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Hi, I’m Alyssa! AKA, The PCOS Nutritionist Alyssa!

I’m a Registered Dietitian dedicated to helping you eliminate your PCOS symptoms with sustainable and realistic nutrition changes.

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What’s The Best Probiotic for PCOS? Top Brands & Benefits

If you have PCOS and digestive issues, you may be wondering: what’s the best probiotic for PCOS? Do I need to take a probiotic? Should I take one? 

As a registered dietitian who specializes in PCOS, I get this question a lot! This blog post will cover what probiotics are, the benefits of them, and the best probiotic for PCOS, along with some brand names.

infographic with a digestive system and pills in the background; text overlay states best probiotics for pcos.

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What is PCOS?

Polycystic ovarian syndrome, or PCOS, is a hormonal disorder that affects approximately 6-12% of women of reproductive age in the United States. The exact cause of PCOS remains unknown, but it has been linked to insulin resistance, chronic inflammation, high androgen levels, and gut dysbiosis. 

It can present in a variety of ways, but some common symptoms of PCOS include: 

  • Irregular periods
  • Infertility
  • Hirsutism (excess hair growth)
  • Hair loss from the scalp
  • Weight gain
  • Cravings

What’s worse is that PCOS is also linked to an increased risk of type 2 diabetes, gestational diabetes during pregnancy, metabolic syndrome, cardiovascular disease, and even endometrial cancer. 

Now let’s talk about what I mentioned earlier: the link between PCOS and gut dysbiosis. 

PCOS & Gut Health: What’s The Link?

When it comes to gut health, we often think of obvious digestive symptoms like bloating, cramping, diarrhea, and constipation, which many women with PCOS experience regularly. In fact, one study found that bloating was one of the most common symptom complaints among women with PCOS using a period tracker phone app (1). 

Even if you don’t struggle with any of these digestive issues routinely, gut health should still be on your radar if you have PCOS though. 

Why, you ask? Well, for starters, research has shown that women with PCOS tend to have gut dysbiosis. This may be gross to think about, but our digestive systems contain trillions of different bacteria, both good and harmful bacteria. This is commonly known as the gut microbiota, or gut microbiome. 

A healthy gut microbiome contains a healthy proportion of beneficial bacteria and a wide diversity of bacteria strains (more on this to come!). Gut dysbiosis, or a suboptimal gut microbiome, has less of the beneficial gut bacteria and/or not much diversity in the types of bacteria strains. 

Women with PCOS tend to have less of the beneficial bacteria Lactobacilli and Bifidobacteria. There is often also an increase in pathogenic bacteria such as Escherichia and Shigella. Additionally, there’s usually an alteration in the balance of certain bacterial species, specifically Bacteroidetes and Firmicutes, leading to altered production of short-chain fatty acids and a negative impact on metabolism, gut barrier integrity, and immunity (2).

infographic showing the relationship between gut dysbiosis and pcos symptoms.

Gut dysbiosis can contribute to the development of chronic inflammation and insulin resistance. Up to 80% of those with PCOS have insulin resistance, so this is pretty important (3). Insulin resistance is when the body’s cells don’t respond to the hormone insulin as effectively anymore. It can lead to high insulin levels, which can ultimately lead to common PCOS symptoms like weight gain and high testosterone levels

It’s theorized that gut dysbiosis may contribute to the development or pathogenesis of PCOS and how it presents itself in certain women (4, 5). 

Signs Your Gut Health Needs Work

Besides the obvious digestive symptoms we mentioned before, some other signs that your gut health may need some work include:

  • Autoimmune diseases like Hashimoto’s, rheumatoid arthritis, and psoriasis
  • Skin issues such as eczema or acne 
  • Chronic fatigue
  • Depression
  • Food intolerances
  • Sugar cravings
  • Insulin resistance
  • Inflammation

Irritable bowel syndrome, or IBS for short, is another condition that is linked to poor gut health. IBS is also more prevalent in those with PCOS. One small study found that up to 42% of women with PCOS also had IBS (6).

Alright, now that we’ve established some background info, let’s dive into what you’re here for: probiotics for PCOS!

What is a Probiotic? 

Probiotics are live bacteria and yeasts that have beneficial effects on your body, particularly your digestive system. There are several different types of probiotic strains available that can improve various aspects of health. There are also several food sources that naturally contain probiotics also. 

infographic list of probiotic-rich foods for pcos.

Some probiotic-rich food sources include:

  • Yogurt
  • Cottage cheese
  • Kefir
  • Tempeh
  • Miso
  • Sauerkraut
  • Kimchi
  • Kombucha

Here’s a few of my favorite recipes that use probiotic-rich foods: 

Mango Kefir Smoothie

Strawberry Cottage Cheese Smoothie

Greek Yogurt Chia Pudding

High Protein Chocolate Pudding

chocolate pudding layered with whipped cream in a glass with whipped cream and chocolate chips on top.

Benefits of A Probiotic for PCOS

The research on probiotics is relatively new, but it’s constantly evolving to show how beneficial they can be for our overall health and even PCOS too. 

Metabolic Health

A recent systematic review found that probiotic and synbiotic supplementation can decrease fasting glucose levels, body weight, BMI, cholesterol levels, and inflammation. Additionally, they improved glucose metabolism and insulin sensitivity. Given the prevalence of insulin resistance and chronic inflammation in those with PCOS, probiotics may be a pretty solid addition to your PCOS management plan.

Synbiotics are a combination of both probiotics and prebiotics. We’ve talked about what probiotics are (aka the good gut bacteria). Prebiotics are compounds in food that promote the growth and reproduction of the good gut bacteria. Basically, prebiotics are the food source of probiotics. Some foods that are good sources of prebiotics include bananas, asparagus, oats, onions, garlic, leeks, apples, beans, barley and whole wheat.  

For more info on how to implement a balanced diet for PCOS that includes several prebiotic foods, check out this blog post: A Dietitian’s 7 Day PCOS Diet Plan PDF

Hormone Levels

Since PCOS is a hormonal disorder, several different hormone imbalances may be present. Research has found that probiotics may be helpful for lowering the hormone insulin, but it may help improve other hormonal imbalances too. 

Probiotics can improve the free androgen index, hirsutism (excess hair growth), sex hormone-binding globulin (SHBG) and total testosterone levels in those with PCOS (7, 8). 

Some research shows that probiotics may have positive effects on other sex hormones too. Luteinizing hormone (LH) levels are often chronically elevated in those with PCOS. Additionally the ratio of LH to follicle stimulating hormone (FSH) is often skewed, which can lead to anovulation and irregular periods. One clinical trial found that a certain probiotic strain, Bifidobacterium lactis V9, decreased LH levels and the LH to FSH ratio significantly (9).

infographic showing the benefits of probiotics for pcos.

Other Probiotic Benefits

Aside from the metabolic and hormonal impact that probiotics can have, there are several other benefits that have been researched! 

Probiotics may be helpful to improve:

  • Vaginal Health. Probiotics may be helpful in the management or prevention of bacterial vaginosis (BV), vaginitis, yeast infections, human papillomavirus (HPV), and even some gynecological cancers (10).
  • Digestive Issues. Probiotics can help improve digestive symptoms, such as abdominal cramping, bloating, gas, diarrhea, and heartburn. It may also be beneficial in the management of inflammatory bowel disease (IBD) and IBS.
  • Immune Function. Research shows that probiotics can help to improve immune function and strengthen the immune system (11).
  • Mental Health. Probiotics may help improve symptoms of depression and anxiety, which occur at higher rates among those with PCOS (12, 13).

Do I Need To Take A Probiotic Supplement?

Whether or not you should take a probiotic supplement will be individualized. If you suspect that you may have gut dysbiosis, a probiotic supplement may be beneficial to trial. Like other supplements for PCOS, you’ll need to weigh the pros and cons to determine what the best fit for you will be – and of course, talk to your healthcare provider. 

What’s The Best Probiotic for PCOS? 

When it comes to choosing the best probiotic for PCOS, there are several things you’ll want to consider. Since dietary supplements, including probiotic supplements, are not FDA approved and regulated, you’ll want to ensure you’re choosing a quality product. 

When choosing a probiotic for PCOS, I generally recommend looking at:

  • Third Party Tested.For any dietary supplement, you want to look for a company that undergoes third party testing to ensure that what they’re advertising, is what you’re getting. 
  • Colony Forming Units (aka CFUs). This is the number of live bacteria or microorganisms that are actually in the probiotic supplement serving. Generally speaking, the higher the number, the better. 
  • Storage. Some probiotic supplements require refrigeration. This may not be something that you mind either way, but something to be aware of. 
  • Consumption.Some probiotic supplements recommend that you take them on an empty stomach. Again, this may not be an issue for you, but if you generally don’t fare well taking pills on an empty stomach, you may want to be aware of this.

The Best Probiotics for PCOS

Ok, so there actually may not be one best probiotic for PCOS, but here are a few of my favorite probiotic brands for women with PCOS. 

infographic with the best probiotic brands for pcos.

As a PCOS dietitian, here are some of my favorite probiotics for PCOS:

Garden of Life Once Daily Women’s Probiotics

NOW Probiotic-10

Douglas Labs Multi-Probiotic 40 Billion

Design for Health ProbioMed 50

I gravitate towards these particular probiotics because they have a good variety of probiotic strains, particularly Lactobacilli and Bifidobacteria strains, which women with PCOS tend to have less of. 

They’re also third party tested and have a good amount of CFUs, so you’re actually getting a decent amount of probiotics per serving. And finally, they’re some of the more cost effective probiotic options. Sure, there are going to be cheaper probiotic options, but it’s usually because they contain a quarter of the probiotic strains or CFUs that these options have. 

What To Expect Taking A Probiotic

If you’re new to probiotics, you may be wondering what to expect when you start taking a probiotic supplement. The truth is that it’s going to vary person to person. 

Bloating and gas are some common symptoms that you may experience during the first few days or weeks of taking a probiotic supplement. That’s because these supplements are working hard to change your gut flora, which can sometimes result in more gas being produced. 

The good news is that these side effects are usually temporary and typically subside after a couple of weeks. 

FAQs

Should You Take A Probiotic With PCOS?

If you suspect that you have gut dysbiosis, a probiotic supplement may be a helpful addition to your daily routine. 

You can also include several different types of gut healthy foods in your diet as well. Kombucha, kimchi, sauerkraut, miso, and fermented dairy products are all great sources of probiotics. 

What Bacteria Helps PCOS?

Research studies have not been able to pinpoint an exact bacteria or probiotic strain that would benefit everyone with PCOS. People with PCOS tend to have less of the beneficial Lactobacillus and Bifidobacterium bacteria though, so including more of these bacterias may help PCOS symptoms. 

How Do You Improve Gut Health With PCOS?

Including prebiotics and probiotics in your diet can help to improve gut health with PCOS. 

Prebiotics can be found in foods like apples, bananas, Jerusalem artichokes, oats, whole wheat, barley, garlic, onion, and leeks. 

Probiotics can be found in foods like kombucha, kimchi, sauerkraut, and fermented dairy products such as kefir, cottage cheese, and Greek yogurt. 

Key Takeaways

The gut microbiome influences a variety of processes within the human body. Women with PCOS tend to have a less diverse gut microbiome than those without PCOS, which can lead to medical conditions like insulin resistance, inflammation, and digestive issues. 

Healthy gut bacteria known as probiotics may be a beneficial tool to improve your gut health. Probiotics can be found in foods such as fermented dairy products, kimchi, tempeh, sauerkraut, and kombucha. 

Probiotic supplements are another treatment option that can be considered. For those with PCOS, a supplement with multiple Lactobacilli and Bifidobacteria strains may be the best option. 

Supplements can be a vital component of an effective PCOS management plan, but how do you know which ones are the best for you? There’s so much information out there that it can certainly get confusing! The PCOS Supplement Guide walks you through how to choose which supplements are right for you, including what the research says, the proper amount to take, and which brands are good options. 

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Disclaimer: this is for informational purposes only. It is not intended to be a substitute for or replace professional medical advice for polycystic ovary syndrome (PCOS) or any other medical condition. Always consult with your healthcare provider prior to starting any probiotic supplementation.

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