A woman suffering from polycystic ovary syndrome (PCOS) requires treatment not only of hormonal disorders, but also of the metabolic disorders that accompany the disease. Probiotics can help.
Treatment for PCOS is based on hormone therapy and lifestyle changes. It is supposed to prevent metabolic complications, such as insulin resistance, type 2 diabetes, lipid disorders, and hypertension. If a he althy lifestyle is not enough to stabilize the carbohydrate balance and reduce excess body weight, doctors often include metformin and other glucose-normalizing drugs.
"Bad" bacteria in PCOS
Studies published in recent years confirm that women suffering from PCOS have a lower composition of intestinal microbiota than he althy ones. It is similar to the microbiota of obese people. This is no coincidence, as as many as 60% of women suffering from PCOS suffer from obesity at the same time. Their intestinal microbiota is composed ofFirmicutesand Mollicutes, which have an adverse effect on metabolism.
Scientists had the idea to see if modulation of the gut microbiota could help them. Earlier studies have confirmed that probiotic therapy has a beneficial effect on metabolism, and when used during a reduction diet, it has a positive effect on the number and variety of protective intestinal bacteria and supports the functioning of the intestinal barrier in overweight or obese people.
Effective synbiotic
The study was conducted by a team led by Dr. Izabela Chudzicka-Strugała, MD. Patients with PCOS as well as those who were overweight or obese participated in the study. The study participants were divided into two groups. The first one took a synbioticSanprobi Super Formulaconsisting of 7 probiotic strains ( Bifidobacterium lactisW51,Bifidobacterium lactisW52 ,Lactobacillus acidophilusW22,Lactobacillus paracaseiW20,Lactobacillus plantarumW21,Lactobacillus salivariusW24 andLactococcus lactisW19) and 2 prebiotics, i.e. substances that nourish bacteria and facilitate their colonization in the intestine (fructo-oligosaccharides and inulin). The other part of the subjects received a placebo. Both groups were advised to additionally reduce the number of calories to 1400-1800 a day, as well as a daily walk for 30-40 minutes. The study was double-blind, whatmeans that neither the participating women nor the researchers knew whether the patient was receiving a supplement or a placebo.
After 12 weeks of administering Sanprobi Super Formula in a dose of 4 capsules a day, it turned out that in women taking synbiotic, the concentration of total testosterone decreased by as much as 32% (in the group taking placebo by 6%), the concentration dropped by 23% triglycerides (in the placebo group by 15%), body mass index by 8% (BMI vs. 5%) and waist circumference by 10% (vs. 6%). a hormone that regulates the production of testosterone.
Mechanism of action of the synbiotic
How to explain the beneficial effects of probiotics on metabolism and the improvement of the hormonal status? The modification of the intestinal microbiota and the reduction of the dominance of pathogenic strains in the intestines of the studied women contributed to the improvement.
Excess pathogenic bacteria promote weight gain because they increase the ability to break down polysaccharide residues remaining in the gastrointestinal tract, which should be removed with the faeces. In addition, they produce pro-inflammatory substances, such as lipopolysaccharides (LPS), which penetrate the intestinal walls into the bloodstream, damaging insulin receptors on the cells of adipose tissue, muscles and liver, which are responsible for glucose metabolism. Damage to these receptors results in insulin resistance, i.e. loss of tissue sensitivity to insulin. In response to glucose metabolism disturbed by insulin resistance, the pancreas produces more insulin, which drives the appetite. This contributes to weight gain, and as you know, overweight and obesity intensify the unfavorable hormonal changes characteristic of PCOS. The reduction of insulin resistance is related to the improvement of the lipid profile. As cells regain insulin sensitivity, they begin to metabolize glucose better. Adipose tissue cells are less lipolyzed and release less free fatty acids into the bloodstream, and liver cells release fewer very low-density lipoproteins (VLDL) into the blood, which are converted into triglycerides.
Is a probiotic with a prebiotic alone enough to reduce adverse metabolic changes in women suffering from PCOS? Probably not. In the conclusions of the study, the scientists state that their use only intensifies the beneficial effects of diet and physical activity on body weight, testosterone levels and symptoms of hyperandrogenism (excess of male hormones), and some metabolic parameters. This is a lot, considering the fact that most PCOS patients admit to having failed attempts to normalize their weight, despite the fact thatdiet and exercise. The cause of these difficulties is insulin resistance. It turns out that modifying the gut microbiota by supplementing certain bacterial strains can effectively help.