Effect of yoga and probiotic intervention on hormonal parameters in pre-menopausal women with polycystic ovary syndrome
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20252719Keywords:
Fertility, Hormonal balance, Integrative medicine, PCOS, Pre-menopauseAbstract
Background: Polycystic ovary syndrome (PCOS) affects reproductive and metabolic health in pre-menopausal women, necessitating innovative therapeutic approaches. This study investigated the combined effects of yoga and probiotic supplementation on hormonal parameters and fertility outcomes compared to yoga alone and control groups.
Methods: Forty pre-menopausal women (35-55 years) diagnosed with PCOS were allocated to three groups: control (n=10), yoga intervention (n=15), and yoga with probiotic supplementation (n=15). The yoga intervention consisted of standardized 30-minute sessions three times weekly for three months. The combined group practised yoga and consumed 5 gm dry-roasted powdered flaxseed in 100 ml of buttermilk twice daily. Primary outcomes included reproductive hormones (E2, FSH, LH, Prolactin), thyroid function (FT3, FT4, TSH), haemoglobin levels, and pregnancy outcomes.
Results: The control group showed no hormonal changes. The yoga-only group demonstrated modest improvements in thyroid function (FT3-12.1%, TSH-8.2%) with minimal reproductive hormone effects. The yoga with probiotics group showed substantial improvements: E2 increased 15.9%, while FSH (-15.0%), LH (-18.7%), and prolactin (-17.5%) decreased significantly. Significantly, 33.3% of participants in the yoga with probiotics group achieved pregnancy during the intervention period, while no pregnancies occurred in other groups.
Conclusions: Combining yoga with probiotic supplementation demonstrates superior efficacy in improving hormonal profiles and fertility outcomes in pre-menopausal women with PCOS compared to yoga alone, offering a promising integrative therapeutic approach.
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References
Singh S, Pal N, Shubham S, Sarma DK, Verma V, Marotta F, Kumar M. Polycystic ovary syndrome: etiology, current management, and future therapeutics. J Clin Med. 2023;12(4):1454. DOI: https://doi.org/10.3390/jcm12041454
Laven J, Neven A, Teede H, Boyle J. A summary on polycystic ovary syndrome: diagnostic criteria, prevalence, clinical manifestations, and management according to the latest international guidelines. Semin Reprod Med. 2018;36(1):05-12. DOI: https://doi.org/10.1055/s-0038-1668085
Sarawad S. Polycystic Ovary Syndrome (PCOS): a comprehensive review. Int J Adv Nurs Manage. 2023;264-5. DOI: https://doi.org/10.52711/2454-2652.2023.00059
Neven AC, Mousa A, Boyle JA, Teede HJ. Endocrine and metabolic interactions in healthy pregnancies and hyperinsulinemic pregnancies affected by polycystic ovary syndrome, diabetes and obesity. Fronti Endocrinol. 2023;13:993619. DOI: https://doi.org/10.3389/fendo.2022.993619
Obaida N, Mousa A, Alshammari A. Comparison of hormonal levels between infertile PCOS and non-PCOS females. World J Biol Pharm Health Sci. 2024;20(2):398-402. DOI: https://doi.org/10.30574/wjbphs.2024.20.2.0805
Bharathi RV, Swetha S, Neerajaa J, Madhavica JV, Janani DM, Rekha SN. An epidemiological survey: Effect of predisposing factors for PCOS in Indian urban and rural population. Middle East Fertil Soc J. 2017;22(4):313-6. DOI: https://doi.org/10.1016/j.mefs.2017.05.007
Sharma S, Mahajan N. (2021). Polycystic ovarian syndrome and menopause in forty plus women. J Mid-Life Health. 2021;12(1):3-7. DOI: https://doi.org/10.4103/jmh.jmh_8_21
Louwers YV, Laven JSE. Characteristics of polycystic ovary syndrome throughout life. Ther Adv Reprod Health. 2020;14(Suppl 14):263349412091103. DOI: https://doi.org/10.1177/2633494120911038
Wang J, Feng W, Zhang S, Chen L, Tang F, Sheng Y, et al. Gut microbial modulation in the treatment of chemotherapy-induced diarrhea with Shenzhu Capsule. BMC Complement Altern Med. 2019;19(1):126. DOI: https://doi.org/10.1186/s12906-019-2548-y
Tremellen K, Pearce K. Dysbiosis of gut microbiota (DOGMA)- a novel theory for the development of polycystic ovarian syndrome. Med Hypothes. 2012;79(1):104-12. ht DOI: https://doi.org/10.1016/j.mehy.2012.04.016
Qi X, Yun C, Sun L, Xia J, Wu Q, Wang Y, et al. Gut microbiota- bile acid-interleukin-22 axis orchestrates polycystic ovary syndrome. Nat Med. 2019;25(8):1225-33. DOI: https://doi.org/10.1038/s41591-019-0509-0
Patil B, Jairam KV, Shashikala K. Yoga for emotional intelligence and holistic empowerment for women. Int J Biol Pharm Sci Arch. 2024;8(1):6-10. DOI: https://doi.org/10.53771/ijbpsa.2024.8.1.0054
Ratnakumari M, Ayda Y, Reka K, Manavalan N, Sathyanath D. Study to evaluate the changes in polycystic ovarian morphology after naturopathic and yogic interventions. Int J Yoga. 2018;11(2):139. DOI: https://doi.org/10.4103/ijoy.IJOY_62_16
Fernández-Martínez E, Onieva-Zafra MD, Parra-Fernández ML. Lifestyle and prevalence of dysmenorrhea among Spanish female university students. PloS One. 2018;13(8):e0201894. DOI: https://doi.org/10.1371/journal.pone.0201894
Przesór A, Medźwiedzka N. The use of yoga in the treatment of PCOS. Qual Sport. 2015;37:57642. DOI: https://doi.org/10.12775/QS.2024.37.57642
Torres PJ, Siakowska M, Banaszewska B, Pawelczyk L, Duleba AJ, Kelley ST, et al. Gut microbial diversity in women with polycystic ovary syndrome correlates with hyperandrogenism. J Clin Endocrinol Metab. 2018;103(4):1502-11. DOI: https://doi.org/10.1210/jc.2017-02153
Insenser M, Martínez-García MÁ, Murri M, Fernández-Durán E, Escobar-Morreale HF, et al. Gut microbiota and the polycystic ovary syndrome: influence of sex, sex hormones, and obesity. J Clin Endocrinol Metab. 2018;103(7):2552-62. DOI: https://doi.org/10.1210/jc.2017-02799
Zhang J, Sun Z, Jiang S, Bai X, Ma C, Peng Q, et al. Probiotic Bifidobacterium lactis V9 regulates the secretion of sex hormones in polycystic ovary syndrome patients through the gut-brain axis. Msystems. 2019;4(2):10-128. DOI: https://doi.org/10.1128/mSystems.00017-19
Khandouzi N, Zahedmehr A, Mohammadzadeh A, Sanati HR, Nasrollahzadeh J. Effect of flaxseed consumption on flow-mediated dilation and inflammatory biomarkers in patients with coronary artery disease: a randomized controlled trial. Eur J Clin Nutr. 2019;73(2):258-65. DOI: https://doi.org/10.1038/s41430-018-0268-x
Shvets OV. Synbiotic effects for correction of the intestinal microbiota composition and functions. Modern Gastroenterol. 2020;0(2):60-5. DOI: https://doi.org/10.30978/MG-2020-2-60
Baker JM, Al-Nakkash L, Herbst-Kralovetz MM. Estrogen- gut microbiome axis: physiological and clinical implications. Maturitas. 2017;103:45-53. DOI: https://doi.org/10.1016/j.maturitas.2017.06.025
Zhang Y, Song M, Fan J, Guo X, Tao S. Impact of probiotics-derived extracellular vesicles on livestock gut barrier function. J Anim Sci Biotech. 2024;15(1):149. DOI: https://doi.org/10.1186/s40104-024-01102-8
Nidhi R, Padmalatha V, Nagarathna R, Ram A. Effect of a yoga program on glucose metabolism and blood lipid levels in adolescent girls with polycystic ovary syndrome. Int J Gynecol Obstet. 2012;118(1):37-41. DOI: https://doi.org/10.1016/j.ijgo.2012.01.027
Jelodar G, Masoomi S, Rahmanifar F. Hydroalcoholic extract of flaxseed improves polycystic ovary syndrome in a rat model. Iran J Basic Med Sci. 2018;21(6):645-50.
Rao A, Nayak G, Kamath A, Kumar PN. Effect of yoga therapy on physical and psychological quality of life of perimenopausal women in selected coastal areas of Karnataka, India. J Mid-Life Health. 2014;5(4):180. DOI: https://doi.org/10.4103/0976-7800.145161
Pal R, Singh SN, Saha M, Chatterjee A. Age-related changes in cardiovascular system, autonomic functions, and levels of BDNF of healthy active males: role of yogic practice. Age. 2014;36(4). DOI: https://doi.org/10.1007/s11357-014-9683-7
Rosenfield RL, Ehrmann DA. The pathogenesis of polycystic ovary syndrome (PCOS): the hypothesis of PCOS as functional ovarian hyperandrogenism revisited. Endocr Revi. 2015;37(5):467-520. DOI: https://doi.org/10.1210/er.2015-1104
Gleicher N, Weghofer A, Barad DH. Defining ovarian reserve to better understand ovarian aging. Reprod Biol Endocrinol. 2011;9(1):23. DOI: https://doi.org/10.1186/1477-7827-9-23
Balen AH, Morley LC, Misso M, Franks S, Legro RS, Wijeyaratne CN, et al. The management of anovulatory infertility in women with polycystic ovary syndrome: an analysis of the evidence to support the development of global WHO guidance. Hum Reprod Update. 2016;22(6):687-708. DOI: https://doi.org/10.1093/humupd/dmw025
Singla R, Aggarwal S, Gupta Y, Khemani M. Thyroid disorders and polycystic ovary syndrome: an emerging relationship. Indian J Endocrinol Metab. 2015;19(1):25. DOI: https://doi.org/10.4103/2230-8210.146860
Salehi S, Allahverdy J, Pourjafar H, Sarabandi K, Jafari SM. Gut microbiota and polycystic ovary syndrome (PCOS): understanding the pathogenesis and the role of probiotics as a therapeutic strategy. Probiot Antimicrob Proteins. 2024;16(5):1553-65. DOI: https://doi.org/10.1007/s12602-024-10223-5
Lindheim L, Bashir M, Münzker J, Trummer C, Zachhuber V, Leber B, et al. Alterations in gut microbiome composition and barrier function are associated with reproductive and metabolic defects in women with polycystic ovary syndrome (PCOS): a pilot study. PloS One. 2017;12(1):e0168390. DOI: https://doi.org/10.1371/journal.pone.0168390
Legro RS, Brzyski RG, Diamond MP, Coutifaris C, Schlaff WD, Casson P, et al. Letrozole versus clomiphene for infertility in the polycystic ovary syndrome. New Engl J Med. 2014;371(2):119-29. DOI: https://doi.org/10.1056/NEJMoa1313517
Cooney LG, Dokras A, Sammel MD, Lee I. High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2017;32(5):1075-91. DOI: https://doi.org/10.1093/humrep/dex044