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Less Diverse Gut Microbiota in PCOS Linked to Hyperandrogenism

by Lewis Chang, PhD

The majority of women with polycystic ovary syndrome (PCOS) have metabolic abnormalities. Because reduced diversity in the gut microbiome has been associated with metabolic disorders, researchers have hypothesized that women with PCOS may also exhibit reduced diversity in their gut microbiota, which may be linked to other hormonal imbalances including increased levels of testosterone.

Investigators from Department of Reproductive Medicine at University of California San Diego (La Jolla, CA), Department of Biology at San Diego State University (San Diego, CA) and Poznan University of Medical Sciences (Poznan, Poland) conducted a study to compare the fecal microbial diversity profile in healthy women (N=48) with women diagnosed with PCOS (N=73).1 They also collected and analyzed samples from a group of women (N=42) with polycystic ovarian morphology but not yet diagnosed with PCOS. Further, they investigated whether changes in the gut microbiota correlated with any clinical parameter in women with PCOS.1

The results showed a significantly lower alpha diversity—the richness and distribution of different taxa of microorganisms in the fecal microbial sample—in women with PCOS compared with healthy women, and the lower alpha diversity was associated with hyperandrogenism (androgen excess), total testosterone level and hirsutism (male-pattern hair growth).1 Women with polycystic ovarian morphology also had lower alpha diversity, a change that was intermediate between women with PCOS and healthy women.

These data suggest that imbalanced hormones may alter the gut microbiota composition in women with PCOS. However, it remains to be seen whether drugs that block testosterone or probiotic supplements would recover microbiota diversity and improve PCOS symptoms.

The study results were published in the Journal of Clinical Endocrinology & Metabolism.

Why is this Clinically Relevant?

  • Women with PCOS have less diversity in their gut microbiota, which may have unfavorable physiological effects
  • Clinicians may consider recommending probiotic supplementation as an integral part of the PCOS management, although future studies are needed to elucidate such therapeutic approaches

Link to abstract


1. Torres PJ, Siakowska M, Banaszewska B, et al. Gut microbial diversity in women with polycystic ovary syndrome correlates with hyperandrogenism. J Clin Endocrinol Metab. 2018;Jan 23:[Epub ahead of print].

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