Recent Advances in Gut Microbiota Alterations in Polycystic Ovary Syndrome; an Updated Review Publisher



Mokhtariardekani A ; Banei F ; Boshagh Z ; Ranjbari P ; Madani ZH ; Zaremoghadam E ; Nasrabad SA
Source: Journal of Preventive Epidemiology Published:2026

Abstract

The gut microbiome, a complex ecosystem of trillions of microorganisms, has a critical role in metabolic regulation, immune function, and hormonal balance, systems all implicated in polycystic ovary syndrome (PCOS). Evidence suggests that women with PCOS exhibit distinct gut microbial profiles, including reduced microbial diversity, decreased abundance of beneficial bacteria, and increased levels of pro-inflammatory and endotoxin-producing species. These shifts are associated with insulin resistance, obesity, low-grade inflammation, and androgen excess—hallmarks of PCOS. Furthermore, gut microbiota influences bile acid metabolism, short-chain fatty acid production, and gut barrier integrity, thereby modulating systemic inflammation and endocrine function. Interventions such as probiotics, prebiotics, dietary modifications, and fecal microbiota transplantation show promise in ameliorating PCOS symptoms through microbiota modulation. Despite these advances, challenges remain, including heterogeneity in study designs, small sample sizes, and the need for longitudinal data. © 2026 The Author(s); Published by Society of Diabetic Nephropathy Prevention.