Polycystic ovary syndrome and iron overload: biochemical link and underlying mechanisms with potential novel therapeutic avenues

Polycystic ovary syndrome (PCOS) and hemochromatosis, a disorder of iron overload, share several clinical features including insulin resistance, increased adiposity, diabetes, fatty liver, infertility, and hyperandrogenism. Both disorders show a noticeable accumulation of excess iron in the body, even in adolescence, due to reduced levels of hepcidin, the iron-regulatory hormone. Gut bacteria play a critical role in controlling iron absorption in the intestine, and changes in bacterial composition in the gut may cause iron overload in both diseases. The study found that phlebotomy, a treatment commonly used for hemochromatosis, showed similar efficacy to oral contraceptives in reversing insulin resistance and hyperandrogenemia in women with PCOS. Dietary interventions, such as elimination of starches, and probiotic supplementation have shown beneficial effects in managing PCOS symptoms. The study concludes that phlebotomy, dietary intervention, and probiotics could be potential therapeutic avenues for both PCOS and hemochromatosis.