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A narrative review of the role of gastrointestinal dysbiosis in the pathogenesis of polycystic ovary syndrome


Parker, J and O'Brian, C and Hawrelak, J, A narrative review of the role of gastrointestinal dysbiosis in the pathogenesis of polycystic ovary syndrome, Obstetrics & gynecology science, 65, (1) pp. 14-28. ISSN 2287-8580 (2022) [Refereed Article]

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Copyright 2022 Korean Society of Obstetrics and Gynecology. Articles published in Obstetrics & gynecology science are open-access, distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

DOI: doi:10.5468/ogs.21185


Diet-induced gastrointestinal dysbiosis has been hypothesized to play a significant role in stimulating an increase in gastrointestinal permeability and activating systemic inflammation in women with polycystic ovary syndrome (PCOS). We reviewed the current proof-of-concept studies on the proposed mechanism of dysbiosis in the pathogenesis of PCOS. A literature search was performed to identify articles on changes in the intestinal microbiome (dysbiosis) and increased intestinal mucosal permeability involving lipopolysaccharide (LPS), LPS-binding protein (LPS-BP), and zonulin. We also searched for systematic reviews and meta-analyses that synthesized the results of studies on the therapeutic effects of prebiotics, probiotics, or synbiotics in women with PCOS. Our search was confined to human studies between 2012 and 2021 using the PubMed, Scopus, and Cochrane databases. Thirty-one studies met the inclusion criteria (14 microbiota, 1 LPS, 1 LPS-BP, 1 LPS and LPS-BP, 5 zonulin, 9 systematic reviews). Our analysis revealed that most studies reported reduced alpha diversity and dysbiosis in women with PCOS. Preliminary studies suggest that LPS, LPS-BP, and zonulin may be involved in the pathophysiology of increased intestinal permeability. Treatment of PCOS with prebiotics, probiotics, and synbiotics appears to have a range of beneficial effects on metabolic and biochemical profiles. This review highlights the need for continued research into the pathophysiological mechanisms of dysbiosis and the clinical efficacy of prebiotics, probiotics, and synbiotics in women with PCOS.

Item Details

Item Type:Refereed Article
Keywords:gastrointestinal microbiota; dysbiosis; polycystic ovary syndrome
Research Division:Biomedical and Clinical Sciences
Research Group:Nutrition and dietetics
Research Field:Clinical nutrition
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Hawrelak, J (Dr Jason Hawrelak)
ID Code:153523
Year Published:2022
Web of Science® Times Cited:9
Deposited By:Pharmacy
Deposited On:2022-09-21
Last Modified:2022-11-21
Downloads:3 View Download Statistics

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