PCOS and the Microbiome 🐛 #45

How is the microbiome linked to PCOS?

Hello everyone,

How was your week? I am still in Berlin and staying at a super cool hotel/student accommodation. It reminded me so much about my student life (What a good life).

I want to touch on another fascinating link to PCOS in today's newsletter: the microbiome. I keep writing this newsletter without getting tired of it because of how fascinating our body is.

This week’s question

How is the microbiome linked to PCOS?

In this newsletter:

• What does the Gut do?

• What is the link to PCOS?

• Do Pre/Probiotics help?

• Snacks and Meals Ideas with Pre/Probiotics

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What does the microbiome do?

The microbiome is made out of trillions of microorganisms. These include not only bacteria but fungi, parasites, and viruses. In a healthy person, these organisms coexist peacefully, with the most significant numbers found in the small and large intestines and throughout the body. From helping with nutrient absorption to reinforcing your immune system, these little superheroes do a lot for our health.

Significant research has emerged in the last years showing the power of these bacteria on numerous functions in the body. Mainly, they can influence our metabolic health, hormonal health and, most importantly, our immune system. In addition, recent studies have emphasized the crucial role of the gut-brain axis, uncovering the intricate communication network between the gut and the brain. This axis acts as an essential bridge, impacting different physiological processes, including cognition, mood, and, surprisingly, hormonal equilibrium.

What is the link to PCOS?

Guess what? They have found differences in microbiomes for women with PCOS. Compared to healthy individuals, we seem to have a lower diversity of good bacteria and an increase in some non-so-nice bacteria. Bacteria such as Bacteroidetes and Firmicutes are increased for us. They are involved in the altered production of short-chain fatty acids, negatively impacting metabolism, gut barrier integrity, and immunity. The beneficial bacteria, such as Lactobacilli and Bifidobacteria, which enhance immunity and nutrient absorption, are significantly reduced in PCOS patients. How great!

Diet choices influence this diversity. However, I hypothesise that using antibiotics at early ages, lack of breastfeeding or a cesarian birth might influence the makeup of our microbiome early on and lead to the activation of specific genes associated with PCOS. (Is anyone keen to fund this study?)

This imbalance can set off systematic inflammation, insulin resistance, and metabolic disturbances, which are all common issues related to PCOS.

Besides, a disrupted gut microbiome can also contribute to weight gain, a known aggravator of PCOS symptoms. Raised levels of androgens, frequently seen in PCOS, can be exacerbated by gut-related issues, prompting an endless loop of hormonal imbalances and metabolic irregularities (lucky us).

Do Pre/Probiotics help?

Prebiotics, the food for our good gut bacteria, have shown their ability to improve insulin sensitivity and decrease androgen levels, consequently improving key PCOS signs.

Probiotics, supplements containing beneficial bacteria, have also been shown to help lower inflammation and support hormonal balance.

Research has disclosed promising bits of knowledge into the impacts of these gut-friendly supplements in relieving the metabolic and hormonal disturbances related to PCOS.

A recent review based on multiple research studies confirmed that probiotic supplementation positively affected the parameters related to PCOS, such as managing fasting blood glucose levels, body mass index, and lipid profiles.

Another scientific review study demonstrated and supported the positive impacts of probiotics on the metabolic and hormonal profiles and inflammatory conditions of obese PCOS adolescents. Lipid metabolism disturbances and inflammatory indicators of PCOS are all found to ameliorate with probiotic supplementation. A potential role in protecting fertility is also observed by improving conditions of BMI, weight, insulin, and insulin research related to PCOS.

As more and more research establishes a link between gut microbiota and PCOS, a randomized controlled trial involving 180 participants comparing probiotic dietary intervention for six months to placebo and metformin is also underway. If it is successful, a new realm of possibilities for treating PCOS will be opened with this new therapy approach.

How can I help my gut with food?

It is now clear that recognising the importance in supporting your gut health is crucial. Incorporating fibre-rich foods like fruits, vegetables, and whole grains into your diet regimen can encourage a healthy gut microbiome. Apart from that, healthy fats, good proteins, and anti-inflammatory foods are also helpful in reducing your PCOS severity. Limiting refined carbs and processed foods will also help (as it always does).

An active lifestyle with regular exercise is also crucial for enhancing gut motility and encouraging a healthy gut environment. Additionally, concentrating on stress management through mindfulness exercises or relaxation techniques to maintain the delicate balance of the gut-brain axis is also necessary for improving well-being.

Snacks and Meals with Pre/Probiotics

Some ideas of healthy food options for PCOS with pre/probiotics:

• omelette with whole-grain bread and a little portion of sauerkraut

• grilled fish or chicken with kimchi or roasted vegetables

• salad based on tomatoes, nuts, mixed greens, flaxseeds and vinaigrette

• roasted or baked sweet potatoes with black beans, salsa, avocado and a dollop of sour cream or yoghurt

• Greek yoghurt with fresh fruit, honey, and a handful of oats

• Whole grain crackers, hummus, with a side of pickles

• frozen berries, banana, almond milk, and a dollop of Greek yogurt.

I hope you enjoyed reading this. If you have been raised taking a lot of antibiotics, I highly recommend testing your microbiome and taking care of your bacteria.

See you next Sunday,

Francesca

¹ Sources

1. 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. https://doi.org/10.3390/nu15143144

Borzan, V., Riedl, R., & Obermayer-Pietsch, B. (2023). Probiotic vs. Placebo and metformin: Probiotic dietary intervention in polycystic ovary syndrome – A randomized controlled trial. BMC Endocrine Disorders, 23. https://doi.org/10.1186/s12902-023-01294-6

Angoorani, P., Ejtahed, S., Marvasti, F. E., Taghavi, M., Ahranjani, B. M., Hasani-Ranjbar, S., & Larijani, B. (2023). The effects of probiotics, prebiotics, and synbiotics on polycystic ovarian syndrome: An overview of systematic reviews. Frontiers in Medicine, 10. https://doi.org/10.3389/fmed.2023.1141355

Arab, A., Hossein-Boroujerdi, M., Moini, A., Sepidarkish, M., Shirzad, N., & Karimi, E. (2022). Effects of probiotic supplementation on hormonal and clinical outcomes of women diagnosed with polycystic ovary syndrome: A double-blind, randomized, placebo-controlled clinical trial. Journal of Functional Foods, 96, 105203. https://doi.org/10.1016/j.jff.2022.105203

Miao, C., Guo, Q., Fang, X., Chen, Y., Zhao, Y., & Zhang, Q. (2021). Effects of probiotic and synbiotic supplementation on insulin resistance in women with polycystic ovary syndrome: A meta-analysis. Journal of International Medical Research. https://doi.org/10.1177/03000605211031758

He Y , Wang Q , Li X , Wang G , Zhao J , Zhang H , Chen W . Correction: Lactic acid bacteria alleviate polycystic ovarian syndrome by regulating sex hormone related gut microbiota. Food Funct. 2021 May 21;12(10):4720-4721. doi: 10.1039/d1fo90033a. Epub 2021 Apr 21. Erratum for: Food Funct. 2020 Jun 24;11(6):5192-5204. PMID: 33881104.