Polycystic ovary syndrome (PCOS) is a hormonal condition that's relatively common among women. When most folks think about PCOS, they often think about the of the symptoms associated with the condition — irregular periods, acne, hirsutism, and more. PCOS has been shown to contribute to infertility and other diseases, like diabetes and heart disease. But a new study is shedding light on a different physical aspect of the condition: New research shows that women who have PCOS tend to have less gut diversity than women who don’t — meaning, there are fewer species of the healthy bacteria that live in our digestive tract for women with this common hormonal condition. And this finding has major implications for how we think about PCOS and other endocrine disorders.
The study, which was published in The Journal of Clinical Endocrinology & Metabolism, examined the fecal matter of women with PCOS and compared it to that of women without the hormonal condition. Researchers from University of California San Diego School of Medicine, Poznan University of Medical Sciences, and San Diego State University also looked at women who had polycystic ovaries but did not have the other symptoms of PCOS. Their findings are yet another reason why gut health is so important.
According to this study, women with PCOS had the least diverse gut bacteria, and women without PCOS or polycystic ovaries had the most gut diversity. Study participants with polycystic ovaries had more gut diversity than women with PCOS, but less than women without it.
In a press release, Varykina Thackray, senior author of the study and associate professor in the Department of Reproductive Medicine at UC San Diego School of Medicine, said, “The findings indicate women with PCOS tend to have less diverse populations of gut bacteria, a trend which appears to be linked to elevated testosterone levels.”
It’s known that the food you eat can impact the health of your gut microbiome, but this new study indicates that hormones can also play a role in gut bacteria diversity. "Our study suggests testosterone and other androgen hormones may help shape the gut microbiome, and these changes may influence the development of PCOS and the impact it has on a women's quality of life," said Thackray.
Due to the prevalence of PCOS, which affects an estimated one in 10 to one in 20 women, this research can have huge implications on women’s health. Although it's not clear that bacteria causes PCOS, additional research still needs to be done to determine how gut bacteria is related to PCOS — and if it offers answers on how to treat the hormonal condition.
"If testosterone drives the microbial composition of the gut, a compelling next step would be to determine if treatment of PCOS with testosterone blockers or oral contraceptives results in the recovery of the gut microbiome," said Thackray. "It would also be important to figure out whether the gut microbiome of women diagnosed with PCOS using the criteria of polycystic ovaries and irregular or no menstrual periods is distinct from the gut microbiome of women diagnosed with the other subtypes of PCOS that require elevated testosterone."
Because the gut microbiome is extremely diverse, future studies will need a larger sample size of women, as this study only examined 163 women total. Subsequent research will likely aim to determine if a specific species of gut bacteria does cause PCOS, according to Thackray. If that is the case, researchers predict probiotics could potentially be a treatment option for PCOS, though much more research is needed to understand how this could work. Probiotics are affordable, minimally invasive, and available over the counter, so it would make treatment accessible to even more women. Currently, various types of birth control are used to treat the symptoms of PCOS.
Millions of women with PCOS don’t even know they have the condition, according to the PCOS Association, but this research adds to what we do know about this condition, and hopefully will make it easier to diagnose and treat. In the meantime, be on the lookout for new developments in PCOS research.