Why Successful Treatment of Polycystic Ovarian Syndrome (PCOS) Depends on the Gut Microbiome

Polycystic Ovarian Syndrome (PCOS) is present in up to 15% of the population of reproductive age, and the rate can vary based on different populations. The disorder of PCOS is complex in that it affects multiple organ systems, fertility being the most obvious. It can also negatively harm skin health, affect the central nervous system (CNS) and neurotransmitter levels potentially increasing the risk for anxiety, depression, and mood disorders. PCOS also significantly increases the risk for insulin resistance, cardiovascular disease, and weight gain.

The treatment of PCOS has largely focused on the treatment of the hormone imbalances observed in the condition. Hormone therapies such as letrozole, clomiphene citrate, and progesterone focus on correcting the imbalance we see as a consequence of different lifestyle, genetic, and gut issues.

New exciting research has shifted focus on the gut microbiome and how it can negatively impact the condition, potentially determining if treatment of this complex hormone condition is successful.  In fact, the intestinal microbiome is a largely ignored facet of the disease, however, new research has shown what a significant impact the digestive health can have on the successful treatment of PCOS. Surprisingly, many of the current treatment options for PCOS seem to actually exert their beneficial impact by impacting the gut microbiome.

Many of the lifestyle factors and modifications recommended for the treatment of PCOS also seem to have a positive impact on the gut microbiome. In fact, regular exercise seems to improve the diversity of healthy gut microbiota and promotes a reduction in inflammation and supports healthy bacteria that positively impact insulin resistance! 

Consuming a diet that is high in sugar and fats seems to increase intestinal permeability, absorption of lipopolysaccharides (toxins from harmful bacteria) and increases inflammation. While consumption of a diet rich in polyphenols, fibre, lower-glycemic index foods, polysaccharides, inulin, certain herbs promote growth of healthy bacteria that reduce insulin resistance, decrease inflammation, and may reduce excess caloric absorption in the digestive tract. 

A common herbal extract, known as Berberine, has also been studied for the treatment of PCOS and was found to be greatly beneficial in reducing weight, supporting healthy ovulation and improving fertility. Berberine seems to impact the gut microbiome by improving populations of microbiota in the gut that reduce inflammation and improve insulin resistance while reducing populations of harmful bacteria.

In particular, decreasing the population of B. Vulgatus seems to reduce bile acid beconjugation and increases concentrations of interleukin-22, which has been shown to significantly improve the symptoms of polycystic ovarian syndrome in animal models. 

This article 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 healtcare provider and only make changes to your medications regimen if recommended by your doctor and under their guidance.