Alterations in neuroendocrine levels and gut microbiota contributing to potential psychiatric disorder prevalence in PCOS: a Review

Abstract

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women, affecting up to 15% of women in the reproductive age. PCOS is a heterogeneous disorder, meaning that there are many different factors that may play a role in the manifestations of this disease, and multiple systems throughout the body can be affected. Studies have shown that PCOS can be linked to multiple psychiatric disorders. The prevalence of anxiety and depression are significantly higher in females with PCOS compared to females without PCOS. Currently, there are several theories discussing the possible causes of the connection between PCOS and psychiatric disorders. Certain causes such as the overactive hypothalamic-pituitary-adrenal axis (HPA axis) or the hypothalamic-pituitary-ovarian axis (HPO axis) found in PCOS could be linked to an altered hormonal profile that manifests as anxiety and depression. Another theory speculates that the altered levels of neurotransmitters and the gut-brain axis dictate the severity and frequency of psychiatric disorders in PCOS. Dietary supplements such as vitamin D and selenium paired with a probiotic have shown to improve neurotransmitter levels as well as significantly reduce the effects of mental distress and manifestations of PCOS symptoms. This approach introduces the possibility of gut nutrient deficiencies in PCOS causing psychiatric disorders. In this review, I will examine different theories on association between PCOS and psychiatric disorders.