Natural treatments for polycystic ovary syndrome

DEFINITION: Treatment of a chronic endocrine disorder in women, which is marked by elevated levels of male hormones, infertility, and other conditions.

PRINCIPAL PROPOSED NATURAL TREATMENTS: Inositol, N-acetylcysteine

OTHER PROPOSED NATURAL TREATMENTS: B vitamins, chromium, cinnamon, green tea, spearmint tea

Introduction

Polycystic ovary syndrome (PCOS) is a chronic endocrine disorder in women. It is characterized by elevated levels of male hormones (androgens) and by infertility, obesity, insulin resistance, hair growth on the face and body, and anovulation, a condition in which the ovaries produce few or no eggs.

Ovaries normally produce follicles that develop into eggs. In women with PCOS, the ovaries produce the follicles, but the eggs may not mature or leave the ovary. The immature follicles can develop into fluid-filled sacs called cysts. Most women with PCOS have cysts, but all women with ovarian cysts do not necessarily have PCOS.

The cause of PCOS is unknown, though genetics may play a role. Some evidence suggests the problem is related to insulin resistance with elevated levels of insulin. These high insulin levels may stimulate excess production of androgens from the ovaries. This could prevent ovulation and lead to enlarged, polycystic ovaries. Treatments for PCOS include drugs to improve insulin sensitivity, along with hormonal treatments and fertility drugs when pregnancy is desired.

Proposed Natural Treatments

Inositol. The supplement inositol, a form of sugar that is naturally found in the body, has shown some promise for PCOS. In a double-blind, placebo-controlled trial, 136 women were given inositol at a dose of 100 milligrams twice daily, while 147 were given placebo. In fourteen weeks, participants given inositol showed improvement in ovulation frequency compared to those given placebo. Benefits were also seen in terms of weight loss and levels of HDL (good) cholesterol. A subsequent study of ninety-four women with PCOS found similar results. However, both of the studies were performed by the same research group. Independent confirmation is necessary before inositol can be considered an effective treatment for PCOS.

N-acetylcysteine. The supplement N-acetylcysteine (NAC) has shown some promise for the treatment of female infertility caused by PCOS. A double-blind, placebo-controlled study evaluated the effectiveness of NAC in 150 women with PCOS who had previously failed to respond to the fertility drug clomiphene. Participants were given clomiphene plus placebo or clomiphene plus 1.2 grams (g) daily of NAC. The results indicated that combined treatment with NAC plus clomiphene was dramatically more effective than clomiphene taken with a placebo. Almost 50 percent of the women in the combined treatment group ovulated, compared to about 1 percent in the clomiphene-alone group. The pregnancy rate in the combined treatment group was 21 percent, compared to 0 percent in the clomiphene-alone group.

However, partially negative results were seen in another study. This trial compared NAC at a dose of 1.8 grams daily with the drug metformin in sixty-one infertile women with PCOS who had, as in the foregoing study, failed to respond to clomiphene. NAC proved far less effective than the drug at inducing ovulation; nonetheless, the data from this study do not rule out the possibility that NAC provided some slight benefit.

Acupuncture. Several studies have been conducted that demonstrate positive outcomes between acupuncture and fertility issues such as PCOS. Acupuncture is believed to affect the production of β‐endorphin, which in turn can stimulate the ovulation and menstrual cycles. However, these studies demonstrate a lack of randomized controlled trials (RCTs), so evidence is somewhat inconclusive.

Other treatments. The herb cinnamon has shown some promise as a treatment for diabetes. On this basis, it has been tried in PCOS. In a small placebo-controlled study, cinnamon appeared to improve insulin sensitivity.

The supplement chromium has shown promise for improving insulin sensitivity, and on this basis, it has been tried as a treatment for PCOS. However, in a small pilot study, the use of chromium at 200 micrograms daily did not have a positive effect on PCOS.

A mixture of B vitamins has shown some promise for improving pregnancy rates in people with PCOS. Green tea has been tried for PCOS, but the one small published study failed to show benefit of any kind. Daily spearmint tea consumption was reported to improve patient-assessed hirsutism and testosterone and other hormone levels in a small trial of women with PCOS.

Several other natural treatments for PCOS have been suggested, though much evidence is anecdotal, and more studies are necessary. Turmeric, zinc, evening primrose oil, cold lover oil, berberine, and a combination of vitamin D and calcium may be effective in treating PCOS and its symptoms. Herbal supplements such as maca root, ashwagandha, holy basil, licorice root, chasteberry, and Tribulus terrestris may also be helpful for PCOS. Maintaining a healthy diet is one of the main natural ways patients with PCOS can treat their condition. A balanced diet of whole foods, with a focus on anti-inflammatory foods, may help PCOS. Individuals should also consider adding iron, magnesium, fiber, and probiotics to their diet, but avoid coffee.

Bibliography

Chan, C. C., et al. “Effects of Chinese Green Tea on Weight, and Hormonal and Biochemical Profiles in Obese Patients with Polycystic Ovary Syndrome.” Journal of the Society for Gynecologic Investigation 13 (2005): 63-68.

Danforn Lim, Chi E., et al. "Acupuncture for Polycystic Ovarian Syndrome." The Cochrane Database of Systematic Reviews, no. 7, 2019, doi.org/10.1002/14651858.CD007689.pub4. Accessed 2 Oct. 2024.

Grant, P. “Spearmint Herbal Tea Has Significant Anti-Androgen Effects in Polycystic Ovarian Syndrome.” Phytotherapy Research 24 (2010): 186-188.

Lucidi, R. S., et al. “Effect of Chromium Supplementation on Insulin Resistance and Ovarian and Menstrual Cyclicity in Women with Polycystic Ovary Syndrome.” Fertility and Sterility 84 (2005): 1755-1757.

Manouchehri, Aliasghar, et al. "Polycystic Ovaries and Herbal Remedies: A Systematic Review." JBRA Assisted Reproduction, vol. 27, no. 1, 2023, pp. 85-91. doi.org/10.5935/1518-0557.20220024.

Rizk, A. Y., et al. “N-acetyl-cysteine Is a Novel Adjuvant to Clomiphene Citrate in Clomiphene Citrate-Resistant Patients with Polycystic Ovary Syndrome.” Fertility and Sterility 83 (2005): 367-370.

Schachter, M., et al. “Prospective Randomized Trial of Metformin and Vitamins for the Reduction of Plasma Homocysteine in Insulin-Resistant Polycystic Ovary Syndrome.” Fertility and Sterility 88 (2007): 227-230.

Thakker, Divyesh, et al. "N-Acetylcysteine for Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials." Obstetrics and Gynecology International, 2015. Wiley Online Library, doi.org/10.1155/2015/817849. Accessed 2 Oct. 2024.

Wang, J. G., et al. “The Effect of Cinnamon Extract on Insulin Resistance Parameters in Polycystic Ovary Syndrome.” Fertility and Sterility 88 (2007): 240-243.

Wilson, Debra Rose, and Kathryn Watson. “Natural Treatment PCOS: 30 Ways to Help Hormones, Insulin, and More.” Healthline, 6 Apr. 2018, www.healthline.com/health/womens-health/natural-treatment-pcos. Accessed 27 Aug. 2023. Ye, Yang, et al. "Underlying Mechanisms of Acupuncture Therapy on Polycystic Ovary Syndrome: Evidences from Animal and Clinical Studies." Frontiers in Endocrinology, vol. 13, 2022. doi.org/10.3389/fendo.2022.1035929. Accessed 2 Oct. 2024.