 days

● Your poo is soft and easy to pass (so no straining, and likewise no sudden urgency to dash to the loo!)

● Your poo is a brown, sausage-like shape, which is smooth looking and has minimal cracks — sausages for tea tonight, anyone?

Yes, this might sound a little gross, but your poo offers you very good insights into what's going on in your body.

Foods that are gut-friendly for PCOS

Eating a varied and balanced diet of nutritious foods can help you improve your gut health. Let’s break it down—get your shopping lists ready!

● Eating low GI carbohydrates and whole grains can cause blood sugar levels to rise slowly. This can improve insulin levels and reduce insulin resistance. Foods to consider are oats, muesli, wholegrain bread, green veggies, fruits, chickpeas, and lentils.

● Eating proteins and healthy fats such as chicken, lean meats, tofu, eggs, and nuts can also help to maintain your blood sugar levels.

● Eating omega-3 fats found in oily fish can lower inflammation. It’s recommended that you eat 1–2 portions a week. Plant-based sources such as seaweed, algae, chia and flax seeds, and walnuts are excellent choices too.

● Eat plenty of fibre as this helps to control blood sugar levels, keep you feeling fuller for longer, and can help with healthy bowel movements. Foods include wholemeal and granary bread, fruit, veggies, brown rice, brown pasta, and potato skins.

● Try to limit or avoid foods high in fat and sugar as they can cause a rapid rise in your blood sugar levels.

Probiotics and prebiotics support your gut health with PCOS


A prebiotic is a good food source for your gut’s microorganisms. Including prebiotics in your diet can help your gut bacteria grow strong. This can boost your immune system, regulate your gut microflora, and reduce inflammation. Prebiotics are in foods such as artichokes, bananas, berries, tomatoes, onions, garlic, green veggies, and wholegrain cereals. Prebiotics are also available as a supplement.


Probiotics are live bacteria and yeasts often added to yoghurts or food supplements.

Research is lacking on how probiotics can improve your gut health with PCOS. A randomised controlled experiment over 12 weeks found that women with PCOS taking a probiotic supplement containing Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidum, had increased levels of SHGB, reduced testosterone levels, and improved inflammation. As we know from earlier, these changes are good for our gut health.

Tips for supporting your gut health with PCOS

So what else can you do to take care of your gut health if you have PCOS? Let’s take a look:

● Eat regular and balanced meals to help keep your blood sugar levels stable and to reduce insulin resistance.

● The NHS recommends you aim for 150 minutes of exercise a week.

● If you feel tired after eating, take a 10-minute stroll to boost your energy levels.

● Try to limit or stop your alcohol intake.

● Stop smoking.

● If you’re feeling depressed or anxious, reach out for support or counselling.

● Practise mindfulness, meditation, and yoga to lower your stress and anxiety levels.

● Try and get a good amount of sleep each night.

● Try complementary therapies such as acupuncture and herbal medicines.

Next steps for taking care of your gut health

Maintaining a healthy gut whilst managing your PCOS symptoms can be a hard, and often lonely, journey. However, you don’t have to go at it alone — that’s where I can help.

Why not hop on a free 30-minute Health Transformation Call to find out about my programmes and services, and how I can help you to manage your gut health.


Cowan, S., et al. (2023). Lifestyle management in polycystic ovary syndrome - beyond diet and physical activity.

Karamali, M., et al. (2018). Effects of probiotic supplementation on hormonal profiles.

Lio, P. A. (2021). Leaky gut and atopic dermatitis.

Zhao, X., et al. (2020). Exploration of the relationship between gut microbiota and polycystic ovary syndrome.

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