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Gut health is closely linked to women’s reproductive wellness. Imbalances can worsen PCOS and endometriosis. Dr Ruhi Jain, an obstetrician and gynaecologist, outlines 9 ways gut bacteria affect hormones.
Advancing medical research is heavily focusing on the correlation between gut health and women’s hormonal and reproductive wellness. A gut microbiome of trillions of microorganisms is integral to the regulation of hormones, immune response, inflammation and metabolism.
An imbalance of gut bacteria can upset these normal functions and may contribute to the onset or progression of gynaecological conditions such as Polycystic Ovary Syndrome (PCOS) and endometriosis.
Dr Juhee Jain, Director – Obstetrics and Gynaecology, Madhukar Rainbow Children’s Hospital, Delhi, says that having a healthy gut is an increasingly accepted, though often ignored, aspect of women's health.
PCOS is commonly associated with irregular periods, weight gain, insulin resistance and difficulties conceiving, while endometriosis is characterised by chronic pelvic pain and inflammation. Recent research suggests that gut dysbiosis affects oestrogen metabolism and the signalling of inflammatory pathways, potentially exacerbating these conditions.
Dr Jain says that a better understanding of the gut-hormone axis could enable more holistic management of gynaecological conditions, combining medical care with lifestyle and nutritional interventions for long-term effectiveness.
The effects of imbalance on hormones
- Hormone balance maintained by gut bacteria: Gut bacteria metabolise excess oestrogen. When dysbiosis occurs, this process is impaired, leading to oestrogen dominance, which worsens symptoms of endometriosis and PCOS.
- Inflammation originates in the gut: "Leaky gut" syndrome, caused by dysbiosis, triggers systemic, chronic, low-level inflammation. This underpins the pain experienced in endometriosis patients and metabolic issues in patients with PCOS.
- Intestinal health and insulin sensitivity: Imbalance in intestinal flora contributes to insulin resistance, a fundamental pathophysiological mechanism in the aetiology of PCOS. Improving gut health may reduce this risk.
- Poor digestion and nutrient malabsorption: Deficiency in Vitamin D, magnesium, B vitamins, and zinc worsens hormonal imbalance and menstrual cycles.
- Constipation recycles hormones: Slow waste movement prolongs oestrogen retention in the colon, recycling it into the bloodstream.
- Gut-brain axis influences stress hormones: Dysbiosis elevates stress hormone, cortisol, intensifying the body’s stress responses. High cortisol can disrupt ovulation and heighten pain sensitivity in women with PCOS/endometriosis.
- Dietary factors: Refined sugars, high processing, and low natural fibre contribute to dysbiosis. Whole nutrient-dense foods support gut balance and hormonal health.
- Probiotics and prebiotics: Foods like curd, kefir, bananas, garlic, and whole grains help rebalance gut flora, indirectly improving hormonal imbalances.
- Lifestyle habits: Adequate sleep, regular exercise, persistent hydration, and stress management are vital to maintaining a healthy gut-endocrine system.
The enhancement, support, and relevance of overall gut health are perhaps the most potent yet most often overlooked "treatability" factors that are fundamental within the realm of symptom modification, management, and the overall causative factors of PCOS and Endometriosis in particular. The gut microbiome is, in fact, irrevocably linked with a healthy hormonal environment.
(The author, Nivedita, is a freelance writer. She writes on health and travel.)
English (US) ·