The Core Issue

PCOS (recently renamed polyendocrine metabolic ovarian syndrome, or PMOS) is tied to gut bacteria imbalance, and doctors have been throwing probiotics, prebiotics, and synbiotics (a combo of both) at it for years with mixed and often conflicting results.

The Finding

Researchers pooled 14 randomized controlled trials covering 755 women with PCOS and, for the first time, split out which of the three interventions actually worked. When taken alone, prebiotic fiber (like inulin, the kind of fiber that feeds good gut bacteria without adding new bacteria) dropped total testosterone by an average of 31 ng/mL and cut hirsutism scores (excess hair growth) by over 2 points. Probiotics and synbiotics, tested the same way, showed no significant hormone benefit at all.

Why it Matters

If you have PCOS and have been taking a probiotic hoping it would help your hormones specifically, this suggests it might not be doing much on that front, even if it helps digestion generally. Plain fiber supplements may be the more promising lever.

Limitations of Study

Only 2 of the 14 trials tested prebiotics by themselves, so this headline result rests on a small slice of the total data. Nearly every outcome also showed high statistical variation between studies, and all 14 trials came from just two countries, Iran and Poland, with every participant already overweight or obese going in.

Conflicting Interests

None reported. The researchers stated no funding and no conflicts of interest.

Interesting Statistics

- 14 randomized controlled trials, 755 women total, run between 2015 and 2025

- Prebiotics alone: testosterone down 31 ng/mL, hirsutism score down 2.02 points, SHBG (a protein that mops up excess testosterone) up 11.43 nmol/L

- All three interventions combined: fasting insulin down 2.07 μIU/mL, triglycerides down 12.22 mg/dL, HDL ("good") cholesterol up 2.13 mg/dL

- Baseline BMI was 24 or higher in every single trial included

TL;DR

Plain prebiotic fiber, not probiotics or combo synbiotics, showed the clearest hormone benefit for PCOS in a pooled analysis of 14 trials, but it is based on only 2 prebiotic-only studies so far.

I got this from u/Electronic-Lie-4547 and I thought it would be helpful to a lot of us here.

https://biomesci.com/prebiotics-outperform-probiotics-pcos-pmos/

My wife’s menstrual cycles range from 38 to 60 days. Her thyroid and prolactin levels are normal, she’s at a healthy weight, and she exercises three times a week, yet her cycles are still irregular.

I can imagine how difficult it must be to struggle with weight due to PCOS, and I so sorry for that. However, in all the PCOS subreddits we’ve looked through, most of the posts seem to be from people struggling with their weight or having difficulty losing it.

We rarely come across people with PCOS whose main issue is irregular periods or not getting their period at all. Is anyone else here dealing with PCOS where the primary symptom is an irregular or absent menstrual cycle rather than weight-related issues? What did you do to improve your menstrual cycle?

im 20F and i’ve been diagnosed with PCOS a couple of months ago. i take meds and go to check-ups so everything so far is stabilised. my real concern is that i’ve seen that PCOS usually affects fertility and even in some cases causes infertility which is my biggest fear because my one dream in the world is to become a mother. how did it affect you? i kind of need reassurance lol

What are your experiences on Inositol vs Metformin?
Got diagnosed with PCOS yesterday and been TTC for 6 months. They were going to put me on Metformin but due to my IBS/IBD/Colitis they told me I should do Inositol instead. Hoping it’ll give me a better chance at getting pregnant!

I'm going on a multi day trip and hoping to avoid sugar crashes as well as stay energized enough to hike for the full day. I know people say to "carb up" before the trip but I've learned that PCOS means we don't use the carbs as efficiently. Just wondering if anybody had something that worked for them in terms of what you ate before and during a trip.

I just got metformin but I haven’t start taking it yet. The thing is I really like to party… and I made a quick google searches and a lot told me that I basically can’t drink on it? My doctor dint mention anything only that “don’t take it if your sick”

is it safe?

Can i just not take it that day and be fine?

Do any or you know how it works with alcohol?

22 female was on iud birth control for three years kyleena hormonal. Went off it for about a year and a few months now. Last year I started having ruptured cyst consistently every month for about five months it would go away for a few months, fast forward to this year I’ve already had six out of the nine months of ruptured cyst. I’ve been to doctors no one can figure out why it’s happening or what to do to manage the pain. All they can suggest is more birth control. Maybe I’m ignorant bc I don’t know but I’m truly exhausted of this pain almost every month. If u experienced this and have any tips to manage it
Please let me know!!

I’m not in the USA. I am married. My birth control options are LIMITED and my husband and I are childfree. I can’t use birth control pills anymore because of them causing hypertension and migraines with aura. Can’t use Depo Provera shot because of meningioma risk. Can’t use IUDs because they don’t go in/stay in. Can’t afford sterilisation (not offered through free public healthcare where I live & my job pays a pittance). Was excited for the implant but the only one available in my country is Jadelle with levonorgestrel. From reading this sub, every goddamn person is shouting from the rooftops that levonorgestrel will ruin my life because I have PCOS apparently BUT I’ve seen a few commenters here and there with positive results. I’m looking for YOU. I would like to hear how you’ve been after starting birth control like Jadelle implant/ Mirena/etc.

I (26F) take one scoop of inositol daily before breakfast and it has helped but lately I feel like it hasn’t as much. Maybe the effects are wearing off. My period has become more regularized and it did help with my mental health but honestly I feel like my hormones are wacky again and I’m constantly tired and anxious. I was bad then good and now and again. I did loose like 5-7 lbs while on inositol so that’s another plus but I am curious about trying a GLP-1.

I’ve been on metformin before and spirolactone but stopped. Spiralactone was kinda cool bc I do feel like it made me more feminine.

What are your thoughts and experiences on a GLP-1? Did it improve ur life? Erase PCOS? Let me know because I’m seriously considering. Yeah the weight loss will be cool (my weight is good, I’m fit and I go to the gym). It took me forever to lose weight and I know the GLP1 will make me shred fat much faster without even trying now. I heard many felt improved energy levels too amongst many things like eliminating their insulin resistance and reducing testosterone levels. My doctor actually had prescribed me a GLP1 years ago before it was popular.

Haven't found posts with my experience so wanted to share. TW for disordered eating/medical maltreatment.

I (20s NB) am anti-doctor in the sense that I refuse to see providers who start with, "have you considered losing weight" / "your BMI is too high". I live with ARFID and OSFED so diet skinny culture is truly the opposite of what I need. So I'm treating myself and seeing what happens. I do not recommend it, it's just where I've landed. My
concerns have always been my triglycerides, A1C and HDL cholesterol.

I tried d chiro/myo inositols and had awful reactions to both. Same with metformin. The only thing that was left for me to try, aside from GLP-1's, was berberine. I ripped the bandaid off 2 weeks ago. At first I was taking horse size capsules (incredibly difficult for my sensory aversions). Then a friend turned me onto the GUMMY version and my life changed.

I take 2000mg a day currently. Still too soon to know if I've reaped any benefits. Just wanted to highlight that even with ARFID/OSFED/autism/ocd/textural struggles, these gummies are working for me so far. I'll get new labs in about a month once I find a "health at every size" doctor that I can actually work with. I refuse to keep being the medical punchline.

Add to that I'm exercising 5x a week (mix of weights/cardio) and I genuinely am hoping to redistribute my body fat somehow. Gain more muscle. The body fat is central in my belly/moon face and those are the only parts of my body I wish would change. I'll update this post with my labs once I have them.

Hello! I was diagnosed with PCOS in June after fighting for years, and today I was given a prescription for Metformin starting with 500mg in the morning and 500mg at night.

Of course with this comes lifestyle changes, which is fine, I’m just struggling to find resources for how to plan meals/know what I can eat easily and how to apply this to my life. I have an eating disorder and I’m neurodivergent, so leaving my comfortable foods full of refined sugar and carbs feels very scary. Add to this that I have deformities in my feet, and asthma, which makes exercise very difficult. I have custom orthotics on the way and take my inhaler, but I’m stuck with changing just eating till the orthotics come and my pain is less severe.

Does anyone have some resources on healthy eating and how to apply it in a practical way?

I have PMOS and HS, both since my teenage years. Back then, I was a healthier weight and tried so many treatments for HS.

Thankfully, although my weight increased dramatically due to bout of bad mental health my HS has been really great the last year, and I have managed to get my periods back from every 200 days, to a cycle between 28 & 35 days for the last 6 months. This was mainly due to having to reduce my stress as it was causing me to be extremely ill.

Since getting back on track I decided to talk to my GP about weightloss, I know GLP1s are an option and for personal reasons I don't want to go down that route right now, but she suggested a new pill (can't remember the name) or metformin which I had been on before.

I started the metformin about 3/4 weeks ago, and since then my HS has significantly worsened. I have flares in areas that I hadn't experienced in years.

Now when I think back, I am almost sure that all my bad experiences with HS were around when I had tried metformin.

I otherwise have found metformin decent, not incredible, but certainly not bad and had no GI issues.

Has anyone else with PCOS experienced this?

I do have quite a few of the symptoms, I'm not going to self diagnose but I just wanted to clarify something. So PCOS develops in late teens or 20s? An irregular period is a symptom. I've had my period since I was 11, I'm 19 now. I have always had an irregular period. It's never been a regular cycle. Does that mean my irregular periods are probably caused by something other than PCOS, given it only develops later?

Also, when getting to my age, do people start noticing changes in their period? Aside from the irregularity, my period is pretty normal. 4-5 days, 2 days heavy ish and 3 days lighter. However my most recent period was 10 days long, but every single day was extremely light. This has never happened to me before.

🌸 PCOD Girls Community — Let’s Talk About Everything

I’m a girl with PCOD myself, and I’ve been thinking about creating a community where girls with PCOD can come together and talk openly about the things we actually go through.

Whether it’s facial hair, weight changes, hair fall, periods, skin problems, body changes, emotional struggles, things doctors have told us, treatments we’ve tried, or even home remedies that worked or didn’t work for us, we can discuss it all without feeling judged.

This isn’t about pretending we have all the answers. It’s about sharing our experiences, learning from each other, supporting one another, and realizing that we’re not alone in this.

We can also have voice calls or Zoom meetings where we can actually talk, share our experiences, ask questions, and get to know each other. 💗

If you have PCOD and you’d like to be part of this community, comment your name or simply say “I’m in”, and we’ll start building a big group of girls who can support each other. 🌷

Let’s create a space where we can talk about the things we sometimes feel too embarrassed or uncomfortable to talk about anywhere else. 🫶

So other then electrolysis or laser what are some at home things bonus points for brands or items you use to keep it under control?

I usually shave but I'm getting tired of it coming back in a few hours. I'm leaning towards waxing because I'd be there plucking for 3 days with the amount that I have. I just don't know anything about waxing to even know what products are even good to use.

I was diagnosed with PCOS about a year ago. I am 23 and 5’9 and 125 pounds. I got off birth control (Depo) at 21 and did not get back on due to awful side effects and not being able to take any that contain estrogen ( heart issues). I didn’t have a period for a year and a half and went to a OB. They did an ultrasound finding that I had multiple cysts on both ovaries and my DHEA was elevated. They put me on Progesterone 10 day dose to cause a withdrawal bleed every 35 days if I don’t start on my own. I went for a follow up ultrasound because they were watching a larger sized cyst and they found they were all gone except the one they were watching. I have now only had 1 period on my own since and it was a week after my withdrawal bleed from the progesterone. Every month I do have some brownish/pink discharge for a couple days. I am looking for advice or suggestions!
I do not want to be put back on birth control due to getting married in the near future and immediately wanting to try for kids and the god awful side effects.

Long time PCOS-er here. I've tried a bunch of things over the years but cannot get control of my bloating, specifically in my stomach and my face.

Does anyone have anything that they swear by that helps significantly? Like even if it's short term solutions that I can take or do daily (especially if I have a beach trip coming up).

THANKS!!

Hello, hello.

I wouldn't mind an extra pair of brains to help me out, since I am struggling to think. I am literally fighting brain fog as we speak. There have been some things on my mind. Something I am really fighting and wanting help with is my brain fog. Lets go over context first.

First, I recently ended my investigation to check if I had NCAH. My endocrinologist said I was insulin resistant (Insulin levels were abnormal at endocrinologist but upper normal at PCP), had high androgens (upper 300 to low 400 from labwork done with PCP and endo clinic), upper-normal testosterone, and 5.7 A1C (first percentage for prediabetes). The ACTH stim test showed 177 ng/dL for 17-OHP, which had my endocrinologist determine I did not have NCAH. Also, my base cortisol at the PCP and endo was normal range. Therefore, I got a diagnosis of PMOS despite only meeting 1 out of the 3 criteria, since I have regular periods and have normal ovaries. My ovary scans were not done recently. They were done during my teenage years, if I am not misremembering having them done at all.

I've been struggling with brain fog and fatigue since covid began circulating. I recall experiencing a very odd and difficult respiratory illness before covid was announced around the world, but It did not compare to when I got diagnosed with covid about two years ago. Anyways, I did lose weight and treated my sleep apnea, which did not improve my symptoms. Recently, about 2-3 months ago, I finally did improve my symptoms. I have been on adderall (15mg. Got on it because I questioned if my adhd was the problem and it worked for the first few months) and walking for 30min after breakfast and maybe lunch. Now, fast forward to about 2-3 weeks ago. I have been feeling good and wanted to go down a dose after being without the medicine for \~5 days (prescription refill mishap and other things too wordy for now). I was still doing great with my usual routine and then about a day before my period, my mental clarity falls. Then a week after, I am sick and my brain fog is almost back to the worst I have felt. Me being medicated and walking does nothing. I am taking metformin and spironolactone too. When I test my glucose, it is in the green (usually \~123 after eating breakfast. Fasting sugars before have told me 110s, so I am assuming that is where my base is). So now I know my brain fog is not about my glucose at the moment. I do wonder if it has to do with illness or something, since I could have been incubating the virus (assumingly a cold) the week before exhibiting symptoms?

But seriously, I need this brain fog cut out of my life. Not only does it significantly reduce my quality of life to the point I feel emotionally and mentally blunted (i don't feel depressed and I am on an ssri that has a highly positive history for me), but the intensity of this brain fog actually worries me a lot. It has gotten me in dangerous and reckless scenarios a few times before and I can't let that happen as I am a parent and I also need to drive to get things I need. Especially in this god damn economy.

A few other questions I have is if I need to revisit any labwork and advocate for myself to re-examine anything. Idk... otherwise, I am open to other guidance or general support. Thank you for listening and being here.

Edit to add: some more recent changes to me is that I have lost ~8 lbs since starting spironolactone and metformin. My sleep hasn't been great the past week because of my illness, but it was fine the week before. I also haven't been eating as much as before because of medication and food noise receding, but I wouldn't say I am eating too little at all. I have at least 2-3 meals a day. The dietician also said my meals sound rather balanced and confused her as to why I felt the way I did. Can't say I have been eating the best recently though, because of my illness. But I try to be fiber and carb/sugar conscious with my meals or daily eating.

A few other contextual notes: school for kid started ~3 weeks ago, my blood pressure before adderall and on new dose is low 100s/60 and low 100s/70 during 15mg, I haven't been sick since probably winter time, and I haven't ever been evaluated for long covid.

Got diagnosed with PCOS about 8 years ago after YEARS of telling doctors that there was something wrong with my periods. Been diagnosed etc etc and largely left to it, however as I’m getting older my symptoms are getting worse and I want to be able to manage them a bit better but the doctors only advice is ‘go on the pill/ bc and lose weight’

I have several musculoskeletal health conditions which mean my mobility can be very restricted with constant fatigue and nausea to boot and I’ve been on a fairly hefty cocktail of medicines since I was a kid and I just don’t want to add anymore into the mix!

Has anyone had any luck with campaigning to their doctors about not going on BC for PCOS and any other degree of treatment there may be?? I just feel so exhausted being told I’m fat all the time which I KNOW and am trying reeeeeaaaaallly hard to be neutral about and it just feels like shit when the experts are so unwilling/ unable to help?? Thank you!

Hi guys--

I'm 26F and I was officially diagnosed with PCOS/PMOS over a year ago; my biggest struggles with it have been depression, weight gain, lack of cycles, unhealthy cravings, and thin hair at the top of my head. I've been taking Optify via pills since my diagnosis, and have recently been off them because my cycle has disappeared and I'm trying to figure out if I need to try something else out.

If anyone has found solution(s) that work long-term, I'd love to hear them. Currently feeling very alone and stuck with it )-:

Hii, I recently bought some tea for pcos symptoms but i’m not sure how to prepare it without a lot of sugar. i’m from the south and sweet tea is my favorite drink but i know excess sugar isn’t good for me with pcos (and type 2 diabetes) does anyone have any like sweetening methods? simple syrup is just boiled sugar and water.. so i really dont want to do that.

thank youuu

So… I (23F) was diagnosed with PMOS last year, and kind of written off and told there is nothing I can do about it for the moment. I have since switched providers, and she had a bunch of bloodwork done. With that said, one number she brought to my attention was my AMH level. It came back as 35.396. With that said, she wants to do some more testing, but she also said to temper my expectations a little towards fertility, and that it’s very likely that having kids might be very difficult.

With all that said, does anyone have experience with an AMH that high, and/or PMOS advice towards having kids? I know my provider has some recommendations, but I’m just really worried (and trying to accept) that there might not be much else for me to do.

After a four year battle with my GP - I finally got my PCOS diagnosis today.

I changed GP and found one that listened and heard me and wanted to work with me not against me.

I feel so many different emotions today, happy to finally have some answers, scared of what’s to come, angry that it’s taken four years to get to this point and a bit of everything else in between.

My GP has recommended metformin which I start tomorrow, and honestly I’m terrified.

I’ve tried to avoid the horror stories and just focus on what it can do for me - i.e. hopefully help with ovulation and TTC.

I’m not eligible right now for any help in the way of ovulation meds like clomid and the like as my BMI is too high so I’m hoping the metformin might help with this alongside calorie counting and exercise.

Does anyone have any success stories with PCOS/metformin/TTC and everything else as I don’t have anyone else to talk to and never had any experience with PCOS so just looking for some tips tricks and a friendly face to talk through it all with!

Chat with your friends from r/PCOS here about your daily progress, or rants and raves related to your PCOS experience. Off topic posts are permitted here, although sub rules otherwise apply!