The gut microbiome is not just a digestive organ system. It is a metabolic and endocrine regulator - shaping insulin sensitivity, inflammation, oestrogen recycling, and importantly in PCOS, androgen production.

Women naturally produce small amounts of androgens such as testosterone, androstenedione and DHEA-S. In physiological ranges, these hormones support follicle development, muscle mass, cognition and libido.

But in polycystic ovary syndrome (PCOS), androgen production becomes excessive - and the ripple effects extend far beyond the ovaries.

 

What are Normal Androgen Levels?

Understanding your pathology results is an important first step. Laboratory reference intervals vary depending on assay technique and population, but typical ranges* for premenopausal women are:

Total Testosterone: 0.3 to 1.9 nmol/L DHEAS: 1-11 µmol/L Androstenedione: 3.5-9.0 nmol/L Sex Hormone Binding Globulin (SHBG): Most testosterone is bound to SHBG. Levels are often low in PCOS. A typical SHBG range for women is 26-100 nmol/L.

*Note that these ranges will differ with different laboratories depending on the technique used. If you have a blood test to check your androgens, your pathology report will include the laboratory’s reference ranges for comparison.

SHBG is critical. Most circulating testosterone is bound to SHBG. When SHBG is low - which commonly occurs in insulin resistance -the proportion of biologically active (free) testosterone rises.

Many women with PCOS sit in the “upper normal” testosterone range but have:

• Low SHBG

• Elevated free androgen index (FAI)

• High LH:FSH ratio

Context matters. A result can fall within the reference interval and still be clinically significant when interpreted alongside symptoms and metabolic markers.

Always review results with a qualified practitioner, particularly if you are interpreting LH, FSH or calculating LH:FSH ratios.

 

What Happens if Androgens are Too High?

High androgens known as hyperandrogenism is a defining feature of PCOS and may present as:

• Acne
• Hair loss
• Male pattern hair growth (hirsutism)
• Irregular Ovulation
• Ovarian Cysts
• Insulin Resistance
• High Cholesterol
• Infertility

High insulin stimulates ovarian theca cells to produce more testosterone. Elevated luteinising hormone (LH) amplifies this further. The result is disrupted follicle maturation and inconsistent ovulation.

What is often overlooked is that gut dysbiosis amplifies this endocrine dysfunction.

What Is the Gut Microbiome - and Why Does It Matter in PCOS?

The gut microbiome refers to the trillions of bacteria, fungi and other microbes that live inside your gastrointestinal tract. Far from being passive passengers, these microbes actively regulate metabolism, immunity and hormone signalling.

In women with PCOS, research consistently shows alterations in gut microbial composition - often described as dysbiosis. Compared to women without PCOS, studies demonstrate:

• Reduced microbial diversity

• Lower production of beneficial short-chain fatty acids (SCFAs) such as butyrate

• Increased intestinal permeability (“leaky gut”)

• Elevated inflammatory markers

The microbiome also interacts with immune pathways and hormone metabolism, meaning imbalances can amplify cycle irregularity, ovulatory dysfunction and metabolic instability.

PCOS is therefore not only an ovarian condition. It is increasingly understood as a metabolic–inflammatory condition with a microbial component.

Supporting microbial diversity through targeted prebiotics, probiotics and nutrients that improve insulin signalling - such as myo-inositol - offers a systems-based approach to restoring hormonal balance.

How do I Naturally Lower Androgens?

Vitamin D supplementation

Vitamin D is essential for healthy functioning of our ovaries, endometrium and our gut. Vitamin D supplementation has been shown to lower total testosterone in women with PCOS [2].

80% of our Vitamin D comes for exposure to ultraviolet light, so pop outside with your arms and legs exposed on a sunny day for 10 to 30 min to soak up some sun. If your skin is darker, you may need a little more exposure to get your vitamin D dose, and if your levels are low you may require a supplement.

Some bacteria in our gut are capable of processing and activating Vitamin D so continue to nurture your gut microbiome and include a Vitamin D3 top up.

 

Myo-inositol

Myo-inositol is one of the most extensively studied compounds in PCOS.

It improves:

• Insulin sensitivity

• Ovulatory function

• Menstrual regularity

• Hyperandrogenism

Clinical trials demonstrate comparable metabolic and reproductive improvements to metformin, without common gastrointestinal side effects.

Absorption, however, matters.

Prebiotics enhance intestinal uptake of myo-inositol, improving bioavailability and metabolic response.

This is why Gut + Hormone was formulated to address multiple layers of PCOS physiology simultaneously. It combines:

• Myo-inositol to support insulin signalling and reduce ovarian androgen stimulation

• Targeted prebiotics to enhance absorption and restore microbial diversity

• Probiotics to support gut barrier integrity

• Vitamin D3 to assist endocrine regulation

Rather than treating PCOS as an isolated ovarian issue, Gut + Hormone addresses the gut–insulin–androgen axis together.

Strength Training

Strength training significantly changes body composition, which lowers high levels of androgens in females [3].

For a general prescription, strength train 2 to 3 times a week with a rest day or two in between sessions to allow for all the beneficial adaptations to take place.

Make sure you are targeting all major muscle groups at a load of 70%–85% of one-repetition maximum (1RM). If you are unsure where to start, see an Accredited Exercise Physiologist for the right guidance.

 

Prebiotic Fibre & Microbiome Diversity

Prebiotics increase SCFA production, improve insulin signalling and reduce systemic inflammation — all upstream drivers of androgen excess.

Supporting microbial diversity is foundational in PCOS care.

For women requiring deeper microbiome restoration, combining Gut + Hormone with broader-spectrum prebiotic diversity (such as Microbiome Essentials) may further enhance SCFA production and metabolic resilience.

 

Add Gut + Hormone to your Daily Rituals

PCOS Is a Systems Condition

When you look at PCOS through a systems lens, it involves:

• Insulin resistance

• Chronic low-grade inflammation

• Altered gut microbiota

• Ovarian hyperandrogenism

Reducing androgens is not about suppression. It is about restoring physiological balance so ovulation can resume, egg quality can improve, and metabolic health can stabilise.

By supporting insulin signalling, microbial diversity and endocrine function together, hormonal balance becomes not just possible - but sustainable.

 

References

1. 1. Khattak, M., et al., Comparison Of Free Androgen Index In Polycystic Ovary Syndrome And Non-Polycystic Ovary Syndrome Infertile Patients. J Ayub Med Coll Abbottabad, 2021. 33(4): p. 577-581.
2. 2. Zhao, J.F., B.X. Li, and Q. Zhang, Vitamin D improves levels of hormonal, oxidative stress and inflammatory parameters in polycystic ovary syndrome: a meta-analysis study. Ann Palliat Med, 2021. 10(1): p. 169-183.
3. 3. Kogure, G.S., et al., Resistance Exercise Impacts Lean Muscle Mass in Women with Polycystic Ovary Syndrome. Med Sci Sports Exerc, 2016. 48(4): p. 589-98.
4. 4. Xue, J., et al., Inulin and metformin ameliorate polycystic ovary syndrome via anti-inflammation and modulating gut microbiota in mice. Endocr J, 2019. 66(10): p. 859-870.
5. 5. Shang, Y., et al., Dietary Modification for Reproductive Health in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne), 2021. 12: p. 735954.
6. 6. Ashkar, F., et al., The Role of medicinal herbs in treatment of insulin resistance in patients with Polycystic Ovary Syndrome: A literature review. Biomol Concepts, 2020. 11(1): p. 57-75.
7. 7. Grant, P., Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. A randomized controlled trial. Phytother Res, 2010. 24(2): p. 186-8.

 

  

Anyone for Tea?

Natural compounds are truly effective for supporting PCOS. Spearmint tea twice a day for 30 days has been shown to have anti-androgen effects in PCOS [6,7]. Our favourite teas are PCOS to Wellness herbies. There is spearmint in Cysterhood Tea so you can relax, unwind and lower androgens at the same time!