A New Approach to Polycystic Ovary Syndrome: The Gut Microbiota

Polycystic ovary syndrome (PCOS) is a widespread endocrine disease that affects 6% to 20% of women of reproductive age and is associated with high risk of infertility, obesity, and insulin resistance. Although genetic, neuroendocrine, and metabolic causes have been stated to lead to PCOS, the etiology of PCOS remains unclear. Recent studies in humans and rodent models have shown an association between changes in the gut microbiome and the metabolic and clinical parameters of PCOS. In addition, it has been proposed that dysbiosis of gut microbiota may be a potential pathogenetic factor in the development of PCOS. In this context, modification of gut microbiota with probiotic, prebiotic, and synbiotic agents suggests that these products may serve as new treatment options for PCOS. In this review, it is aimed to explain the relationship between PCOS and gut microbiota with possible mechanisms and to examine the new treatment approaches that can be developed in this direction.Key teaching points Studies have shown that gut microbiota may be a potential pathogenetic factor in the development of PCOS. Dysbiosis of gut microbiota in women with PCOS appears to be associated with PCOS phenotypes. Studies suggest that insulin resistance, sex hormone concentrations, and obesity may affect the diversity and composition of gut microbiota in women with PCOS. With better understanding of the role of intestinal microbiota in PCOS, interventions including prebiotics, probiotics, and synbiotics can be considered as future treatment options.