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  • Denice Bracken

PCOS & The Gut Microbiome

The gut microbiome could be interplaying with Polycystic Ovarian Syndrome. Nutrition and lifestyle could help support both!

crochet uterus on desk of someone working on a computer

BACKGROUND


Polycystic Ovarian Syndrome is a challenging condition affecting the whole body. The exact cause of PCOS is still undetermined, yet it has strong association with environmental factors such as diet and lifestyle, genetics, and in more recent research discovery-the gut microbiome.


The gut microbiome is taking the research world by storm when it comes to conditions such as diabetes, PCOS, autoimmune conditions, neurological diseases, pharmaceutical effectiveness, and even mental health.


The gut microbiome is a complex balance of bacteria, fungi, protozoa, archaea, and even viruses. It has hundreds of functions in the human body, so many that it could be considered a whole body system much like our central nervous system. To name a few, it provides us protection from less friendly bugs, can be immune supportive, and provides us access to nutrients from our foods such as B12.


Going even further, we get several benefits from the byproducts that our microbiome produces from feeding off food we consume. These metabolites produced by a diverse populace of bacteria can be highly beneficial for glucose regulation, immune system regulation, gut tissue health, and hormones.


WHAT IS GUT DYSBIOSIS?


In short, gut dysbiosis is a disruption of our gut microbiome that can induce unwanted side effects or even chronic diseases. It can be considered as a decrease in certain beneficial bacteria and an increased dominance of less beneficial bacteria in the gut. Gut dysbiosis can also be considered an overgrown bacterium in certain parts of our gut like our small intestine (you may have heard of SIBO). It is normal to have bacteria in the small intestine, but an overgrowth can cause unwanted symptoms (bloat, gas, rashes, brain fog, insomnia, cravings, fatigue etc.) In general, think of dysbiosis as an imbalance in an ecosystem.

hands holding belly with red flower

WHY IS THIS IMPORTANT WHEN IT COMES TO PCOS?


Recent literature supports an emerging hypothesis that gut dysbiosis could be playing a significant role in the development of PCOS. The theory suggests that a loss of microbiota diversity can allow dysbiosis and less favorable strains of bacteria to take up residency in increased abundance in their environment (i.e., your gut). These strains of bacteria can cause immune system reactions (inflammation) in the GI tract and systemically. Inflammation can induce or exacerbate chronic illnesses such as PCOS leading to insulin resistance and other neuroendocrine disruptions.


Gut dysbiosis in PCOS has been linked to increased gut permeability, systemic inflammation, reduced insulin sensitivity, and elevated androgens. These are hallmark to PCOS and are part of a few identified underlying causes of this condition.


Another mentionable finding showing up in recent studies is that gut dysbiosis and hyperandrogenism (excessive testosterone) in PCOS are linked. However, the debate is rather chicken or egg. Researchers have not found the exact mechanisms yet as to how sex hormones and the microbiome are interplaying. Does elevated testosterone encourage gut dysbiosis or does gut dysbiosis elevate androgens? It is likely that both are at play in the relationship. Address elevated androgens, gut diversity improves. Address gut dysbiosis and testosterone levels improve.


WHAT CAN BE DONE ABOUT GUT DYSBIOSIS & PCOS?

The good news is there are several dietary and lifestyle recommendations that can be explored to see improved gut microbiome health as well as improvements with PCOS.


The following recommendations are not rules. If one of them calls to you- explore it. If one screams not right now or gives you stress-avoid it. Our approaches to improving our health should be as diverse as we are- and as diverse as our gut microbiomes!



NUTRITION FOR PCOS & GUT DYSBIOSIS

The food we consume not only feeds us-it feeds our microbiome. Our diverse microbiome thrives off diversity itself. Eating a wide range of fruits, vegetables, grains, nuts, and seeds can improve our gut health and diversity. Consuming less foods high in refined sugar (think white sugar, white breads, soda, candy) can be a beneficial first step. Those foods not only are associated with increased insulin resistance, but they can cause further gut dysbiosis by providing an ample supply of food for less beneficial bacteria to feed on- further strengthening their dominance in the gut.


Another recommendation is to slowly increase fiber intake. Rapidly increasing fiber intake can worsen bloating, gas, heartburn, and microbiome dysbiosis.

Listen to your body. Begin to notice how certain foods make you feel. Avoid foods you know you are allergic, intolerant, or sensitive to. If you are interesting in learning more about supporiting PCOS and gut dysbiosis through food click here.


Making small sustainable steps is key. Cutting out all the things you love or being super restrictive isn’t going to make you happy. Work towards finding more nutrient dense foods you love and add them slowly into your life. Explore and give yourself permission to make up your own opinions about foods.



blueberry bush in the sunlight

VITAMIN D

Vitamin D has several crucial roles in the human body. One of those roles is in immune function and intestinal lining integrity. When one is in a chronic state of inflammation with gut dysbiosis, the gut lining that normally has tight cellular links, which would prevent things from passing through, becomes weak and allows things to ‘leak’ into our systemic circulation. This can be referred to as ‘leaky gut.’ The immune system mounts an attack on these ‘leaked’ invaders, further creating more inflammation and even food sensitivities.


Vitamin D can be produced by getting a safe amount of sunlight daily. It can be consumed from quality vitamin D supplements, mushrooms, eggs, fish, animal products, and fortified foods. Get 15% off quality supplements through my fullscript shop.


REDUCING EXCESS ANDROGRENS

As mentioned above there is relationship between elevated androgens and gut dysbiosis. Supporting the body in reduced production and removal of excess androgens can improve PCOS symptoms and gut dysbiosis. Exercise, lowering refined carbohydrates consumption, eating foods rich in fiber and phytochemicals, and stress management are a few ways to aid your body in reducing excess androgens.


For more ways on how to support health hormone and testosterone levels in PCOS see my free Balanced Plan.


STRESS MANAGEMENT

No surprise here. As anyone with PCOS will tell you, stress is often turned up to 11 for us, and you can bet stress is linked with gut disruption. The parasympathetic nervous system (think of this system for rest and digest) is predominately controlled by the Vagus nerve. Repeated exposure to stressful events, chronic stress, has been linked with impaired vagal nerve function and subsequently gut dysbiosis.


Getting into a state of a parasympathetic resurgence can improves gut microbiome diversity, improved digestion, and strengthens intestinal permeability and reduced inflammation. Finding ways that help you unwind throughout the day, breathing deep into your diaphragm, and reducing mental burden can improve vagal nerve tone.


redheaded woman observing the forest in the mountains

EXERCISE

Another no surprise here, but did you know that beneficial and joyful movement can improve gut microbiome health and improve intestinal motility. Movement affords us many benefits such as blood and lymph flow, improved blood sugar regulation, better sleep, removal of waste products, and pain reduction.


Regular, enjoyable movement can improve the overall function of several bodily systems. Hike, walk, swim, dance, climb trees or rocks (be safe, but have fun). Exercise doesn’t have to be lifting weights or doing crunches, although those things can be fun too for some.


SLEEP

Did you know that your little gut microbes can alter your sleep and energy levels? Some can induce sleepiness at inappropriate times and others can excite. Some can release anti-inflammatory metabolites, and some can produce hormones that can improve sleep/wake cycles such as serotonin or GABA. Sleep disruptions can be linked with gut dysbiosis and dysfunctional intestine motility and vice versa.


Getting quality sleep can be a challenge with PCOS. Insomnia is a very common symptom among those with the condition. Promoting a safe, restful environment can improve the likelihood of getting better quality of sleep. Find a nighttime ritual that can help you wind down from the day. Gentle stretching, diaphragmatic breathwork, journaling, and meditation are a few common favorites. Avoid screens and other sources of bright, blue light which can disrupt melatonin production. Avoid any late-night caffeine and try to eat your last meal of the day at least 2 hours before you go to bed.


green gray cotton sheets and pillows in a dim lit bedroom

FINAL THOUGHTS


There is no one way to address gut dysbiosis and PCOS. It is a process. It is a journey. Exploring several things can easily become overwhelming and that alone can worsen how you feel. Give yourself permission to try out one new thing at a time. Give yourself permission to also step away as you need. Hope for a healthy, vibrant life doesn’t have to be elusive.


 

If you resonate with this post and wish to invest in your nutrition journey with PCOS, reach out and let's connect. Sign up for updates on blog posts, recipes, and events!


 

References for PCOS & Gut Microbiome Intersection


  • Bonaz B, Bazin T, Pellissier S. The Vagus Nerve at the Interface of the Microbiota-Gut-Brain Axis. Front Neurosci. 2018 Feb 7; 12:49. doi: 10.3389/fnins.2018.00049. PMID: 29467611; PMCID: PMC5808284.

  • Duan L, An X, Zhang Y, et al. Gut microbiota as the critical correlation of polycystic ovary syndrome and type 2 diabetes mellitus. Biomed Pharmacother. 2021; 142:112094. doi: 10.1016/j.biopha.2021.112094

  • He FF, Li YM. Role of gut microbiota in the development of insulin resistance and the mechanism underlying polycystic ovary syndrome: a review. J Ovarian Res. 2020;13(1):73. Published 2020 Jun 17. doi:10.1186/s13048-020-00670-3

  • Matenchuk BA, Mandhane PJ, Kozyrskyj AL. Sleep, circadian rhythm, and gut microbiota. Sleep medicine reviews. 2020 Oct 1. 53:101340.

  • Rizk MG, Thackray VG. Intersection of Polycystic Ovary Syndrome and the Gut Microbiome. J Endocr Soc. 2020 Nov 16;5(2): bvaa177. doi: 10.1210/jendso/bvaa177. PMID: 33381671; PMCID: PMC7757431.

  • Vitamin D. The Nutrition Source. Harvard T.H. Chan. School of Public Health. https://www.hsph.harvard.edu/nutritionsource/vitamin-d/.

  • Images. Free Stock Photos. Source: Canva.com & Pexel.com


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