Recent research shows a possible causative relationship of PCOS
pathogenies with gut and vaginal dysbiosis. Reduction in (α) diversity and modification
in beta (β) diversity and relative abundance of taxa of gut and vaginal microbiome is
well known among PCOS women. Gut dysbiosis results in leaky gut and endotoxemia,
which lead to chronic inflammation, insulin resistance, and hyperandrogenism with
metabolic and reproductive PCOS phenotype. Altered microbial metabolites such as
Short-Chain Fatty Acids (SCFA), Branch-Chain Amino Acids (BCAA), and Bile Acids
(BA) contribute to the pathogenesis of PCOS. The gut-brain axis is also contributed
mainly through the modification of gut peptide hormones. The interplay between gut
dysbiosis and Hyperandrogenism (HA) is bidirectional. The understanding of this link
between microbial dysbiosis has opened new therapeutic opportunities in PCOS.
Keywords: Bile acids, Gut-brain axis, Gut microbiome, Vaginal microbiome, Short chain fatty acids.
