Intestinal modulation as treatment alternative in Polycystic Ovarian Syndrome – PCOS
DOI:
https://doi.org/10.33448/rsd-v14i7.47734Keywords:
Polycystic Ovary Syndrome, Gastrointestinal Microbiome, Inflammation.Abstract
Polycystic Ovary Syndrome (PCOS) is an endocrine-metabolic disorder characterized by elevated testosterone levels, ovulatory dysfunction, polycystic-appearing ovaries, irregular gonadotropin secretion, low-grade inflammation, hyperandrogenism, and hirsutism that lead to infertility, spontaneous abortions, and pregnancy complications. Additionally, patients with PCOS have an increased risk of peripheral insulin resistance, obesity, hyperlipidemia, hypertension, cardiovascular disease, and cancer. Considering the complexity of the disease, this narrative literature review aimed to investigate the role of intestinal modulation as a possible alternative therapeutic approach in the treatment of PCOS. To this end, 27 scientific articles published in Portuguese and English between 2006 and 2024 were selected and available in the main databases: National Library of Medicine (PubMed), Web of Science, Scientific Electronic Library Online (SciELO), Google Scholar, Medical Literature Analysis and Retrieval System Online (MEDLINE) and Virtual Health Library (VHL). Intestinal modulation through probiotics and prebiotics was able to promote; when associated with lifestyle changes, improvements in the reduction of free androgens, inflammatory markers, transaminases, lipid parameters and insulin resistance; increased SHBG and nitric oxide. Furthermore, there was an improvement in the waist-to-hip ratio and weight of patients, favoring the reduction of inflammatory stress and the influence of the obesogenic condition.
References
Ajmal, N.; Khan S. Z. & Shaikh, R. (2019). Polycystic ovary syndrome (PCOS) and genetic predisposition: A review article. European Journal of Obstetrics & Gynecology and Reproductive Biology: X, 3(100060), 100060.
Alves, M. L. S.; Donne, R. D. D.; Romano, R. M.; & Romano, M. A. (2022). Síndrome de ovários policísticos (SOP), fisiopatologia e tratamento, uma revisão. Revista Research, Society and Development, 11(9), e25111932469.
Alves, P. H. R.; Ferron, A. J. T.; Costa, M. R.; Hashimoto, F. K.; Gregolin, C. S.; Garcia, J. L.; Campos, D. H. S.; Cigogna, A. C.; MatteI, L.; Moreto, F.; Bazan, S. G. Z.; FrancisquetI-Ferron, F. V.; & Corrêa, C. R. (2021). Relação entre Resposta Imune Inata do Receptor Toll-Like-4 (TLR-4) e o Processo Fisiopatológico da Cardiomiopatia da Obesidade. Arquivos brasileiros de cardiologia, 117(1), 91–99.
Azziz, R.; Carmina, E.; Chen, Z.; Dunaif, A.; Laven, J. S.; Legro, R. S.; Lizneva, D.; Natterson-horowtiz, B.; Teede, H. J.; & Yildiz, B. O. (2016). Polycystic ovary syndrome. Nature Reviews Disease Primers, v. 2.
Bueno, I. B.; Diniz, R. V.; Souza, R. M. P.; Mussi, L. E. L.; & Frade, R. C. S. M. (2024). O papel da microbiota intestinal na patogênese das doenças autoimunes. Revista Ibero-Americana de Humanidades, Ciências e Educação, [S. l.], 10(8), 3000–3007.
Casarin, S. T.; Porto, A. R.; Gabatz, R. I. B.; Bonow, C. A.; Ribeiro, J. P.; & Mota, M. S. (2020). Tipos de revisão de literatura: considerações das editoras do Journal of Nursing and Health / Types of literature review: considerations of the editors of the Journal of Nursing and Health. Journal of Nursing and Health, 10(5),.
Castro, A. C. G.; Bizzi, M. F.; & Ribeiro-de-Oliveira Júnior, A. (2020). Amp- activated protein kinase (ampk): The protein link between metabolism and cancer. Revista Médica de Minas Gerais, v. 30.
Chudzicka-Strugała, I.; Kubiak, A.; Banaszewska, B.; Zwozdziak, B.; Siakowska, M.; Pawelczyk, L.; & Duleba, A. J. (2021). Effects of synbiotic supplementation and lifestyle modifications on women with polycystic ovary syndrome. Revista The journal of clinical endocrinology and metabolism, 106(9), 2566–2573.
Chuluck, J. B. G.; Martinussi, G. O. G.; Freitas, D. M.; Guaraná, L. D.; Xavier, M. E. D.; Guimarães, A. C. C. M.; Santos, A. M.; Bohnenberger, G.; Lima, M. P. G.; & Zanoni, R. D. (2023). A influência da microbiota intestinal na saúde humana: uma revisão de literatura. Revista Brazilian Journal of Health Review, 6(4), 16308–16322.
Gnanadass, A. S.; Prabhu, Y. D.; & Gopalakrishnan, A. V. (2021). Association of metabolic and inflammatory markers with polycystic ovarian syndrome (PCOS): an update. Archives of Gynecology and Obstetrics, 303(3), 631–643.
Guarner, F.; Sanders, M. E.; Szajewska, H.; Cohen, H.; Eliakim, R.; Herrera, C.; Karakan, T.; Merenstein, D.; Piscoya, A.; Ramakrishna, B.; & Salminen, S. (2023). Diretrizes Mundiais da Organização Mundial de Gastroenterologia: Probióticos e prebióticos, World Gastroenterology Organisation.
He, F .F.; & Li, Y. M. (2020). Role of gut microbiota in the development of insulin resistance and the mechanism underlying polycystic ovary syndrome: a review. Journal of ovarian research, 13(1), 73.
Hueb, C. K.; Dias Junior, J. A.; Abrão, M. S.; & Kaillás Filho, E. (2015). Drilling: medical indications and surgical technique. Revista da Associação Médica Brasileira, 61(6), 530–535.
Kaur I.; Suri, V.; Sachdeva, N.; Rana, S. V.; Medhi, B; Sahni, N.; Ahire, J.; & Singh, A. (2022). Efficacy of multi-strain probiotic along with dietary and lifestyle modifications on polycystic ovary syndrome: a randomised, double-blind placebo-controlled study. Revista European journal of nutrition, 61(8), 4145–4154.
Kwok, K. O.; Fries, L. R.; Silva-Zolezzi, I.; Thakkar, S. K.; Iroz, A.; & Blanchard, C. (2022). Effects of probiotic intervention on markers of inflammation and health outcomes in women of reproductive age and their children. Revista Frontiers in nutrition, v. 9.
Machado, T.; Dias, G. M.; Sigwalt, M. F.; Nassif, P. A. N.; & Tabushi, F. I. (2022). Qual é a influência da microbiota na obesidade e em seu quadro inflamatório? Revista Médica do Paraná, 80(1), 1705.
Moraes, A. C. F.; Silva, I. T.; Almeida-Pititto, B.; & Ferreira, S. R. G. (2014). Microbiota intestinal e risco cardiometabólico: mecanismos e modulação dietética. Arquivos brasileiros de endocrinologia e metabologia, 58(4), 317–327.
Nordi, J. B.; Moresco, E.; & Ortiz, M. E. P. (2024). Diagnóstico de Resistência à Insulina na Síndrome do Ovário Policístico. Revista Research, Society and Development, 13(2), e8513245028.
Oliveira, M. (2019). 10 Coisas Que Você Precisa Saber Sobre a Síndrome dos Ovários Policísticos. Sociedade Brasileira de Endocrinologia e Metabologia. https://www.endocrino.org.br/10-coisas-que-voce-precisa-saber-sobre-a-sindrome-dos-ovarios-policisticos.
Paixão, L. A.; & Castro, F. F. S. (2016). Colonização da microbiota intestinal e sua influência na saúde do hospedeiro. Revista Universitas Ciências da Saúde, v. 14(1).
Perbelin, A. S.; Silva, C. V.; Mello, E. V. S. L; & Schneider, L. C. L. (2019). O papel da microbiota como aliada no sistema imunológico. Arquivos do Mudi, 23(3),. 345-358.
Righi, G. M.; Oliveira, T. F.; & Baracat, M. C. (2021). Síndrome dos ovários policísticos e sua relação com a microbiota intestinal. Revista Feminina, 10, 631–635.
Rother, E. T. (2007). Revisão sistemática X revisão narrativa. Acta Paulista de Enfermagem, 20(2), v–vi.
Salles, B. I. M.; Cioffi, D.; & Ferreira, S. R. G. (2020). Probiotics supplementation and insulin resistance: a systematic review. Diabetology & metabolic syndrome, 12(1).
Silva, R. C.; Pardini, D. P; & Kater, C. E. (2006). Síndrome dos Ovários Policísticos, Síndrome Metabólica, Risco Cardiovascular e o Papel dos Agentes Sensibilizadores da Insulina. Arq Bras Endocrinol Metab vol 50 nº 2.
Souza, L. H. M.; Assunção, M. P. P.; Rocha, N. O.; Leal, N. S.; Leandro, P. A. P.; & Pascoal, T. C. L. (2022). A influência dos fatores dietéticos na modulação da microbiota intestinal e controle do diabetes mellitus tipo 1 e tipo 2: uma revisão da literatura. Revista Científica FACS, [S. l.], 20(25), 56–64.
Tabrizi, R.; Ostadmohammadi, V.; Akbari, M.; Lankarani, K. B.; Vakili, S.; Peymani, P.; Karamali, M.; Kolahdooz, F.; & Asemi, Z. (2022). The effects of probiotic supplementation on clinical symptom, weight loss, glycemic control, lipid and hormonal profiles, biomarkers of inflammation, and oxidative stress in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. Probiotics and antimicrobial proteins, 14(1), 1–14.
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Copyright (c) 2025 Raiane Guilherme Malaquias; Simone Domingues Salata; Sergio Ricardo de Brito Bello; Camila Tedeschi Pazello; Raquel Simone Maccarini Zarpellon; Amanda Caroline Venturelli; Roxane Wirschum Silva
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