Unraveling the Womb-Gut Connection: Understanding its Role in PCOS

If you have PCOS and you are trying to conceive today's article is for you!  Consider this a hot take on addressing PCOS and infertility holistically.   It's also my personal entry point into this work and why I focus on women with PCOS in our practice. (More on that later)

Many women with PCOS struggle to conceive and suffer from a myriad of symptoms.  If you have PCOS, you already get it--unwanted facial hair, weight that wont come off, exhaustion, uncontrollable cravings for carbs, insulin resistance, thinning hair, acne and a whole host of other symptoms because PCOS is NOT ONE THING.  It's a collection of symptoms.  So my PCOS may not look like your PCOS.  

So let's get into it:

PCOS: Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder affecting millions of women worldwide. While its exact cause remains elusive, because like we said, PCOS (and really anytime you hear syndrome) refers to a collection of symptoms.  Researchers are increasingly turning their attention to the intricate interplay between various bodily systems. One such emerging area of interest is the connection between the womb (uterus) and the gut. In this article, we delve into the fascinating world of the womb-gut connection and its implications for PCOS.

The Womb-Gut Axis: The womb and the gut may seem distant anatomical neighbors, but they are intimately connected through a network of hormonal signaling pathways and microbial communities. This bidirectional communication pathway, known as the womb-gut axis, plays a crucial role in maintaining overall health and regulating various physiological processes.

Understanding PCOS: PCOS is characterized by hormonal imbalances, irregular menstrual cycles, cystic ovaries, and metabolic disturbances such as insulin resistance and obesity. While traditionally viewed as a reproductive disorder, mounting evidence suggests that PCOS is a systemic condition involving multiple organ systems, including the womb and the gut.

The Role of Gut Microbiota: The gut microbiota, composed of trillions of bacteria, fungi, and other microorganisms, exert profound effects on health and disease. Emerging research indicates that alterations in the gut microbiota composition, known as dysbiosis, may contribute to the development and progression of PCOS. Dysbiosis in PCOS patients has been associated with insulin resistance, chronic low-grade inflammation, and metabolic dysfunction.

Impact on Metabolic Health: Insulin resistance is a hallmark feature of PCOS, leading to hyperinsulinemia and compensatory hyperglycemia. Studies have shown that gut dysbiosis can exacerbate insulin resistance by promoting inflammation, impairing insulin signaling, and altering energy metabolism. Furthermore, dysregulated gut microbiota may contribute to obesity, a common comorbidity in women with PCOS.

Inflammation and Immune Dysregulation: Chronic low-grade inflammation is another key player in the pathogenesis of PCOS. The gut microbiota play a pivotal role in modulating immune responses and maintaining intestinal barrier integrity. Dysbiosis-induced disruption of the gut barrier can lead to increased intestinal permeability, allowing the translocation of bacterial endotoxins into the bloodstream, triggering systemic inflammation and metabolic dysfunction.

Hormonal Crosstalk: Hormonal imbalances lie at the heart of PCOS, with elevated levels of androgens such as testosterone contributing to menstrual irregularities and ovarian dysfunction. Interestingly, the gut microbiota influence estrogen metabolism and may impact circulating hormone levels. Imbalances in gut microbial populations can disrupt estrogen metabolism, potentially exacerbating hormonal disturbances in PCOS.

So at this point you hear that as as one part of the body becomes imbalanced it impact other parts of the body and cascades 

Holistic Fertility Implications: As Holistic Fertility practitioners we approach PCOS differently.  But we are also different.  I (Regina Kankinza) have a degree in Neuroscience and have spent a decade as student and practitioner of Ayurveda.  My partner in this practice, Manorah Sangeet Raj is a trained Somatic Therapist but has been a traditional midwife and birth worker that has attended nearly 200 births!   While many doctors in the reproductive space focus on reproductive organs, egg & sperm quality and quantity and hormonal health--we understand that fertile body is a healthy body.  We've developed what we call our framework the Feminine Axis of Fertility which goes beyond the traditional Brain-Gut connection and realizes that this axis extends down into the womb.  In truth for us womb bearing women, it's truly the Brain-Gut-Womb axis!  This also our site of intervention.  All of our fertility interventions are targeted at restoring balance for each of these sites. And for women with PCOS this is especially important.

My Story:

Technically speaking, I was jacked up!  I had gained weight I couldn't take off, was diagnosed as pre diabetic, my hormones & menstrual cycle were off, & I had insomnia. At the time I was a raw food vegan, running daily on the 1200 calories I had limited myself to.  I went to hot yoga multiple times of week and was doing all the things I thought were "healthy" but something wasn't adding up.  I knew something was off.  Doctors advice was to eat right & workout but I was already doing those things. 

Eventually I met an Ayurvedic practitioner who told me that the core issue was how I was living for my body type.  What became obvious in ayurveda is that we all don’t inhabit the same body–and inputs into one body type do not result in the same outputs in another body type.  Functional medicine is recently discovering the importance of collecting information on the individual before making recommendations but Ayurveda has known this for 5000 years.  And as I used to hear the elders say “everything ‘aint for everybody.”  

When I learned what was actually healthy for my body (and it wasn’t salad, smoothies & restriction) my body naturally restored itself.  Six weeks later I was no longer pre diabetic, the weight melted off, my sleep went back to being solid and I felt great! Part of the power of this experience rested in the fact that I realized if I learned the language of my body & just did what it was saying, I could be my own healer.  

So now my work is to curate transformative healing journies for womxn with complex metabolic issues & women trying to conceive where they realize they too can be their own healers.  I promise you that once you start & see its possible it’s an addictive form of power you’ll be hesitant to ever give away again.

Conclusion: Ayurveda and many indigenous medical systems have always known the gut/our digestion is the key to our health and therefore the key to our fertility.  But modern science is hot on the trail and producing lots of new research on the womb-gut connection and it offers new insights into the pathophysiology of PCOS. This new research looks at the complex interplay between the uterus and the gut, researchers hope to uncover novel therapeutic targets for this multifaceted disorder. Ultimately, a holistic approach that considers the bidirectional relationship between reproductive health and gut function we believe is key to reversing PCOS symptoms.  

We see it all the time in our practice with women who suffer from PCOS that creating the optimum gut healing conditions (balanced blood sugar, feeding and repairing the microbiome, caring for our nervous system) is what ultimately leads to a fertile, healthy body.  

If you have PCOS and have been looking for fertility support, we specialize in PCOS and fertility and we would love to help you get to your baby.  You can find more information here.