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Gut Health

The Connection Between Gut Health and PCOS

By September 11, 2021September 14th, 2021No Comments

What is PCOS?

PCOS (Polycystic ovary syndrome), as any suffer will attest, is a complicated endocrine disorder that is estimated to affect as many as 10% of women of childbearing age in Ireland. It is one of the most common causes of infertility because it interferes with a woman’s ability to ovulate, or release an egg for fertilisation.

In addition to infertility, other complications of PCOS include:

  • Irregular or absent menstrual cycles
  • High levels of androgens or “male” hormones, which may cause symptoms like acne, facial hair growth and head hair loss
  • Insulin resistance (thought to be a primary driver or “root cause” in PCOS)
  • Vitamin and mineral deficiencies
  • Chronic low-grade inflammation
  • Pregnancy complications such as gestational diabetes or high blood pressure
  • Obesity
  • Sleep apnoea
  • Elevated cholesterol levels and heart disease

What causes PCOS?

What causes PCOS, however, is less clear cut, with scientific research yet to settle on one — or several— explanations.

There are many theories to what triggers PCOS, including genetic and environmental factors. One such theory — and one that is relatively new but is currently being explored by scientist and researchers across the globe —is the theory that an imbalance of microbes in the gut can trigger the development of PCOS.

While some microbes are pathogenic (capable of causing a disease) to us, there are a host of microorganisms (MOs) that help us carry out many of our bodily functions and protect us from the “bad” MOs.

Believe it or not but there are actually approximately as many bacterial cell in the human body as there are human cells. A recent study found that there are approximately 38 trillion bacterial cells, with a resulting mass of roughly 0.2kg, and 30 trillion human cells in the average 70kg man aged between 20-30, with minor quantitative variations for women.

Most of these bacterial cells can be found in the gastrointestinal (GI) tract where they function to protect us against bad bacteria, aid in biochemical signalling, and help us by increasing the nutrition value in much of the food we eat. The imbalance, or maladaptation, of microorganisms in the gut— which is referred to as dysbiosis of the gut — is certainly a ‘hot topic’ in the medical world right now.

What is Dysbiosis of the gut?

We have a symbiotic relationship with our normal flora, or “good bacteria”, where we act as their host and they facilitate many of our bodily processes.

What constitutes as our gut microbia is largely determined at birth and during the first three years of life, where exposure to the mother’s normal flora and the environment determine the phylogenic contents of our adult gut microbiota.

“Good” bacteria helps us in a number of different ways including displacing “bad bacteria”, assisting us in the breaking down of larger molecules so that they may be safely absorbed into our blood stream, and producing certain chemicals, such as serotonin, that we may use for various processes throughout our bodies.

In order for these bacterial to thrive me must produce a favourable environment for them; otherwise “bad’ bacteria may over populate, causing a microbia imbalance, or dysbiosis of the gut.

It should be acknowledged that dysbiosis is a catch-all term since there is no “perfect” microbiome. Every human is unique, and that means that every microbiome is unique, too. However, researchers have identified three broad signs of dysbiosis that are related to the quantity of certain microbes in relation to others:

  1. Overgrowth of some bacteria or yeasts
  2. Absence or insufficiency of beneficial bacteria
  3. Low diversity of species in the microbiome

What happens when there is Dysbiosis of the gut?

When we consume a poor diet (low in fibre) and excessive amounts of alcohol, our good bacteria become “uncomfortable”, which results in the pH in the GI tract increased, creating a more favourable environment for “bad bacteria”.

If a poor diet is consumed over a sustained period, the ratio of “good” to “bad” bacteria will likely decrease to a point where the by-products of the “bad” bacteria will reduce the integrity of the GI tract wall.

When the wall of the GI tract is compromised, its permeability increases and, subsequently, large molecules, which are not meant to pass between the epithelial cells of the GI wall, are able to enter the blood stream, creating a number of unfavourable responses.

Studies have shown that women with PCOS have dysbiosis and less diverse gut bacteria than woman without PCOS, which may contribute to symptoms and disease progression. Researchers have also found that the higher the androgens, the lower the gut bacterial diversity is in PCOS. In addition, the complications associated with PCOS (obesity, insulin resistance, etc) may lead to worsening dysbiosis, further complicating things.

How does dysbiosis of the gut relate to PCOS?

Two biochemical factors have always been in agreement
and observed in the majority of women with PCOS: the presence of chronic inflammation and insulin resistance (metabolic dysfunction). Many studies have found a correction between gut microbiota and metabolic dysfunction, where it is said that mediators of the brain-gut axis — by which messages are sent between the central nervous system and the GI tract — may be regulated by “good” bacteria.
One study found that women with PCOS had higher levels of certain “bad” bacterial strains in their stool sample than non-PCOS women; this demonstrated a positive correlation with BMI and testosterone in women with PCOS[1].

In recent years a new concept, referred to as microgenderome (or sexual dimorphism in microbiome), reveals a potential relationship between sex hormones and gut microbiota. At this time, the studies encompassing the microgenderome concept are largely animal-based; nonetheless, these studies are significant stepping stones in discovering connections between hormone concentrations and gut microbiota in humans.

The imbalance between “good” and “bad” bacteria within the gut can potentially affect the exacerbation, and possibly the development, of PCOS in a number of different ways.

“Bad” bacteria contain what is known as lipopolysaccharide (LPS), a known stimulant of inflammation, on their cell wall. Inflammation in the GI (gastrointestinal) tract can increase the permeability of the GI tract walls as it compromises the integrity of the ‘tight junction’ proteins that keep the wall cells tightly bound. Inflammatory promoting factors are then released in the blood stream; these factors have been associated with the inactivation of insulin receptors on our cells, preventing insulin from binding its respective receptor; thereby preventing glucose from entering a cell to be used as fuel.

An increase in blood insulin levels, as well as the increase in certain inflammatory factors, trigger a rise in androgen production from the theca cells of the ovaries. High levels of blood insulin also reduces the Sex Hormone Binding Globilin (SHBG) released from the liver which allows more free, bioavailable, testosterone to exist throughout the body.

Prolonged inflammation further weakens tight junctions creating a positive feed-back loop. Therefore, the evidence indicates that dysbiosis of the gut has the potential to make serious contributions to the development and aggravation of PCOS.

Reference:
[1] Guo Y, Qi Y, Yang X, Zhao L, Wen S, Liu Y,et al. (2016) Association between Polycystic Ovary Syndrome and Gut Microbiota. PLoS ONE 11(4):e0153196. doi:10.1371/journal.pone.015319

What can women with PCOS do?

While there is no cure for PCOS, overweight and obese women can help balance their hormone levels by losing weight. Otherwise, treatment is aimed at managing symptoms.

The most common way to control the condition is through diet and exercise. The former is especially important if the aim is to bring balance to the gut microbiota. A healthy diet of unprocessed foods, limited alcohol, and high fibre (women of childbearing age need at least 25 grams of fibre per day) will help to produce an environment for good bacteria to thrive[1].

A good probiotic supplement, such as Nua Fertility, will help to jumpstart gut microbial replenishment and should be taken regularly. The “friendly bacteria” they contain can help restore balance and composition in the gut microbiome and help to address or prevent dysbiosis. Furthermore, probiotics support the proper digestion and absorption of nutrients, support the immune system, and may reduce inflammation in the digestive tract.

Additional ways to alleviate the effects of PCOS include stress-management, reducing the intake of sugar and ensuring sufficient sleep is achieved.

Reference:
[1] Rowland I, Gibson G, Heinke A, Scott K, Swann J, Thiele I, Tuohy K (2017) Gut Microbiota functions: metabolism of nutrients and other food components. Eur J Nutr. doi:10.1007/s00394-017-1445-8

In Summary

PCOS is closely linked to an imbalanced gut microbiome, so supporting gut health is an incredibly important component in managing PCOS and boosting fertility.

For Women thinking, planning or trying for a baby with PCOS, NuaBiome Women  supports gut health.

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Amy Martin

Marketing Director

Amy is a high achieving individual with a number of marketing awards under her belt, including Young Digital Business Person of the Year 2019. She is a big believer in digital marketing and an expert in executing personalised targeted campaigns. Amy strives to learn from data and campaigns that show return on investment.

Robert Gordon

Managing Director, Gordons Chemists

 

Robert Gordon, director at Gordons Chemist's. Gordons Chemists is a chain of more than 60 pharmacies, located in NI and Scotland. Gordons Chemists is Northern Ireland's largest independent pharmacy chain.

Dr. Debbie Collins

MBBchBAO MRCGP

 

Dr. Debbie Collins MBBchBAO MRCGP, a practicing GP and partner in Belfast. She has a passion for patient education and advocacy. Her special interests are Women's Health and Fertility

Sarah Trimble

Nutritional Therapist

 

Sarah Trimble - a nutritional therapist with a passion for good food instead of fad diets. Sarah has a particular Interest in using the power of nutrition to support hormonal imbalances and reproductive health.

Barbara Scott

Director, Seren Natural Fertility
Chair, Association of Reproductive Reflexologists

 

Barbara Scott is Chair of The Association of Reproductive Reflexologists, founder of Seren Natural Fertility and author of Reflexology for Fertility. In 2017, she was awarded ‘Complementary Therapist of the Year’ by the Federation of Holistic Therapists and has been nominated for several awards within the field of complementary therapy. In 2019 she was awarded the Innovation in Reflexology Award by the Association of Reflexologists.

Barbara speaks and lectures globally on her integrative approach to supporting couples having difficulties conceiving. She has spoken at many of the Fertility Shows and Fertility Fest. Alongside her own busy clinics, she also trains practitioners in providing this integrative, approach to fertility and reproductive healthcare and well-being. The ARR (Association of Reproductive Reflexologists) has trained practitioners globally, from Australia, New Zealand, Canada, Europe, and most areas of the UK.

Her expertise and passion is in advocating a patient-centred and integrative approach to supporting both men and women on their journey to parenthood.

Cindy Charles

Fertility coach and Founder of Fertilelife

 

Cindy Charles- Fertility coach and Founder of Fertilelife. Cindy is a committed advocate of social and personal development. Her own life experiences inspired her fertility support services. Cindy has worked with the Fertility Network UK, and has had the privilege to work as a resident Fertility Coach for the London Women's Clinic on Harley Street. Cindy believes in the importance of nurturing our own fertility.

Dr. Lyuda Shkrobot

MD, MSc Gynecologist, Fertility specialist at unq.life fertility clinic

 

Dr Lyuda has a special interest in reproductive immunology. Dr Shkrobot assisted in establishing the first European Donor Egg programme at Sims, coordinating and liaising with Intersono Clinic in Ukraine Advisors. She is passionate about patient-centred, results-driven care.

Jill Martin

Business Development Director

 

Jill Martin is a trained nurse and highly experienced pharmaceutical professional. Most of her business acumen and skills were developed by the world class training she received at Glaxo Smith Kline (GSK). Hard work and focus have resulted in a varied and successful career working in several different disease areas. As part of the Diabetes team at GSK, an opportunity arose to develop and support education programmes that were rolled out to the NHS across the UK, which resulted in improvement of Strategy and Patient Care. Jill feels that education is the key to understanding and has made it a personal goal to self-improve and support learning for others especially within the healthcare arena. The last 10 years have been devoted to trying to impart the importance of Fertility Health early in the life cycle of us all, rather than when infertility issues arise. She is delighted to have joined Nua Fertility on their mission to support people and communities to understand the importance of gut health on our fertility well-being.
 

Share a little about yourself—the things we wouldn’t learn from simply reading your professional bio.

The most important thing to me in life are family and friends, it breaks my heart when people are broken and I know that I am always trying to find solutions to problems. I love being outside rather than sitting at a desk and would rather lift the phone and have a chat with someone rather than email or message. I find people interesting and will often be that annoying person who starts a conversation on a train or plane.
 

What was your journey to parenthood like?

I feel very blessed to have had my family naturally, although not without some challenges. Following a miscarriage and thyroid issues conception wasn’t as easy as I would have hoped. My personal experience made me appreciate how important it is to value ways to improve your fertility health. This set me on my own journey to find out more, by surrounding myself with a network of experts in this area who I am continually learning from. When possible I take every opportunity to share best practice or send information to others that I know who are also seeking to understand more.
 

What is your ideal way to relax and unwind?

Juggling home life and working full time with a lot of travel, for most of my adult life made me find a way to relax that may seem strange. I love getting my trainers on and going for a long walk or run, even in the rain! Sometimes I will listen to a podcast and other times just be mindful of my surroundings. I find this a great way to clear my head, think about priorities and take time out for myself.
 

If there was just one thing you could impart on women on their journey to parenthood, what would it be.

From an early age I loved to make jigsaws, little did I know that this skill would help me later in life to understand the complexity of fertility and the miracle of life. Everyone is unique, every situation is different, like a jigsaw there are lots of pieces that need to be put together to become complete. Explore all options, chat to experts don’t be afraid to ask for help.

Aoibheann Murphy

Chief Financial Officer

 

Having trained with PWC, Aoibheann qualified as a Chartered Accountant in 1997. She subsequently spent eight years working in industry, gaining invaluable experience in many areas In 2005 Aoibheann became MD of Pangur Consulting, providing professional expertise to a broad client base. She is looking forward to the new challenge of Nua Fertility.
 

Share a little about yourself—the things we wouldn’t learn from simply reading your professional bio.

 

What was your journey to parenthood like?

Right craic!
 

Do you prefer podcasts or books? And of the one that you prefer, what is a show or title that you recommend?

I love sport…any sport…and the outdoors. Living in the Barrow valley I get to enjoy swimming and kayaking in the Barrow and exploring the Blackstairs mountains. Since I hung up my soccer boots (the body just couldn’t take it anymore!), I’ve been cycling with my lovely friends in Mount Leinster Wheelers and was chuffed to have completed the Ironman 70.3 triathlon event in Dublin in 2019!
I’m an avid reader…books beat podcasts hands down!...although recently I’ve dabbled with audio books through the library app Borrow Box. “A Little Life” left its mark on me. A harrowing story, definitely not for the faint hearted.
 

If there was just one thing you could impart on women on their journey to parenthood, what would it be?

Don’t be consumed by the roles in your life – parent, partner, employee etc. Parenthood, be it getting there or going through it, will have its tough times. Cherishing yourself as an individual and making time for yourself can help you through those times….it’s good to be a bit selfish!!

Mark Mullins

Director of Sales

 

What was your journey to parenthood like?

To be honest it was very difficult. At the beginning we thought that when we decided that we wanted to start a family Deborah would fall pregnant shortly afterwards like many of her friends. As time went by, we started to suspect something was wrong. After initial tests we found out that I had a low sperm count which meant that we would have to go down the assisted pregnancy route. This took me several months to get my head around as I blamed myself for this. All I wanted was my wife to be able to go through the pregnancy journey. We couldn’t wait to become parents. There were many long and painful nights where I thought this would never happen for us. After several failed attempts we decided to look at further ways of improving our chances. This led us to look at fertility supplements, our diet, exercise. I will never forget when that morning during our Two Week Wait when Deborah woke me up at 5 a.m. to show me those two lines, we had both been yearning for! We are blessed to now have our beautiful daughter.
 

On challenging days, what kept you going? Where did you find inspiration?

My wife was my inspiration. She kept me going through those challenging months and years. She was there to help me deal with everything. The guilt I felt when I saw her having to go through everything.
 

What is your ideal was to relax and unwind?

My latest passion is cooking on my BBQ. I find it so peaceful and I just switch off. It just gives me a bit of alone time which everyone needs.
 

If there was just one thing you could impart on men as they begin trying to become parents, what would it be?

I would highly recommend communicating with friends and family. A problem shared is a problem halved. Failing that there are some really good private Facebook groups for men suffering from infertility. I found this great support through the good and especially the bad times.