The Role of Polycystic Ovarian Syndrome in Chronic Inflammation, Psychological Health, and the Gut Microbiota State: A Case Report

Case Report

J Fam Med. 2022; 9(1): 1285.

The Role of Polycystic Ovarian Syndrome in Chronic Inflammation, Psychological Health, and the Gut Microbiota State: A Case Report

Davis CC and Popp JK*

Athletic Training Program, Purdue University, USA

*Corresponding author: Jennifer K Popp, Athletic Training Program, Purdue University, 800 West Stadium Avenue, West Lafayette, IN 47907, USA

Received: December 18, 2021; Accepted: January 13, 2022; Published: January 20, 2022


Polycystic Ovarian Syndrome (PCOS) is endocrine and gynecological disorder that affects women of reproductive age. This is a case report of a patient with PCOS who was misdiagnosed and presented with several endocrine and gynecological symptoms. This case emphasizes the need for a holistic healthcare approach to treat the underlying organ dysfunction in women with PCOS. It highlights the interconnectedness between endocrine and reproductive dysfunction. This case report examines the chronic inflammatory state, risk of developing psychological disorders, and gut microbiota diversity in women with PCOS.

Keywords: Polycystic Ovarian Syndrome; Endocrinology; Gynecology; Psychology; Primary Care


CBT: Cognitive-Behavioral Therapy; CNS: Central Nervous System; CRP: C-reactive Protein; GI: Gastrointestinal; GM: Gut Microbiota; HPA Axis: Hypothalamus-Pituitary-Adrenal Axis; IR: Insulin Resistance; PCOS: Polycystic Ovarian Syndrome

Case Presentation

Patient is a 22-year-old female who was diagnosed with polycystic ovarian syndrome (PCOS) at 14 years of age. At the age of 13, the patient experienced menarche, followed by amenorrhea for 6 months. During this period of amenorrhea, she presented with unexplained extreme fatigue, headaches, muscular weakness, decreased immunity, and concentration impairment, and was diagnosed with mononucleosis. However, her symptoms lasted 9 months, rather than 2-4 weeks, which is typical with a mononucleosis diagnosis. During these 9 months, the patient was evaluated by many specialists, and underwent a battery of diagnostic tests. At the age of 14, the patient resumed menses; however, the resumption of menses brought the following symptoms: abnormal menstrual cycles, mood swings, cystic acne, anxiety, sharp pelvic pain, abdominal weight gain, and gastrointestinal dysfunction. An internal medicine physician diagnosed the patient with PCOS at the age of 14 years based on chronic fatigue and results of blood work, which revealed the following: elevated insulin levels, decreased thyroid stimulating hormone, and elevated estrogen and androgen levels, along with nutritional deficiencies that included decreased magnesium, and vitamins B12 and D levels. A transvaginal ultrasound performed at age of 20 resulted in additional diagnoses of cystic ovaries and endometriosis.

Immediately following her PCOS diagnosis, the patient began a holistic lifestyle change consisting of healthy foods, regulation of macromolecule input, exercise regimen conducive with her hormonal levels, vitamin supplementation, and stress management techniques. After three months of these lifestyle changes, the patient experienced a significantly improved quality of life. Continued interventions include a complete blood count and comprehensive metabolic panel 2-3 times per year to ensure the interventions are appropriate. The patient is able to function normally; however, her symptoms are cyclical based on menstrual cycle. During periods of stress, the patient becomes fatigued, and struggles to maintain normal insulin levels, which causes an increase in inflammatory markers, leading to gastrointestinal upset and nutrient malabsorption.


PCOS is a multifaceted endocrine and gynecological disorder which effects 15-20% of women of reproductive age [1]. This disorder effects every part of the endocrine system [3-13]. The diversity of PCOS symptoms leads to prolonged diagnosis and misguided treatment plans [2]. Diagnosis of PCOS is made by utilizing the Rotterdam Diagnostic Criteria, presented in Table 1 [2]. Symptoms occur as a result of endocrine organs (Table 2) and body systems (Table 3) affected by PCOS [3-13].