Polycystic ovarian syndrome (PCOS) is a multifaceted health issues and it truly requires a multifaceted treatment plan for optimal management of the symptoms associated with this condition.
PCOS is estimated to affect upwards of 15% of our population and it can significantly disrupt quality of life as well as fertility. The management of PCOS is currently largely focused on regulating or suppressing ovulation/menses, lowering androgen hormone levels and if you are working with an informed healthcare provider they will discuss the management of insulin resistance as well.
However, the management of the Gut Microbiome is largely missed in Patients with PCOS. And this, I believe, is a big mistake in our approach to supporting Patients improve not only fertility, but also quality of life.
Research has suggested PCOS is associated with various changes in the digestive function and gut microbiome. There is an observed reduction in diversity of the gut microbes and higher populations of more pathogenic bacteria. There also seems to be disrupted production of certain short chain fatty acids (SCFAs which can affect inflammation), trimethylamine (can promote cardiovascular disease) and increased gut membrane permeability (a.k.a."leaky gut"). The increased gut membrane permeability can affect absorption of toxic byproducts from pathogenic bacteria, such as, lipopolysaccharides (LPS) which have been associated with worse PCOS symptoms.
Probiotics and Polycystic Ovarian Syndrome:
More studies have now observed that supplementing with beneficial probiotics may help increase diversity of the gut microbiome and this may contribute in to various therapeutic outcomes in the management of PCOS.
Supplementing with specific probiotics have now been observed to help reduce testosterone levels, reduce markers of inflammation, improve insulin sensitivity and promote antioxidant status. Additionally there may be improved digestive function that can occur as a result of these probiotics as well.
Lifestyle and Environmental Factors that can affect the Gut Microbiome in PCOS:
Supporting the gut microbiome is multifaceted as well. I want to emphasize that while taking a probiotic may be beneficial for some individuals, it is highly unlikely that on its own it can solve everyone's digestive issues. There are more comprehensive methods of supporting a healthy gut microbiome that also involve prebiotics, antimicrobials and biofilm disruptors (help to eradicate the protective barrier that microbes can evade detection from the host's immune system).
Additional lifestyle and environmental factors that can negatively affect the gut microbiome in PCOS Patients include, but are not limited to, unhealthy dietary patterns, limited physical activity, elevated stress hormones, elevated androgen hormones, elevated body mass index (BMI), alcohol consumption and smoking.
Should probiotics be used in the management of PCOS?
Always discuss with your healthcare provider your specific symptoms and treatment goals, as personalized treatment plans addressing the gut microbiome can be immensely beneficial in supporting management of PCOS symptoms and helping to improve quality of life. Targeted therapies are always preferred instead of using any probiotic strain you find in an over the counter product that may or may not have strains or probiotic dose potency to match your specific case.
This article is being shared as educational content and is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about their Health should speak with their Naturopathic Doctor. Please discuss with your healthcare provider and only make changes to your medications regimen if recommended by your doctor and under their guidance and supervision.
Reference:
Calcaterra, V., Rossi, V., Massini, G., Casini, F., Zuccotti, G., & Fabiano, V. (2023). Probiotics and polycystic ovary syndrome: A perspective for management in adolescents with obesity. Nutrients, 15(14), 3144.
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