Did you know?
Women with PCOS produce more than double the amount of anti-Müllerian hormone (AMH) compared to women without PCOS—so much so that some researchers have proposed renaming the condition “AMH syndrome.”
Polycystic ovary syndrome (PCOS)
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Divine Aleru
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Divine Aleru
Read MoreI am a biochemist with a deep curiosity for the human microbiome and how it shapes human health, and I enjoy making microbiome science more accessible through research and writing. With 2 years experience in microbiome research, I have curated microbiome studies, analyzed microbial signatures, and now focus on interventions as a Microbiome Signatures and Interventions Research Coordinator.
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Karen Pendergrass
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Karen Pendergrass
Read MoreKaren Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.
Polycystic ovary syndrome (COS) is a common endocrine disorder that affects women of reproductive age, characterized by irregular menstrual cycles, hyperandrogenism, and insulin resistance. It is often associated with metabolic dysfunctions and inflammation, leading to fertility issues and increased risk of type 2 diabetes and cardiovascular disease.
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Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
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Overview 
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References Overview
Polycystic ovary syndrome (PCOS) is a common and complex endocrine and metabolic disorder affecting women of reproductive age, with a global prevalence ranging from 4% to 20% depending on the diagnostic criteria used.[1][2] It is typically characterized by the presence of hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology,[3] and is strongly associated with various health issues including infertility, insulin resistance (IR), type 2 diabetes mellitus, and cardiovascular disease.[4][5] Although the precise pathogenesis of PCOS is not fully understood, accumulating evidence suggests a complex interplay of genetic predisposition, epigenetic modifications, and environmental factors such as dietary choices and lifestyle,[6] with emerging research highlighting the causal role of gut dysbiosis in its development. [7][8][9]
Diagnosis
PCOS diagnosis typically involves the identification of a combination of clinical and biochemical features, primarily focusing on hyperandrogenism, ovulatory dysfunction including irregular menstrual cycles, infrequent ovulation, or anovulation, and polycystic ovarian morphology (PCOM) on ultrasound.[10] The Rotterdam criteria requires at least two out of these three features for diagnosis, after excluding other causes, as ovarian cysts alone are not enough for a diagnosis, as they can occur in other conditions. [11]
Causal Theories
The pathogenesis of PCOS is multifactorial, involving genetic, environmental, and hormonal factors. Insulin resistance is a central feature, and hyperinsulinemia leads to increased ovarian androgen production.[12] This can disrupt normal follicular development and contribute to the clinical manifestations of PCOS. Environmental factors, including diet and lifestyle, can exacerbate insulin resistance, while genetic predispositions to hyperandrogenism and metabolic dysfunction further complicate the condition.[13] There is emerging evidence supporting the role of gut microbiota in the development and progression of PCOS, with altered microbial compositions being linked to insulin resistance and inflammation.[14]
Associated Conditions
PCOS is a complex condition with significant associations to a variety of metabolic, hormonal, and psychological comorbidities. These include infertility, which is a hallmark feature due to anovulation, metabolic syndrome, and insulin resistance, which elevate the risk of type 2 diabetes.[15][16] Women with PCOS also face a higher risk of cardiovascular diseases, such as hypertension and dyslipidemia, due to hormonal imbalances and metabolic dysfunctions.[17] Endometrial cancer is another concern, as prolonged anovulation leads to unopposed estrogen exposure, increasing the risk of endometrial hyperplasia.[18] Additionally, women with PCOS are more likely to experience depression, anxiety, and eating disorders, potentially exacerbated by physical symptoms like hirsutism, acne, and weight gain.
Primer
To understand PCOS comprehensively, it is essential to explore the intersections of hormonal dysregulation, insulin resistance, and the gut microbiome. The elevated levels of insulin in PCOS not only contribute to metabolic abnormalities but also directly affect ovarian steroidogenesis, exacerbating the symptoms of hyperandrogenism.[19] Dysbiosis in the gut microbiome is now being recognized as a significant contributor to the inflammation and metabolic dysfunction observed in PCOS. Studies suggest that gut microbial imbalances may lead to the development of insulin resistance through mechanisms such as the leakage of lipopolysaccharide (LPS) into the bloodstream, which in turn activate immune pathways that interfere with insulin receptor function.[20][21] This relationship between the gut microbiome and insulin resistance is crucial to understanding the broader pathophysiology of PCOS, particularly regarding the gut-brain axis and hormonal regulation and presents opportunities for microbiome-based diagnostics and microbiome-targeted interventions (MBTIs).[22]
Metallomic Signature
Heavy metals and trace elements play a significant role in the pathophysiology of polycystic ovary syndrome (PCOS). Studies have revealed imbalances in several essential trace elements such as zinc, copper, manganese, and the accumulation of toxic metals like lead (Pb), and cadmium (Cd) in PCOS patients. These elements contribute to oxidative stress (OS), inflammation, and hormonal dysregulation, which are hallmarks of PCOS. Elevated zinc and nickel levels, in particular, are indicative of inflammation and metabolic dysfunction, which are key components of PCOS pathology. By examining the metallomic signature alongside microbial shifts in PCOS, it becomes clear that targeting these imbalances could offer novel therapeutic avenues, including dietary interventions and chelation therapies, to manage oxidative stress and inflammation in PCOS patients.
What are the metallomic signatures of PCOS?
Copper
Copper is an essential trace element involved in various enzymatic and redox processes, but in the context of polycystic ovary syndrome (PCOS), its role is complex. Studies have shown that copper levels are often elevated in women with PCOS, and this imbalance contributes to oxidative stress and inflammation, two key features of the condition.[23][24] Copper is involved in redox reactions, and when present in excess, it can generate reactive oxygen species (ROS), exacerbating oxidative damage to cells and tissues. This contributes to insulin resistance and impaired ovarian function, both of which are central to the pathophysiology of PCOS. High copper levels have also been linked to increased estrogenic activity, which might aggravate hormonal imbalances seen in PCOS.[25][26]
Zinc
Zinc is critical for many enzymatic functions, including those involved in immune response and reproductive health. Zinc deficiency could lead to biochemical features of PCOS via decreasing the antioxidant capacity, causing insulin resistance and apoptosis.[27] In women with PCOS, zinc supplementation has been associated with improved ovulatory function and reduced androgen levels. Increased zinc levels have also been linked to lower levels of oxidative stress markers such as malondialdehyde (MDA), which is commonly elevated in PCOS.[28][29][x]
Selenium
Selenium is a trace element that plays a vital role in antioxidant defense mechanisms. In women with PCOS, serum selenium levels are significantly lower in hyperandrogenic women, suggesting its potential role in regulating oxidative stress and reproductive dysfunction.[30] Selenium supplementation has been shown to improve glucose homeostasis and reduce free androgen index levels in women with PCOS.[31]
Magnesium
Magnesium is involved in over 300 enzymatic processes, including those related to insulin sensitivity and glucose metabolism. In women with PCOS, magnesium deficiency is associated with higher levels of oxidative stress and insulin resistance.[32] Supplementation with magnesium has been shown to reduce biomarkers of inflammation and improve hormonal balance . Additionally, magnesium plays a role in the regulation of testosterone and estradiol levels in women with PCOS, with a positive correlation observed between magnesium and testosterone in obese patients.[33]
Chromium
Chromium is essential for normal glucose metabolism. It enhances insulin sensitivity, and in women with PCOS, chromium supplementation has demonstrated beneficial effects on glucose homeostasis and insulin resistance, key issues in the condition.[34][35][x] It is also associated with improvements in metabolic parameters, including serum lipids and oxidative stress markers.[36] However, some studies have shown mixed results, with variations in chromium levels observed between different populations of women with PCOS.
Manganese
Manganese is another essential trace element involved in the defense against oxidative stress. Studies have indicated that lower levels of manganese are observed in women with PCOS, particularly in those with insulin resistance.[37] Its deficiency is thought to exacerbate oxidative stress, contributing to the pathophysiology of PCOS.[38]
Nickel
Nickel has been found to accumulate at higher levels in women with PCOS, especially in those with obesity. Nickel exposure is associated with endocrine disruption and mitochondrial dysfunction, which can impair folliculogenesis and ovulation.[39][40] The metal also induces inflammatory responses, further complicating the symptoms of PCOS
Lead
Lead exposure is another significant concern in women with PCOS. Even at low levels, lead has been shown to contribute to oxidative stress, which exacerbates the metabolic and reproductive dysfunctions in PCOS. Studies indicate that elevated blood lead levels (BLLs) are associated with a higher incidence of insulin resistance, a key feature of PCOS. Lead disrupts cellular functions by generating ROS and impairing antioxidant defenses, contributing to the chronic inflammation seen in PCOS.[41] Additionally, lead exposure can alter hormone levels, including those involved in the regulation of ovarian function, thus worsening symptoms like anovulation and infertility.
Cadmium
Cadmium, a heavy metal known for its toxicity, is linked to increased oxidative stress in women with PCOS. Cadmium exposure leads to the generation of reactive oxygen species (ROS), which can damage cellular components and exacerbate insulin resistance.[42][43]
Nutritional Immunity
In PCOS, imbalances in essential micronutrients like zinc, copper, and manganese contribute to immune dysfunction and inflammation. Deficiencies in these nutrients are linked to increased oxidative stress and metabolic issues, such as insulin resistance and hormonal disturbances.[44][45][x][46] In addition to these micronutrients, calprotectin, a protein involved in inflammation and immune response, plays a critical role in modulating the immune system in PCOS. Elevated calprotectin levels have been associated with increased inflammation and oxidative stress in PCOS patients, further highlighting the importance of balancing trace elements and inflammatory markers.[47] Addressing these nutritional imbalances and the inflammatory pathways, including calprotectin regulation, through targeted interventions could help manage inflammation, improve metabolic function, and restore microbial balance, offering potential benefits for PCOS management.
Microbiome Signature: Polycystic ovary syndrome (PCOS)
Interventions
Our validation method confirms the effectiveness of microbiome-targeted interventions (MBTIs) by linking their therapeutic impact on microbial imbalances with clinical outcomes, key pathological markers, and major microbial associations (MMAs) associated with PCOS. This dual approach ensures that interventions effectively target both the microbial imbalances and the fundamental biological processes of PCOS, reinforcing the precision of microbiome signatures and the success of MBTIs. Moreover, promising candidates demonstrating preliminary benefits or partial alignment are highlighted for further exploration, contributing to a pipeline of novel treatments for future validation.
| Intervention | Classification | MBTI Status |
|---|---|---|
| Fecal Microbiota Transplantation (FMT) | Microbiota-based therapy | Validated |
| Metformin | Drug Repurposing | Validated |
| Curcumin | Supplement | Validated |
| Resistant Dextrin | Supplement | Validated |
| Statin Therapy | Pharmaceutical | Validated |
| Probiotics | Supplement | Validated |
| Synbiotics | Supplement | Validated |
FAQs
What is the role of the microbiome in PCOS?
What is the role of the microbiome in PCOS?
Emerging research suggests that the gut microbiome may play a significant role in the development and progression of PCOS. Imbalances in gut bacteria, known as dysbiosis, may contribute to the inflammation, insulin resistance, and metabolic dysfunction often seen in PCOS. Certain microbial populations have been linked to increased oxidative stress, which worsens symptoms like acne, hirsutism, and insulin resistance. Additionally, microbial imbalances can affect the body’s ability to process hormones and nutrients, which may contribute to the hormonal irregularities characteristic of PCOS. Research is ongoing, but maintaining a healthy gut microbiome through diet, prebiotics, probiotics, and possibly fecal microbiota transplantation may offer new ways to manage PCOS-related symptoms.
What treatments are available for managing PCOS symptoms?
What treatments are available for managing PCOS symptoms?
Treatment for PCOS typically includes hormonal therapies such as birth control pills or anti-androgens to regulate periods and reduce symptoms like acne and hirsutism. For women trying to conceive, ovulation-inducing medications may be prescribed. Metformin is also used to manage insulin resistance, which is common in PCOS.
How is PCOS diagnosed?
How is PCOS diagnosed?
PCOS is diagnosed through a combination of clinical symptoms, physical examination, and medical tests. A healthcare provider will evaluate symptoms such as irregular menstrual cycles, hirsutism, and acne. Blood tests are used to measure hormone levels, including androgens and insulin, while an ultrasound may be performed to check for the presence of cysts on the ovaries. The diagnosis is often confirmed if at least two of the following criteria are met: irregular or absent ovulation, elevated levels of androgens (male hormones), and polycystic ovaries visible on ultrasound. It is important for women to consult with a healthcare provider for proper diagnosis and treatment options.
Research Feed
Evaluation of the relationship between polycystic ovary syndrome and intestinal inflammation as measured by fecal calprotectin levels
August 22, 2024
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Polycystic ovary syndrome (PCOS) •
Polycystic ovary syndrome (PCOS)
Did you know?
Women with PCOS produce more than double the amount of anti-Müllerian hormone (AMH) compared to women without PCOS—so much so that some researchers have proposed renaming the condition “AMH syndrome.”
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Alteration in gut mycobiota of patients with polycystic ovary syndrome
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Dysbiosis of the Saliva Microbiome in Patients With Polycystic Ovary Syndrome
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Association between Polycystic Ovary Syndrome and Gut Microbiota
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Gut microbiome in PCOS associates to serum metabolomics: a cross‑sectional study
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Characterization of the gut microbiota in polycystic ovary syndrome with dyslipidemia
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Dysbiosis of Gut Microbiota Associated with Clinical Parameters in Polycystic Ovary Syndrome
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Alterations of bacteriome, mycobiome and metabolome characteristics in PCOS patients with normal/overweight individuals
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Exploration of the Relationship Between Gut Microbiota and Polycystic Ovary Syndrome (PCOS)
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Insulin Resistance and the Polycystic Ovary Syndrome Revisited: An Update on Mechanisms and Implications
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Causal relationships between gut microbiota and polycystic ovarian syndrome
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Gut microbiota alterations reveal potential gut–brain axis changes in polycystic ovary syndrome (PCOS)
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Gut and Vaginal Microbiomes in PCOS: Implications for Women’s Health
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Dysbiosis of Gut Microbiota (DOGMA) – A novel theory for the development of Polycystic Ovarian Syndrome
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Role of gut microbiota in the development of insulin resistance and the mechanism underlying polycystic ovary syndrome (PCOS)
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Polycystic ovary syndrome: pathophysiology and therapeutic opportunities
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Polycystic Ovary Syndrome: Etiology, Current Management, and Future Therapeutics
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Low intakes of dietary fiber and magnesium are associated with insulin resistance and hyperandrogenism in polycystic ovary syndrome
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The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome
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The effects of probiotics, prebiotics, and synbiotics on polycystic ovarian syndrome
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Mediterranean Diet Combined With a Low-Carbohydrate Dietary Pattern in the Treatment of Overweight Polycystic Ovary Syndrome Patients
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Ketogenic diet improves fertility in patients with polycystic ovary syndrome: A brief report
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Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS)
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Vitamin D and probiotic co-supplementation affects mental health, hormonal, inflammatory and oxidative stress parameters in women with polycystic ovary syndrome
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Probiotics and Polycystic Ovary Syndrome: A Perspective for Management in Adolescents with Obesity
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Lower Fiber Consumption in Women with Polycystic Ovary Syndrome
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High-Fiber Diet or Combined With Acarbose Alleviates Heterogeneous Phenotypes of Polycystic Ovary Syndrome by Regulating Gut Microbiota
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Increased circulating conjugated primary bile acids are associated with hyperandrogenism in women with polycystic ovary syndrome
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The Gut Microbiome in Polycystic Ovary Syndrome and Its Association with Metabolic Traits
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Circulating bile acid profile characteristics in PCOS patients and the role of bile acids in predicting the pathogenesis of PCOS
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Profile of Bile Acid Metabolomics in the Follicular Fluid of PCOS Patients
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The Implication of Mechanistic Approaches and the Role of the Microbiome in Polycystic Ovary Syndrome (PCOS)
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Metformin use in women with polycystic ovary syndrome
June 27, 2014
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Polycystic ovary syndrome (PCOS) •
Polycystic ovary syndrome (PCOS)
Did you know?
Women with PCOS produce more than double the amount of anti-Müllerian hormone (AMH) compared to women without PCOS—so much so that some researchers have proposed renaming the condition “AMH syndrome.”
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Role of Metformin in Polycystic Ovary Syndrome (PCOS)-Related Infertility
August 21, 2023
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Polycystic ovary syndrome (PCOS) •
Polycystic ovary syndrome (PCOS)
Did you know?
Women with PCOS produce more than double the amount of anti-Müllerian hormone (AMH) compared to women without PCOS—so much so that some researchers have proposed renaming the condition “AMH syndrome.”
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Evidence for statin therapy in polycystic ovary syndrome.
April 1, 2010
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Polycystic ovary syndrome (PCOS) •
Polycystic ovary syndrome (PCOS)
Did you know?
Women with PCOS produce more than double the amount of anti-Müllerian hormone (AMH) compared to women without PCOS—so much so that some researchers have proposed renaming the condition “AMH syndrome.”
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Effects of Probiotic Supplementation on Pancreatic β-cell Function and C-reactive Protein in Women with Polycystic Ovary Syndrome
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The effects of synbiotic supplementation on hormonal status, biomarkers of inflammation and oxidative stress in subjects with polycystic ovary syndrome
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Fecal Microbiota Transplantation: A Potential Tool for Treatment of Human Female Reproductive Tract Diseases
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Combination therapy of curcumin and fecal microbiota transplant: Potential treatment of polycystic ovarian syndrome
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The effect of resistant dextrin as a prebiotic on metabolic parameters and androgen level in women with polycystic ovarian syndrome
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A New Approach to Polycystic Ovary Syndrome: The Gut Microbiota
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Levels of Trace Elements in Erythrocytes as Endocrine Disruptors in Obese and Nonobese Women with Polycystic Ovary Syndrome
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Serum Copper Level and Polycystic Ovarian Syndrome: A Meta-Analysis
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A Comparative Study of Blood Levels of Manganese, Some Macroelements and Heavy Metals in Obese and Non-Obese Polycystic Ovary Syndrome Patients
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Serum trace elements and heavy metals in polycystic ovary syndrome
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Are Heavy Metal Exposure and Trace Element Levels Related to Metabolic and Endocrine Problems in Polycystic Ovary Syndrome?
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Association of Trace Elements with Polycystic Ovary Syndrome in Women—A Case-Control Study
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Antioxidant status in relation to heavy metals induced oxidative stress in patients with polycystic ovarian syndrome (PCOS)
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Heavy Metals and Essential Elements in Association with Oxidative Stress in Women with Polycystic Ovary Syndrome
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Repurposing new drug candidates and identifying crucial molecules underlying PCOS Pathogenesis Based On Bioinformatics Analysis
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Systems pharmacology to investigate the interaction of berberine and other drugs in treating polycystic ovary syndrome
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The Comparative Effects of Myo-Inositol and Metformin Therapy on the Clinical and Biochemical Parameters of Women of Normal Weight Suffering from Polycystic Ovary Syndrome
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Identification of polycystic ovary syndrome potential drug targets based on pathobiological similarity in the protein-protein interaction network
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Promising Drug Candidates for the Treatment of Polycystic Ovary Syndrome (PCOS) as Alternatives to the Classical Medication Metformin
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Infertility
Infertility is the inability to conceive after 12 months of regular, unprotected sex. It affects both men and women and can be due to various physical, hormonal, or genetic factors. Treatments include medication, surgery, assisted reproductive technologies, and lifestyle changes.
Microbiome-Targeted Interventions (MBTIs)
Microbiome Targeted Interventions (MBTIs) are cutting-edge treatments that utilize information from Microbiome Signatures to modulate the microbiome, revolutionizing medicine with unparalleled precision and impact.
Metallomic Signatures
A metallomic signature is the condition-specific profile of trace metals and metal-binding molecules that reflects disrupted metal homeostasis.
Microbiome-Targeted Interventions (MBTIs)
Microbiome Targeted Interventions (MBTIs) are cutting-edge treatments that utilize information from Microbiome Signatures to modulate the microbiome, revolutionizing medicine with unparalleled precision and impact.
Major Microbial Associations (MMAs)
Major Microbial Associations (MMAs) are fundamental in understanding disease-microbiome interactions and play a crucial role in advancing microbiome-targeted interventions aimed at treating or preventing diseases through microbial modulation.
Fecal Microbiota Transplantation (FMT)
Fecal Microbiota Transplantation (FMT) involves transferring fecal bacteria from a healthy donor to a patient to restore microbiome balance.
Metformin
Metformin is a synthetic derivative of guanidine derived from the guanidine alkaloid of the plant Galega officinalis L. with significant hypoglycemic effects. It is a first-line antihyperglycemic agent due to its efficacy, low cost, and favorable safety profile.
Validation of Metformin as a Microbiome-Targeted Intervention for Polycystic ovary syndrome (PCOS)
Metformin targets both the microbiome and inflammatory mechanisms in PCOS, improving insulin sensitivity, reducing hyperandrogenism, and restoring ovulation. Its microbial effects validate the condition’s microbiome signature, making it a promising microbiome-targeted intervention for managing infertility in PCOS.
Validation of Resistant Dextrin as a Microbiome-Targeted Intervention for Polycystic ovary syndrome (PCOS)
Resistant dextrin targets both metabolic and microbial imbalances in PCOS. It reduces fasting blood glucose, lipids, and androgens, while improving microbial composition, supporting its role as a microbiome-targeted intervention (MBTI) for PCOS-related infertility and metabolic health.
Validation of Statin Therapy as a Microbiome-Targeted Intervention for Polycystic ovary syndrome (PCOS)
Statins target both microbial imbalances and inflammatory mechanisms in PCOS. By improving gut microbial composition and metabolic parameters, statins validate the microbiome signature of PCOS and enhance fertility and metabolic health outcomes.
Probiotics
Probiotics are live microorganisms that offer significant health benefits when administered in adequate amounts. They primarily work by modulating the gut microbiome, supporting a balanced microbial ecosystem. Probiotics have been shown to improve gut health, modulate immune responses, and even influence metabolic and mental health disorders. With growing evidence supporting their therapeutic potential, probiotics are increasingly recognized for their role in treating conditions like irritable bowel syndrome (IBS), antibiotic-associated diarrhea (AAD), and even mental health conditions like depression and anxiety through their impact on the gut-brain axis.
Validation of Probiotics as a Microbiome-Targeted Intervention for Polycystic ovary syndrome (PCOS)
Probiotic supplementation addresses microbial dysbiosis and inflammatory processes in PCOS, improving metabolic and hormonal outcomes, thereby validating its role as an MBTI.
Validation of Synbiotics as a Microbiome-Targeted Intervention for Polycystic ovary syndrome (PCOS)
Synbiotics restore gut microbiome balance in PCOS, improving insulin sensitivity, reducing inflammation, and normalizing androgen levels. This validation reinforces its role as a microbiome-targeted intervention.
References
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- Serum micro- and macroelements levels in women with polycystic ovary syndrome associated with pelvic inflammatory disease. Tatarchuk, T. F., Kosei, N. V., Vetokh, H. V., & Gunkov, S. V. (2016). (REPRODUCTIVE ENDOCRINOLOGY, (27), 26–29.)
- Are Heavy Metal Exposure and Trace Element Levels Related to Metabolic and Endocrine Problems in Polycystic Ovary Syndrome?. Kirmizi, D. A., Baser, E., Turksoy, V. A., Kara, M., Yalvac, E. S., & Gocmen, A. Y. (2020). (Biological Trace Element Research.)
- Serum copper assessment in patients with polycystic ovary syndrome and tubal infertility: A retrospective 5-year study. Liu, Y., Zhang, W., Liu, Z., Zheng, A., Liang, B., Li, H., & Meng, Q. (2024).. (Food Science & Nutrition, 12, 5979–5989.)
- Association of Trace Elements with Polycystic Ovary Syndrome in Women—A Case-Control Study. Srnovršnik, T., Pinter, B., Horvat, M., Snoj Tratnik, J., Falnoga, I., Mazej, D., Verdenik, I., & Virant-Klun, I. (2025).. (Metabolites, 15(2), 79.)
- A Comparative Study of Blood Levels of Manganese, Some Macroelements and Heavy Metals in Obese and Non-Obese Polycystic Ovary Syndrome Patients. H. Mhaibes S, A. Taher M, H. Badr A, H. Badr A.. (Iraqi Journal of Pharmaceutical Sciences [Internet]. 2017 Dec. 26 [cited 2025 Mar. 12];26(2):85-94)
- Levels of Trace Elements in Erythrocytes as Endocrine Disruptors in Obese and Nonobese Women with Polycystic Ovary Syndrome. Pokorska-Niewiada, K., Brodowska, A., Brodowski, J., & Szczuko, M. (2022). (International Journal of Environmental Research and Public Health, 19(2), 976.)
- Serum micro- and macroelements levels in women with polycystic ovary syndrome associated with pelvic inflammatory disease. Tatarchuk, T. F., Kosei, N. V., Vetokh, H. V., & Gunkov, S. V. (2016). (REPRODUCTIVE ENDOCRINOLOGY, (27), 26–29.)
- Are Heavy Metal Exposure and Trace Element Levels Related to Metabolic and Endocrine Problems in Polycystic Ovary Syndrome?. Kirmizi, D. A., Baser, E., Turksoy, V. A., Kara, M., Yalvac, E. S., & Gocmen, A. Y. (2020). (Biological Trace Element Research.)
- Heavy Metals and Essential Elements in Association with Oxidative Stress in Women with Polycystic Ovary Syndrome-A Systematic Review. Srnovršnik T, Virant-Klun I, Pinter B.. (Antioxidants (Basel). 2023 Jul 7;12(7):1398)
- Serum micro- and macroelements levels in women with polycystic ovary syndrome associated with pelvic inflammatory disease. Tatarchuk, T. F., Kosei, N. V., Vetokh, H. V., & Gunkov, S. V. (2016). (REPRODUCTIVE ENDOCRINOLOGY, (27), 26–29.)
- Levels of Trace Elements in Erythrocytes as Endocrine Disruptors in Obese and Nonobese Women with Polycystic Ovary Syndrome. Pokorska-Niewiada, K., Brodowska, A., Brodowski, J., & Szczuko, M. (2022). (International Journal of Environmental Research and Public Health, 19(2), 976.)
- Serum micro- and macroelements levels in women with polycystic ovary syndrome associated with pelvic inflammatory disease. Tatarchuk, T. F., Kosei, N. V., Vetokh, H. V., & Gunkov, S. V. (2016). (REPRODUCTIVE ENDOCRINOLOGY, (27), 26–29.)
- Levels of Trace Elements in Erythrocytes as Endocrine Disruptors in Obese and Nonobese Women with Polycystic Ovary Syndrome. Pokorska-Niewiada, K., Brodowska, A., Brodowski, J., & Szczuko, M. (2022). (International Journal of Environmental Research and Public Health, 19(2), 976.)
- A Comparative Study of Blood Levels of Manganese, Some Macroelements and Heavy Metals in Obese and Non-Obese Polycystic Ovary Syndrome Patients. H. Mhaibes S, A. Taher M, H. Badr A, H. Badr A.. (Iraqi Journal of Pharmaceutical Sciences [Internet]. 2017 Dec. 26 [cited 2025 Mar. 12];26(2):85-94)
- A Comparative Study of Blood Levels of Manganese, Some Macroelements and Heavy Metals in Obese and Non-Obese Polycystic Ovary Syndrome Patients. H. Mhaibes S, A. Taher M, H. Badr A, H. Badr A.. (Iraqi Journal of Pharmaceutical Sciences [Internet]. 2017 Dec. 26 [cited 2025 Mar. 12];26(2):85-94)
- Serum trace elements and heavy metals in polycystic ovary syndrome. Kurdoglu Z, Kurdoglu M, Demir H, Sahin HG. (Hum Exp Toxicol. 2012 May;31(5):452-6.)
- Serum copper assessment in patients with polycystic ovary syndrome and tubal infertility: A retrospective 5-year study. Liu, Y., Zhang, W., Liu, Z., Zheng, A., Liang, B., Li, H., & Meng, Q. (2024).. (Food Science & Nutrition, 12, 5979–5989.)
- Are Heavy Metal Exposure and Trace Element Levels Related to Metabolic and Endocrine Problems in Polycystic Ovary Syndrome?. Kirmizi, D. A., Baser, E., Turksoy, V. A., Kara, M., Yalvac, E. S., & Gocmen, A. Y. (2020). (Biological Trace Element Research.)
- Levels of Trace Elements in Erythrocytes as Endocrine Disruptors in Obese and Nonobese Women with Polycystic Ovary Syndrome. Pokorska-Niewiada, K., Brodowska, A., Brodowski, J., & Szczuko, M. (2022). (International Journal of Environmental Research and Public Health, 19(2), 976.)
- Evaluation of the relationship between polycystic ovary syndrome and intestinal inflammation as measured by fecal calprotectin levels. Bihter Senem Feyzioğlu, Zerrin Avul. (Zeynep Kamil Med J. 2024; 55(4): 207-212)
Sun J, Wang M, Kan Z.
Causal relationship between gut microbiota and polycystic ovary syndrome: a literature review and Mendelian randomization study.Front Endocrinol (Lausanne). 2024
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Gut and Vaginal Microbiomes in PCOS: Implications for Women’s Health.Front Endocrinol (Lausanne). 2022.
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Gut microbiota alterations reveal potential gut–brain axis changes in polycystic ovary syndrome.Journal of Endocrinological Investigation. 2021.
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Insulin Resistance and the Polycystic Ovary Syndrome Revisited: An Update on Mechanisms and Implications.Endocrine Reviews, 2012.
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Exploration of the Relationship Between Gut Microbiota and Polycystic Ovary Syndrome (PCOS): a Review.Geburtshilfe Frauenheilkd. 2020
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Polycystic ovary syndrome: pathophysiology and therapeutic opportunitiesBMJ Med. 2023
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Causal relationship between gut microbiota and polycystic ovary syndrome: a literature review and Mendelian randomization study.Front Endocrinol (Lausanne). 2024
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Role of gut microbiota in the development of insulin resistance and the mechanism underlying polycystic ovary syndrome: a review.Journal of Ovarian Research. 2020.
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Dysbiosis of Gut Microbiota (DOGMA) – A novel theory for the development of Polycystic Ovarian SyndromeMedical Hypotheses, 2012.
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Insulin Resistance and the Polycystic Ovary Syndrome Revisited: An Update on Mechanisms and Implications.Endocrine Reviews, 2012.
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Causal relationship between gut microbiota and polycystic ovary syndrome: a literature review and Mendelian randomization study.Front Endocrinol (Lausanne). 2024
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Polycystic ovary syndrome: pathophysiology and therapeutic opportunitiesBMJ Med. 2023 Oct 12;2(1):e000548
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Causal relationship between gut microbiota and polycystic ovary syndrome: a literature review and Mendelian randomization studyFront Endocrinol (Lausanne). 2024 Feb 1;15:1280983
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Exploration of the Relationship Between Gut Microbiota and Polycystic Ovary Syndrome (PCOS): a ReviewGeburtshilfe Und Frauenheilkunde, 80(02), 161–171.
Read ReviewLiang, Z., Di, N., Li, L., & Yang, D. (2021).
Gut microbiota alterations reveal potential gut–brain axis changes in polycystic ovary syndromeJournal of Endocrinological Investigation, 44(8), 1727–1737
Read ReviewSun J, Wang M, Kan Z.
Causal relationship between gut microbiota and polycystic ovary syndrome: a literature review and Mendelian randomization studyFront Endocrinol (Lausanne). 2024 Feb 1;15:1280983
Read ReviewYang, T., Li, G., Xu, Y. et al.
Characterization of the gut microbiota in polycystic ovary syndrome with dyslipidemiaBMC Microbiol 24, 169 (2024)
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Role of gut microbiota in the development of insulin resistance and the mechanism underlying polycystic ovary syndrome: a reviewJournal of Ovarian Research, 13(1)
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Dysbiosis of Gut Microbiota Associated with Clinical Parameters in Polycystic Ovary SyndromeFrontiers in Microbiology, 8, 234522.
Read ReviewAbudawood, M., Tabassum, H., Alanazi, A.H. et al.
Antioxidant status in relation to heavy metals induced oxidative stress in patients with polycystic ovarian syndrome (PCOS)Sci Rep 11, 22935 (2021)
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Serum Copper Level and Polycystic Ovarian Syndrome: A Meta-AnalysisGynecol Obstet Invest (2021) 86 (3): 239–246.
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Alteration in gut mycobiota of patients with polycystic ovary syndromeMicrobiol Spectr11:e02360-23
Read ReviewLiu, Y., Zhang, W., Liu, Z., Zheng, A., Liang, B., Li, H., & Meng, Q. (2024).
Serum copper assessment in patients with polycystic ovary syndrome and tubal infertility: A retrospective 5-year studyFood Science & Nutrition, 12, 5979–5989.
Read ReviewTatarchuk, T. F., Kosei, N. V., Vetokh, H. V., & Gunkov, S. V. (2016)
Serum micro- and macroelements levels in women with polycystic ovary syndrome associated with pelvic inflammatory diseaseREPRODUCTIVE ENDOCRINOLOGY, (27), 26–29.
Read ReviewSrnovršnik, T., Pinter, B., Horvat, M., Snoj Tratnik, J., Falnoga, I., Mazej, D., Verdenik, I., & Virant-Klun, I. (2025).
Association of Trace Elements with Polycystic Ovary Syndrome in Women—A Case-Control StudyMetabolites, 15(2), 79.
Read ReviewSrnovršnik T, Virant-Klun I, Pinter B.
Heavy Metals and Essential Elements in Association with Oxidative Stress in Women with Polycystic Ovary Syndrome-A Systematic ReviewAntioxidants (Basel). 2023 Jul 7;12(7):1398
Read ReviewSrnovršnik T, Virant-Klun I, Pinter B.
Heavy Metals and Essential Elements in Association with Oxidative Stress in Women with Polycystic Ovary Syndrome-A Systematic ReviewAntioxidants (Basel). 2023 Jul 7;12(7):1398
Read ReviewTatarchuk, T. F., Kosei, N. V., Vetokh, H. V., & Gunkov, S. V. (2016)
Serum micro- and macroelements levels in women with polycystic ovary syndrome associated with pelvic inflammatory diseaseREPRODUCTIVE ENDOCRINOLOGY, (27), 26–29.
Read ReviewKirmizi, D. A., Baser, E., Turksoy, V. A., Kara, M., Yalvac, E. S., & Gocmen, A. Y. (2020)
Are Heavy Metal Exposure and Trace Element Levels Related to Metabolic and Endocrine Problems in Polycystic Ovary Syndrome?Biological Trace Element Research.
Read ReviewLiu, Y., Zhang, W., Liu, Z., Zheng, A., Liang, B., Li, H., & Meng, Q. (2024).
Serum copper assessment in patients with polycystic ovary syndrome and tubal infertility: A retrospective 5-year studyFood Science & Nutrition, 12, 5979–5989.
Read ReviewSrnovršnik, T., Pinter, B., Horvat, M., Snoj Tratnik, J., Falnoga, I., Mazej, D., Verdenik, I., & Virant-Klun, I. (2025).
Association of Trace Elements with Polycystic Ovary Syndrome in Women—A Case-Control StudyMetabolites, 15(2), 79.
Read ReviewH. Mhaibes S, A. Taher M, H. Badr A, H. Badr A.
A Comparative Study of Blood Levels of Manganese, Some Macroelements and Heavy Metals in Obese and Non-Obese Polycystic Ovary Syndrome PatientsIraqi Journal of Pharmaceutical Sciences [Internet]. 2017 Dec. 26 [cited 2025 Mar. 12];26(2):85-94
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Levels of Trace Elements in Erythrocytes as Endocrine Disruptors in Obese and Nonobese Women with Polycystic Ovary SyndromeInternational Journal of Environmental Research and Public Health, 19(2), 976.
Read ReviewTatarchuk, T. F., Kosei, N. V., Vetokh, H. V., & Gunkov, S. V. (2016)
Serum micro- and macroelements levels in women with polycystic ovary syndrome associated with pelvic inflammatory diseaseREPRODUCTIVE ENDOCRINOLOGY, (27), 26–29.
Read ReviewKirmizi, D. A., Baser, E., Turksoy, V. A., Kara, M., Yalvac, E. S., & Gocmen, A. Y. (2020)
Are Heavy Metal Exposure and Trace Element Levels Related to Metabolic and Endocrine Problems in Polycystic Ovary Syndrome?Biological Trace Element Research.
Read ReviewSrnovršnik T, Virant-Klun I, Pinter B.
Heavy Metals and Essential Elements in Association with Oxidative Stress in Women with Polycystic Ovary Syndrome-A Systematic ReviewAntioxidants (Basel). 2023 Jul 7;12(7):1398
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Serum micro- and macroelements levels in women with polycystic ovary syndrome associated with pelvic inflammatory diseaseREPRODUCTIVE ENDOCRINOLOGY, (27), 26–29.
Read ReviewPokorska-Niewiada, K., Brodowska, A., Brodowski, J., & Szczuko, M. (2022)
Levels of Trace Elements in Erythrocytes as Endocrine Disruptors in Obese and Nonobese Women with Polycystic Ovary SyndromeInternational Journal of Environmental Research and Public Health, 19(2), 976.
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Serum micro- and macroelements levels in women with polycystic ovary syndrome associated with pelvic inflammatory diseaseREPRODUCTIVE ENDOCRINOLOGY, (27), 26–29.
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Levels of Trace Elements in Erythrocytes as Endocrine Disruptors in Obese and Nonobese Women with Polycystic Ovary SyndromeInternational Journal of Environmental Research and Public Health, 19(2), 976.
Read ReviewH. Mhaibes S, A. Taher M, H. Badr A, H. Badr A.
A Comparative Study of Blood Levels of Manganese, Some Macroelements and Heavy Metals in Obese and Non-Obese Polycystic Ovary Syndrome PatientsIraqi Journal of Pharmaceutical Sciences [Internet]. 2017 Dec. 26 [cited 2025 Mar. 12];26(2):85-94
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Read ReviewKurdoglu Z, Kurdoglu M, Demir H, Sahin HG
Serum trace elements and heavy metals in polycystic ovary syndromeHum Exp Toxicol. 2012 May;31(5):452-6.
Read ReviewLiu, Y., Zhang, W., Liu, Z., Zheng, A., Liang, B., Li, H., & Meng, Q. (2024).
Serum copper assessment in patients with polycystic ovary syndrome and tubal infertility: A retrospective 5-year studyFood Science & Nutrition, 12, 5979–5989.
Read ReviewKirmizi, D. A., Baser, E., Turksoy, V. A., Kara, M., Yalvac, E. S., & Gocmen, A. Y. (2020)
Are Heavy Metal Exposure and Trace Element Levels Related to Metabolic and Endocrine Problems in Polycystic Ovary Syndrome?Biological Trace Element Research.
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Levels of Trace Elements in Erythrocytes as Endocrine Disruptors in Obese and Nonobese Women with Polycystic Ovary SyndromeInternational Journal of Environmental Research and Public Health, 19(2), 976.
Read ReviewBihter Senem Feyzioğlu, Zerrin Avul
Evaluation of the relationship between polycystic ovary syndrome and intestinal inflammation as measured by fecal calprotectin levelsZeynep Kamil Med J. 2024; 55(4): 207-212
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