The Gut-PCOS Connection: Can Microbes Ease Your Symptoms?

Polycystic ovary syndrome, or PCOS, affects millions of people worldwide and can lead to symptoms such as irregular periods, weight gain, acne, hair loss and fatigue. While the condition is often associated with hormonal imbalances and insulin resistance, emerging research highlights a crucial link between PCOS and the gut microbiome. 

In this article, we explore how gut health may influence PCOS symptoms and provide actionable strategies to support your microbiome. Insights are provided by Vivere's Head of Nutrition, Yusra Serdaroglu Aydin, a registered dietitian with a background in nutrition, food engineering and culinary arts. Her approach is grounded in science and shaped by a strong understanding of personalised nutrition and the human microbiome.

Here are the five biggest takeaways from this article about the connection between the gut and PCOS:

• Imbalances in gut bacteria may contribute to hormonal dysregulation and inflammation in PCOS.

• Certain bacterial strains can influence insulin sensitivity and weight management, impacting PCOS symptoms.

• A diet rich in fibre, prebiotics and fermented foods supports a healthier gut environment.

• Lifestyle factors such as sleep, stress management and exercise play a significant role in gut and hormone health.

• Personalised gut microbiome testing can guide targeted interventions to improve symptom management.

PCOS is a complex endocrine disorder with multiple underlying mechanisms. Insulin resistance is common in people with PCOS and can exacerbate symptoms such as weight gain, excess hair growth and irregular cycles. Hormonal imbalances, including elevated androgen levels, are also central to the condition [1].

While genetics and lifestyle factors are important contributors, research increasingly points to the gut microbiome as a potential contributor. A large body of studies has demonstrated that gut microbiota can regulate the synthesis and secretion of insulin, and affect androgen metabolism and follicle development, providing new insight into the pathogenesis of PCOS [2].

The trillions of microbes in the digestive system are responsible for metabolising nutrients, producing essential metabolites and communicating with the immune and endocrine systems. Dysbiosis, or an imbalance in gut bacteria, can therefore affect insulin sensitivity, inflammation and hormone regulation, potentially intensifying PCOS symptoms [3].

Studies show that individuals with PCOS often exhibit lower microbial diversity and altered levels of specific bacteria compared to those without the condition [4]. Certain gut bacteria can impact the production of short-chain fatty acids, which help regulate inflammation and glucose metabolism. Low levels of these beneficial compounds may contribute to insulin resistance, one of the primary drivers of PCOS [5].

In addition, the gut microbiome influences oestrogen metabolism through the oestrobolome, a collection of bacterial genes capable of processing oestrogen. Imbalances in these bacteria may affect hormone levels and worsen PCOS symptoms such as irregular cycles and fertility challenges [6].

Diet plays a pivotal role in modulating the gut microbiome. Evidence-based strategies include:

Fibre-rich foods such as vegetables, fruits, legumes and whole grains feed beneficial gut bacteria, promoting the production of short-chain fatty acids. A higher fibre intake can also support blood sugar regulation and improve insulin sensitivity [7].

Probiotic supplementation, especially with Lactobacillus and Bifidobacterium species, can help improve blood sugar and cholesterol markers [8].

Prebiotics, found in foods such as garlic, onions, asparagus and leeks, provide fuel for beneficial bacteria. Fermented foods like yoghurt, kefir, kimchi and sauerkraut introduce live microbes that can enhance microbial diversity and support digestion.

Low-grade inflammation is common in PCOS. Omega-3 fatty acids from oily fish, antioxidants from colourful vegetables and polyphenols from berries, green tea and dark chocolate may help reduce inflammatory markers and support gut integrity [9][10].

Diets high in refined sugars and ultra-processed foods can promote the growth of harmful bacteria and exacerbate insulin resistance. Prioritising whole, minimally processed foods helps maintain a balanced gut ecosystem.

Nutrition alone is not enough to optimise gut health in PCOS. Lifestyle factors such as sleep, stress management and physical activity play a significant role [11]:

• Sleep: Poor sleep can disrupt gut microbiota composition and hormone regulation. Prioritising 7-9 hours of quality sleep per night supports both metabolic and gut health.

• Stress management: Chronic stress alters gut microbiota diversity and may worsen inflammation. Mindfulness practices, yoga and meditation are effective strategies to support the gut-brain axis.

• Exercise: Regular physical activity improves insulin sensitivity, reduces inflammation and promotes microbial diversity. A mix of cardiovascular and resistance training exercises is ideal.

It is important to note that supplements are most effective when tailored to an individual's gut microbiome and metabolic profile.

The growing understanding of the gut-PCOS connection highlights the potential of personalised interventions. By identifying specific microbial imbalances, individuals can make targeted dietary, lifestyle and supplement changes that may reduce symptoms and improve overall health. 

Vivere’s state-of-the-art microbiome testing provides actionable insights that go beyond general recommendations, enabling people to take control of their health with a data-driven approach.

“Understanding the interplay between the gut microbiome and PCOS opens new opportunities for symptom management and long-term health. Small, evidence-based changes in diet, lifestyle and targeted supplementation can positively influence microbial diversity, hormone regulation and inflammation. By personalising interventions to your unique gut profile, it is possible to support insulin sensitivity, balance hormones and improve quality of life.”

Vivere helps you take control of your health with personalised insights from state-of-the-art gut microbiome testing, nutritional guidance, science-backed supplements and expert support. Sign up today and start living better, for longer.

[1] Polycystic Ovary Syndrome: Etiology, Current Management, and Future Therapeutics - PMC

[2] Gut microbiota dysbiosis in polycystic ovary syndrome: Mechanisms of progression and clinical applications - PMC

[3] Gut microbiota: a hidden player in polycystic ovary syndrome - BMC

[4]  Unraveling the gut microbiota’s role in PCOS: a new frontier in metabolic health - Frontiers

[5] Impact of Gut Microbiota and SCFAs in the Pathogenesis of PCOS and the Effect of Metformin Therapy - PMC

[6] Gut and Vaginal Microbiomes in PCOS: Implications for Women’s Health - Frontiers

[7] Lower Fiber Consumption in Women with Polycystic Ovary Syndrome: A Meta-Analysis of Observational Studies - PMC

[8] Interplay of Gut Microbiota in Polycystic Ovarian Syndrome: Role of Gut Microbiota, Mechanistic Pathways and Potential Treatment Strategies - PMC

[9] Role of Omega-3 Fatty Acids in Improving Metabolic Dysfunctions in Polycystic Ovary Syndrome - PMC

[10] Role of polyphenols in remodeling the host gut microbiota in polycystic ovary syndrome - PMC

[11] Lifestyle management in polycystic ovary syndrome - beyond diet and physical activity - PMC