Intersection of Polycystic Ovary Syndrome and the Gut Microbiome

Maryan G. Rizk; Varykina G. Thackray


J Endo Soc. 2021;5(2) 

In This Article


In summary, this review highlights recent progress made in understanding the relationship between PCOS and dysbiosis of the gut microbiome in both humans and rodent models. Although there is considerable variability in the results obtained from 16S rRNA and metagenomic gene sequencing, many studies support the idea that changes in gut microbiota are associated with PCOS, including a decrease in biodiversity as well as changes in specific bacterial taxa. Notably, these changes occur both in adolescent girls and women with this disorder that are normal weight or obese, suggesting that a gut dysbiosis manifests along with other features of PCOS during puberty independently of BMI, although it is unclear whether obesity influences changes in the gut microbiome observed in PCOS. In addition, changes in gut microbiota are correlated with HA, indicating that elevated levels of testosterone may regulate the composition of the gut microbiome in females. We explored hypotheses that HA as well as dysbiosis of the gut microbiome could act as drivers of PCOS through their interaction with each other, although future studies are needed to understand the mechanisms involved. Moreover, we reviewed the limited studies that investigated changes in specific microbial metabolites associated with PCOS. While preliminary, these studies justify further exploration of this understudied area, with the exciting potential to uncover novel targets for small molecule therapeutics focused on PCOS. Finally, we reviewed studies investigating the efficacy of prebiotic, probiotic, and postbiotic treatments that modulate the gut microbiome and, in turn, improve symptoms of PCOS in both human and rodent studies. Although most of these studies need to be reproduced, the positive results on reproductive and metabolic features of PCOS from treatment with dietary fibers, probiotics such as Bifidobacterium and Lactobacillus, and small molecules including bile acids and anti-inflammatory cytokines indicate that this is an area deserving of future study.