Probiotics for PCOS: What you need to know

Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal disorders, affecting up to 15% of women of reproductive age. It’s a complex condition characterized by irregular menstrual cycles (periods), small cysts on the ovaries, and raised androgen hormone (testosterone) levels. 

In recent years, scientists have been investigating a possible link between gut health and PCOS, leading to growing interest in the potential role of probiotics for PCOS. But can probiotics really make a difference to women with PCOS? In this article, we’ll explore what the research says, how probiotics may help, and practical tips for including them in a PCOS-friendly lifestyle.

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What is PCOS? A quick overview 

PCOS is a hormonal imbalance that affects ovarian function and the menstrual cycle. The exact cause of PCOS is not fully understood yet, although genetics and lifestyle factors likely play a significant role. Common symptoms include: 

Irregular periods. It can involve having long cycles or missing periods completely. Periods can also be heavier than normal. 

Infertility. PCOS is the most common cause of female infertility. Irregular or absent periods are a sign that you’re not ovulating regularly and this can significantly reduce your chances of conceiving. 

Weight gain and obesity. PCOS and having a raised BMI are commonly linked. Between 40% to 80% of women with PCOS are overweight or obese. 

Insulin resistance. 50%-90% of women with PCOS are insulin-resistant. The exact cause for insulin resistance in PCOS is still unclear although it is likely to be related to raised androgen levels and weight gain. 

Signs of excess androgen hormones. Abnormal hair growth on the face, arms, chest and abdomen, thinning hair, and acne can be signs of raised levels of androgens (male sex hormone). 

Cysts. Ultrasound scans may reveal enlarged ovaries with multiple follicles (egg sac cysts) on them.

Only recently have scientists begun to uncover a potential link between gut health and PCOS. While the exact connection is not yet fully understood, ongoing research is working to clarify how probiotics may influence PCOS symptoms, treatment, and overall outcomes. 

Understanding probiotics 

Probiotics are live microorganisms, also referred to as ‘good bacteria’, that support a healthy gut environment. Your gut contains trillions of microorganisms, including many different strains of bacteria, that help it to function healthily. You can find them naturally in fermented foods like yoghurt, kefir, and sauerkraut, or dietary supplements. 

The gut microbiome plays a crucial role both within the digestive system and outside of it. A healthy gut microbiome supports digestion, enhances nutrient absorption, strengthens the immune system, influences the nervous system, and helps regulate hormonal balance. Dysbiosis, the name given to describe a gut microbiome that is out of balance, may contribute to conditions like obesity, insulin resistance, and chronic inflammation. All of which are linked to PCOS and many other chronic health conditions. 

The connection between gut health and PCOS 

Emerging research has revealed that women with PCOS may have different gut bacteria compared to women without the condition. Specifically, they tend to have less bacterial diversity (fewer different types of gut bacteria) and more pro-inflammatory bacteria in their gut. 

A 2017 pilot study looked at the gut microbiome of 24 women with PCOS and 19 healthy controls. It found that women with PCOS had lower gut biodiversity than the healthy controls. There was also a small but significant increase in gut inflammation in women with PCOS but further research is required to understand how this may affect symptoms. The researchers noted that these differences could be due to a combination of factors like insulin resistance and age rather than solely PCOS, but larger studies are needed to investigate this. 

A more recent 2023 review of current evidence concluded that the relationship between PCOS and the gut was close but complex and further studies are needed to help guide future prevention and treatment. 

Are probiotics good for PCOS? 

While research on probiotics and PCOS is limited, there have been some studies performed that look at whether probiotics have any effect on the hormonal markers and symptoms of PCOS. 

A 2022 randomized placebo-controlled trial found that a 12-week course of probiotics significantly increased levels of sex hormone-binding globulin (SHBG) in the blood. SHBG is

responsible for binding and regulating androgen and estrogen levels. Low SHBG levels are a marker for hormonal imbalance and are also associated with insulin resistance. However, the study noted no significant changes in other hormone levels, which may be due to the relatively short 12-week duration. Studies involving longer interventions and larger groups are needed to further evaluate the effect. 

What are the best probiotics for PCOS? 

If you’re considering starting a probiotic as part of your PCOS management plan, here are a few things to keep in mind: 

Consult a healthcare provider. If you have any other underlying health conditions, take any medications, or have any concerns then consider consulting your healthcare provider before starting any new supplements. 

Consider the strain. Different probiotic supplements will contain different strains of bacteria. Look for supplements that specify which strain they contain, as different strains may have different effects. For example, women with PCOS often have a reduction in Lactobacilli and Bifidobacteria. 

CFU count. CFU stands for ‘colony-forming units’, a measure of live bacteria. A range of 1 to 10 billion CFU per serving is often a good starting point but needs may vary. ● Quality matters. The supplement market is often unregulated so it’s important to choose a reputable brand that the bacteria are alive at the time of use, not just the time of manufacture. 

In addition to supplements, incorporating naturally probiotic-rich foods like yogurts with live culture, kefir, miso, kimchi, and sauerkraut into your diet can support your gut microbiome and your overall health. 

Practical tips for incorporating probiotics for PCOS 

Here are 5 tips to help you incorporate both natural probiotics and supplements into your daily life: 

1. Start slowly. If you’re new to probiotics, start with a small amount to allow your digestive system to adjust. 

2. Be consistent. Regular, small amounts of probiotics may be more beneficial than sporadic larger doses. 

3. Experiment. Find a natural source of probiotics that you enjoy and find easy to incorporate into your diet. This may take some experimenting with different foods that are naturally rich in probiotics, to begin with. 

4. Pair with prebiotics. According to the Mayo Clinic, prebiotics are parts of food that the body doesn’t digest but that feed good gut bacteria. They’re mainly high-fiber foods like garlic, onions, bananas, and oats. They can enhance the effectiveness of probiotics.

5. Support your overall gut health. A diet high in fiber, whole grains, and a variety of different fruits and vegetables will support a diverse and healthy microbiome alongside probiotics. 

When to talk to a healthcare professional 

While probiotics might be a helpful tool in the PCOS management toolbox, they’re not a cure-all for PCOS. 

PCOS is a complex condition that affects multiple systems in the body, the management plan for PCOS is highly individual and often combines both medications and lifestyle changes. 

You should always discuss starting any new medication or supplement with your healthcare provider first. They will be able to take a personalized approach when looking at new supplements or medications and how these may interact with any underlying health conditions you have and any other medications you take. 

Key takeaways 

PCOS is a complex condition linked to hormonal imbalances, insulin resistance, and infertility. 

Gut health may play a role in PCOS symptoms, and probiotics help support a healthier gut environment. 

Some studies show that probiotics could improve certain hormonal levels in women with PCOS. 

Choosing the right strains and maintaining overall gut health through diet are important steps. 

Always consult a healthcare professional before starting new supplements or making significant changes to your management plan. 

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