PCOS and Leaky Gut | What’s the Gut-Hormone Connection?

The Gut-Hormone Connection

If you suffer from hormone-related issues, like PMS, acne, mood swings, fatigue, PCOS, missing or irregular periods, low libido, or hair loss, you’re likely suffering from an underlying hormone imbalance. 

With PCOS, poor gut health or a leaky gut is often a contributing factor to worsening symptoms. One way you can heal hormone imbalance symptoms, like those occurring as a result of PCOS, is by addressing gut health.

Balanced hormones depend on a healthy gut. 

If you’re here, you likely already know that medications like Metformin or hormonal birth control can be helpful for some people to treat PCOS, but they don’t address root causes of PCOS. The good news is that the foods you eat, your gut health, and lifestyle choices definitely can.

Rebalancing your gut health can support healthy hormone balance, stabilize insulin and blood sugar, and decrease the inflammation that’s often at the root of PCOS symptoms.

PCOS Affects Millions of Women

Polycystic ovarian syndrome, or PCOS, affects your endocrine system, and it’s one of the most common causes of infertility in women. PCOS interferes with fertility because it can prevent ovulation–or the process of an ovary releasing an egg for fertilization. It’s estimated that PCOS affects as many as 1 in 5 women (that’s 5-6 million or more) during reproductive years (1). It’s not known how many people have a leaky gut, but poor gut health is a risk factor for many health issues.

Other symptoms of PCOS include:

  • Missing or irregular menstrual cycles
  • Insulin resistance
  • Obesity
  • Nutrient deficiencies
  • Hormone imbalance
  • Increased body hair (known as hirsutism), acne, or hair loss caused by high levels of androgens
  • Chronic low grade inflammation
  • High cholesterol 

>>>Don’t know where to start to improve your PCOS symptoms? Download the PCOS guide FREE.

How Your Gut Influences PCOS

Recent studies have found a correlation between gut health and the microbiome, and different metabolic or inflammatory conditions like PCOS. 

Here are the main factors in your gut that affect PCOS.

“Dysbiosis” in Your Microbiome

Microbiome refers to the trillions of tiny, living microorganisms that inhabit your digestive tract and help your body perform important functions, like:

  • Hormone balance
  • Digestion and absorption of nutrients
  • Immune system regulation
  • Inflammation
  • Keeping pathogenic bacteria (like Candida) under control
  • Manufacturing neurotransmitters that affect mood

When the good bacteria and harmful bacteria become imbalanced, this is referred to as dysbiosis. Gut dysbiosis can lead to several health problems, including hormone imbalance, and a leaky gut. 

Studies have shown that women with PCOS have a greater likelihood of dysbiosis and less diverse gut bacteria overall than those without PCOS (2). This could contribute to worse symptoms and progression.

Researchers have also found an inverse relationship between androgens (male hormones like testosterone) and gut bacteria diversity (2). Higher androgens resulted in fewer “friendly” gut bacteria.

Additionally, some bacteria overgrowths, like Candida, have been shown to contribute to insulin resistance, furthering the cycle of PCOS symptoms (3).

A Leaky Gut

Leaky gut, or intestinal hyperpermeability, occurs when the gaps in your intestinal walls remain open, allowing particles of undigested food, bacteria, or toxins to pass into your bloodstream. 

This can trigger an inflammatory response from your immune system, which causes a myriad of health issues, including worsening of PCOS symptoms. 

Both dysbiosis and increased intestinal permeability (aka leaky gut) are associated with PCOS (4).   To complicate matters, hormonal birth control is a common treatment for PCOS, but studies show this can actually contribute to an unhealthy microbiome and intestinal hyperpermeability (5).  

Related: Natural Solutions for Fertility with PCOS

Signs and Symptoms of an Unhealthy Gut

Most people are familiar with digestive symptoms like diarrhea, constipation, or bloating, but  many symptoms of poor gut health manifest in other ways. In holistic medicine, doctors refer to an unhealthy microbiome as dysbiosis. Here are some key symptoms of an unhealthy gut, or dysbiosis:

  • Hormone imbalances
  • Frequent heartburn
  • Acne, eczema, or other skin issues
  • Brain fog, difficulty concentrating
  • Headaches
  • Trouble sleeping
  • Frequent illness (anything from colds to yeast infections)
  • Depression or anxiety 
  • Fatigue

Read more: 9 Unexpected PCOS Symptoms

Tips for Healing Gut Health and Improving PCOS

There isn’t a cure for PCOS (yet!), but there are a few key things you can start doing right now that will improve your symptoms and get you on the road to a more comfortable cycle. These tips will help you avoid a leaky gut and support hormone balance.

Eat more fiber.

Women with PCOS who ate more fiber had lower body fat (especially belly fat) and more stable insulin levels than those who ate less fiber (6).

The same correlation didn’t show up for women without PCOS, which suggests that fiber may be particularly helpful if you have PCOS.

Vegetables, low-sugar fruits, and whole grains are the best sources of fiber. They’re also packed with anti-inflammatory compounds and micronutrients. Some of the higher-fiber fruits and veggies include:

  • Broccoli or cauliflower
  • Greens like kale, chard, and spinach
  • Berries like raspberries, blueberries, or blackberries
  • Avocado
  • Fennel
  • Zucchini
  • Cabbage, red and green
  • Peppers

Fermented foods or probiotics.

Women with PCOS often have an imbalance in healthy gut bacteria, which could make symptoms worse. 

Some bacteria are very important to help break down estrogen, keeping your hormones balanced. If you don’t have enough of these gut bacteria, or if they can’t properly do their job, you may struggle with hormone imbalance and problems like estrogen dominance. 

Estrogen dominance is common with PCOS, and can make symptoms more severe.

Yogurt, kefir, kombucha, sauerkraut, kimchi, and other fermented foods are all packed with probiotic bacteria that can improve your gut health and help you bring your hormones back into balance (7). 

Try eating a serving or two of fermented foods every day

Decrease processed carbs and refined sugars.

Processed carbs like bread, pasta, cereal and others contribute to high insulin levels and inflammation, which makes them one of the most problematic foods for people with PCOS.

Sugars and carbohydrates also contribute to two common problems I see in PCOS patients, which are:

  1. Candida overgrowth
  2. Gluten intolerance

Avoiding, or at least drastically reducing, refined carbohydrates is one of the best ways to control your insulin levels and lose weight.

Address your stress.

It’s no secret that prolonged stress is not good for health, but it can actually alter your gut microbiome. Stress can cause a reduction in good bacteria, and contribute to leaky gut, causing you to be more sensitive to foods. Because stress can come in physical, mental, and emotional forms, it’s so important to include lots of behaviors that provide you relief. 

Journaling, meditation, spending time with friends, exercising, and setting appropriate boundaries for yourself are all practices you can use daily.

Eat an anti-inflammatory diet.

Eat plenty of antioxidants from foods like leafy green veggies, green tea, and berries. Getting enough protein, and omega-3 fats is important to keep inflammation levels low as well.

Get simple and delicious anti-inflammatory recipes here!

Consider supplements.

There are a few herbs, vitamins, and minerals that can help you rebuild and maintain a healthy gut, while supporting hormonal balance and PCOS symptoms. 

Berberine supports a healthy response to insulin and microbiome function.

Magnesium promotes metabolic health, blood sugar balance, and a stable mood.

Myo-inositol reduces androgens, supports ovarian function, and insulin sensitivity

Browse: Hormone Helper on the East West Way

Get enough sleep

Research suggests there’s a link between inadequate sleep and dysbiosis. Since fatigue is one common symptom of PCOS, it’s crucial to make sleep a top priority to support hormone balance and a healthy microbiome.

Make sure your bedroom is cool and calming and you turn off devices (or use blue-blocking lenses) 2 hours before bedtime. Waking and going to bed at consistent times each day also helps set a regular circadian rhythm.  

Avoid frequent snacking

Giving your gut a rest has several benefits, like allowing your migrating motor complex to fully activate and cleanse your gut. Your migrating motor complex works by “sweeping” particles of food and bacteria down further into your colon, or large intestine. Your MMC is actually an electrical impulse that you feel as your stomach is rumbling, and it occurs in waves that happen about 2 hours after you’ve eaten, and in approximately 90-minute cycles (8). 

If we’re constantly disrupting the cycle of our MMC bacteria meant to be pushed down into the colon can migrate into the small intestine, where they’re not supposed to be. So if you’re a frequent snacker, your MMC might not have a chance to do its job, resulting in a greater chance of bacterial imbalance or digestive discomfort.

Healing Your Gut to Improve PCOS Symptoms

Gut health is directly linked to hormonal conditions like PCOS and others. Repairing and maintaining a healthy gut is one of the most important factors toward managing PCOS symptoms.

Eating a quality diet, including plenty of anti-inflammatory and antioxidant foods, and taking care of your microbiome promotes a healthy gut and may help manage PCOS progression. 

If you’re working on managing your PCOS symptoms, it’s important to consult a qualified holistic practitioner to help you navigate your hormone journey.

Get started healing your PCOS symptoms now with my free guide.


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392092/
  2. https://pubmed.ncbi.nlm.nih.gov/29897462/
  3. https://pubmed.ncbi.nlm.nih.gov/24974682/
  4. https://www.ncbi.nlm.nih.gov/pubmed/28045919
  5. https://www.ncbi.nlm.nih.gov/pubmed/6231418
  6. https://www.ncbi.nlm.nih.gov/pubmed/30449604
  7. https://www.ncbi.nlm.nih.gov/pubmed/28768651 
  8. http://www.vivo.colostate.edu/hbooks/pathphys/digestion/stomach/mmcomplex.htm