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Can Probiotics Treat Polycystic Ovary Syndrome?  

In a recent study, researchers attempt to determine whether probiotic pills can be used to treat women with polycystic ovary syndrome.

Polycystic ovary syndrome is a hormonal disorder in women that can result in the enlargement of ovaries and other metabolic issues. This disease affects the fertility of 10% of women. Polycystic ovary syndrome affects glucose metabolism and insulin resistance. Similarly, long-term complications, such as type 2 diabetes and endometrial cancers are more likely to occur in those with polycystic ovary syndrome.

Previous research has suggested a link between insulin resistance and inflammatory factors in the development of polycystic ovary syndrome. Researchers have looked to the benefits of probiotics in recent years for their benefits in treating gastrointestinal diseases, diabetes, and infections, among other things. Probiotics are live microorganisms that can be ingested to influence gut microbiomes.

Evidence suggests that gut microbiota may play a role in the development of polycystic ovary syndrome. More specifically, gut microbiota may influence insulin resistance, obesity, and inflammation, which are all factors in the development of polycystic ovary syndrome. In addition, apelin, a peptide elevated in overweight humans plays a role in inhibiting insulin and may be expressed during inflammation. Thus, it seems that apelin may also play a role in the development of polycystic ovary syndrome.

Therefore, in addition to improving exercise and diet, Karimi and colleagues sought to see whether altering the gut microbiota may be therapeutic to overweight patients with polycystic ovary syndrome. A randomised, double-blind study was conducted on overweight women between the ages of 19 to 37 years old with polycystic ovary syndrome. Over 12 weeks, 44 controls received a placebo, and 44 patients from the study group received probiotics containing seven strains of bacteria. This Iranian study was recently published in the British Journal of Nutrition.

Probiotics Did Not Alter Markers of Inflammation or Blood Sugar

The researchers conducted a series of tests in both the placebo and probiotic group to determine overall health. Plasma glucose fasting 2-h (PGF-2h), a measure of glucose levels in the blood, was measured in both the control and treatment group. At baseline, the PGF-2h was higher in the treatment group compared to the control group. Other measurements pertaining to insulin resistance did not differ substantially between the probiotic group and placebo group at baseline.

After 12 weeks, there were no significant differences in fasting blood sugar, markers of inflammation, or in the levels of insulin resistance. Interestingly, there was a reduction in a peptide of the apelin gene, apelin 36, in the treatment group compared to the control.

Difficult to Interpret Data

Considering that the results only produced a change in apelin but not insulin resistance or other factors associated with inflammation, the authors suggested that apelin reduction could be a result of a new, unknown mechanism in the development of polycystic ovary syndrome. The authors concluded that it is hard to interpret their data since little literature exists to explain the link between polycystic ovary syndrome and apelin. The data suggested that it might be a change in gut microbiota that affects the production of apelin, but is independent of polycystic ovary syndrome outcome and prognosis.

More Research Needed

Their study was limited in their ability to draw concrete conclusions. For example, they did not examine changes in the bacterial population through a stool analysis. Nutrition logs of the patients were self-reported, which could have resulted in an uncontrolled bias. Their insulin response measurements were not the most accurate method. Finally, the 1000mg dosage of probiotics was not previously supported in other documentation, though it was approved by a pharmacist for the study. Overall, more studies need to be conducted to explore this relationship, and more replication studies need to be done over longer periods of times with larger samples and other strains of bacteria.

Written by Olajumoke Marissa Ologundudu B.Sc. (Hons)

Reference: Karimi E, Moini A, Yaseri M, Shirzad N, Sepidarkish M, Hossein-Boroujerdi M, Hosseinzadeh-Attar MJ. Effects of synbiotic supplementation on metabolic parameters and apelin in women with polycystic ovary syndrome: a randomised double-blind placebo-controlled trial.  British Journal of Nutrition. 2018;119(4): 398-406. doi: 10.1017/S0007114517003920.



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