Article

The PCOS and Gut Dysbiosis Connection

Published on Wednesday, May 11, 2022
by Andy De Santis

Health & Wellness

What’s the Connection Between PCOS and Gut Health?

In addition to hosting Mother’s Day, the month of May is also home to National Women’s Health Week—so I could hardly think of a better time to turn my writer’s gut health gaze toward the topic of PCOS.

Polycystic ovary syndrome (PCOS) affects around 5 million women in the United States and is a leading cause of female infertility.

A growing body of evidence suggests that, in addition to insulin resistance and elevated androgen (male hormone) levels, imbalances in the gut microbiome (dysbiosis) may also play a significant role.

PCOS and the Gut Microbiome

While the exact progression of PCOS is still not fully understood, emerging research points to a connection between insulin resistance and imbalances in gut bacteria.

A number of preliminary studies—including those published in Frontiers in Microbiology (2017) and the Frontiers in Cellular and Infection Microbiology (2023)—have shown that women with PCOS tend to have:

Lower gut microbiome diversity
Greater likelihood of dysbiosis

Further research published in Frontiers in Endocrinology suggests that dysbiosis may be driven by both elevated androgen levels and insulin resistance—meaning the relationship between gut health and PCOS may be bidirectional.

In other words: Your gut may influence PCOS—and PCOS may influence your gut.

Can Improving Gut Health Help PCOS?

This leads to one very important question:

Do interventions that improve the gut microbiome actually improve PCOS outcomes?

While the answer is still evolving, researchers have begun exploring this through:

Probiotic supplementation
Synbiotics (probiotics + prebiotics)
Dietary strategies

Insulin Resistance & Probiotics

A 2021 meta-analysis published in the Journal of International Medical Research examined probiotic supplementation in women with PCOS.

The findings showed that:

Multi-strain probiotics (including Lactobacillus and Bifidobacterium)
Taken over 8–12 weeks

Were associated with improvements in insulin resistance, one of the most significant metabolic features of PCOS.

From a dietary perspective, low glycemic index eating patterns—featuring:

Legumes
Nuts and seeds
Whole grains (brown rice, quinoa, oats)

…may also support insulin sensitivity.

These foods are also rich in fiber and magnesium, two nutrients often under-consumed in women with PCOS.

Androgens, Inflammation & Gut Health

A systematic review and meta-analysis published in the European Journal of Nutrition explored probiotic and synbiotic supplementation in PCOS.

The review found that these interventions may:

Reduce testosterone levels
Improve inflammatory markers
Support metabolic health

The probiotics studied commonly included strains such as:

Lactobacillus acidophilus
Lactobacillus casei

And prebiotics included:

Inulin
FOS (fructooligosaccharides)

These prebiotic fibers are naturally found in foods like:

Garlic
Onion
Bananas
Asparagus
Oatmeal
Artichokes

A Quick Note on Fermented Foods

Although there are currently no direct fermented food intervention studies in PCOS, research in other areas shows that fermented foods like:

Kefir
Kimchi
Kombucha

…can:

Increase microbiome diversity
Reduce inflammation

This makes them an interesting area for future research in PCOS management.

Final Thoughts

Dysbiosis is increasingly recognized as a feature of PCOS that may interact with two of its most prominent markers:

Insulin resistance
Elevated androgen levels

Emerging—though still limited—evidence suggests that improving gut health through:

Probiotic and synbiotic supplementation
Fiber-rich dietary patterns

…may offer meaningful benefits.

That said, these strategies are best viewed as supportive tools, not standalone treatments.

The current consensus? Improving gut health is a low-risk, potentially beneficial approach that can complement broader PCOS management strategies.

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