"The polycystic ovary syndrome (PCOS) consists of anovulation, acne, hirsutism (resulting from hyperandrogenism), and reversed serum LH to FSH ratio and two hallmarks that include low grade inflammation and insulin resistance. These features place women with PCOS as a group of patients related to the metabolic syndrome. Baranova et al. even stated that ""it seems appropriate to consider polycystic ovary syndrome as the ovarian manifestation of metabolic syndrome"". Following the known evidence on the involvement of the microbiota in inducing low grade inflammation, the involvement in insulin resistance, how the gut microbiota and diet affect each other and a recent study on the favorable effect of diet even in lean PCOS patients, it is tempting to study gut microbiota primarily in lean PCOS patients, since this would neutralize the effect of obesity and the metabolic syndrome. It is possible that gut microbiota population, as the relevant ""environment"" of the patients, could bridge the gap and explains much of what has remained enigmatic in PCOS. This can also contribute significantly to treatment modalities, as interventions to alter gut microbial population profile have been shown to provide benefits in other situations."