Dietary interventions for modulating the gut microbiome in PCOS management

Summary

This systematic review synthesises evidence on how dietary interventions modulate the gut microbiome in polycystic ovary syndrome (PCOS), a condition affecting approximately 10% of reproductive-age women. The review evaluates multiple dietary approaches—including Mediterranean, low-glycemic index, anti-inflammatory diets, time-restricted eating, and probiotic supplementation—for their capacity to restore microbial balance, reduce systemic inflammation, improve insulin sensitivity, and lower androgen levels. The evidence suggests that dietary modification offers a therapeutic route to address the dysbiosis implicated in PCOS pathogenesis and associated metabolic and reproductive dysfunction.

Regional applicability

The review draws on international evidence from observational studies and randomised trials, making findings broadly applicable to United Kingdom dietary practice and PCOS management. Implementation would need to consider UK food access, cultural dietary preferences, and integration within NHS dietary guidance frameworks for metabolic and reproductive health.

Key measures

Gut microbiota composition and diversity, microbial richness, Firmicutes/Bacteroidetes ratio, insulin sensitivity, lipid metabolism markers, androgen levels, systemic inflammation markers, intestinal permeability, PCOS symptom severity

Outcomes reported

The review evaluated how specific dietary patterns (Mediterranean diet, low-glycemic index diets, anti-inflammatory diets, time-restricted eating, and probiotic supplementation) influence gut microbiome composition and diversity, and their effects on insulin sensitivity, lipid metabolism, hormonal regulation, and PCOS clinical outcomes. Results demonstrated that dietary interventions can beneficially alter microbiota, reduce systemic inflammation, improve insulin sensitivity, and lower androgen levels.

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