Date of Award

2024

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

McHugo, Jeanie

Keywords

PCOS, Probiotics, Synbiotics, Microbiome, Testosterone, Androgens, Anthropometrics, Glycemic Control

Abstract

Polycystic ovarian syndrome (PCOS) is a multifactorial metabolic, endocrinologic, and gynecologic condition affecting up to 5 million women in the United States. It is a disease characterized by oligo- or anovulation, hyperandrogenism, and/or polycystic ovaries. Phenotypic presentation can include irregular menstrual cycles, obesity, hirsutism, insulin resistance, or difficulty conceiving. If untreated, PCOS can result in a sequelae of chronic disease burden. Current standard of care consists of metformin for blood sugar control, oral contraceptives for menstrual regularity, and spironolactone for androgen imbalance, but newer research is identifying gut dysbiosis as a possible contributing etiology to disease development and symptomology. This literature review aims to investigate the effectiveness of probiotic supplement regimens in improving the gut microbiome and subsequent outcomes for patients with PCOS, specifically inflammatory, anthropometric, androgen, and blood sugar markers. A comprehensive literature review was performed using PubMed and Clinical Key databases. A variety of keywords and similar articles were used to identify studies that were further screened for inclusion and exclusion criteria. Studies were excluded if they were systematic reviews, published over 10 years ago, utilized non-human subjects, had poor study design, or looked at conditions outside of PCOS. There were 16 articles that met final criteria and were included in this review. Results showed significant improvement in androgen and inflammatory markers but were inconsistent in anthropometric and blood sugar findings. Further studies with longer duration and increased generalizability are needed to more adequately compare probiotics to standard of care in the treatment of PCOS.

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