Role of Probiotics and Synbiotics in Polycystic Ovary Syndrome: A Systematic Review
DOI:
https://doi.org/10.64149/J.Carcinog.24.3s.199-203Keywords:
Pcos, Probiotics, Synbiotics, Gut Microbiota, Insulin Resistance, Reproductive HealthAbstract
Background: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder with reproductive, metabolic, and psychological manifestations. Alterations in gut microbiota and low-grade systemic inflammation have recently emerged as contributors to PCOS pathophysiology. Probiotics and synbiotics may play a therapeutic role in modulating gut dysbiosis, insulin resistance, hyperandrogenism, and chronic inflammation.
Objective: To systematically review current evidence on the efficacy of probiotics and synbiotics in the management of PCOS, focusing on metabolic, hormonal, reproductive, and inflammatory outcomes.
Methods: A systematic literature search was conducted across PubMed, Scopus, Embase, Web of Science, and Cochrane Library from January 2010 to March 2025. Randomized controlled trials (RCTs), cohort studies, and systematic reviews/meta-analyses evaluating probiotics or synbiotics in women with PCOS were included. Outcomes assessed included insulin resistance, lipid profile, androgen levels, menstrual regularity, ovulation, inflammatory markers, and gut microbiota composition. The quality of evidence was appraised using Cochrane risk-of-bias tools and PRISMA guidelines.
Results: Twenty-eight studies were included (5 RCTs, 2 cohort studies, and 7 systematic reviews/meta-analyses). Probiotics and synbiotics demonstrated consistent improvement in HOMA-IR, fasting insulin, and lipid parameters. Several RCTs reported reductions in testosterone and LH/FSH ratio, improvement in menstrual cyclicity, and enhanced ovulation rates. Synbiotics showed superior efficacy compared to probiotics alone in modulating metabolic outcomes. Evidence also highlighted reductions in inflammatory biomarkers such as TNF-α and CRP. Gut microbiota analysis revealed restoration of beneficial taxa including Lactobacillus and Bifidobacterium.
Conclusion: Probiotics and synbiotics represent promising adjunctive therapies in PCOS by targeting gut dysbiosis, metabolic dysfunction, and systemic inflammation. Synbiotics appear to offer greater benefits than probiotics alone. However, heterogeneity in strains, doses, and study durations warrants further high-quality, large-scale RCTs to establish standardized therapeutic recommendations.
