Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders, affecting approximately 5% to 15% of women of reproductive age [13]. Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. , PCOS is diagnosed if two out of the three following features are met:

  1. Chronic oligo- or anovulation

  2. Anatomically polycystic ovaries on ultrasonography

  3. And clinical and/or biochemical hyperandrogenism [1].

Insulin resistance along with hyperinsulinemia affects approximately 40–50% of PCOS patients whether obese or lean Insulin [4–8]. In an obese patient, the prevalence of insulin resistance accompanied by compensatory hyperinsulinemia approaches 80% [9]. Insulin resistance and hyperinsulinemia are NOT included in the criteria of PCOS but they are responsible for typical clinical signs and hormonal disorders associated with PCOS. Insulin resistance can cause the ovaries to produce more testosterone and androgens, thus contributing to PCOS symptoms.

What Are The Symptoms Of PCOS?

Symptoms of PCOS can vary based on the woman and her hormonal imbalances. They can include one or multiple of the following:

  • Weight gain or obesity

  • Menstrual Bleeding Problems: Menstrual irregularities, Heavy menstrual flow,Absent period, or Abnormal mid-cycle bleeding

  • Acne

  • Hirsutism  and or Hair loss

  • History of ovarian cysts

  • Recurrent miscarriage

  • Anovulatory cycles (when the ovary doesn’t release an egg)

  • Estrogen excess symptoms like  fibrocystic breast disease( Breast pain) and PMS

  • Infertility

Lifestyle and evidence-based herbal medicine effective in the treatment of PCOS.

Dietary therapy for women with PCOS focuses on eliminating foods that increase blood glucose and bringing in foods that help stabilize blood sugar, help with insulin resistance and provide therapeutic effects. In the following dietary plan, in addition to changing food choices, women should eat more small meals throughout the day as opposed to a few larger meals. This helps balance blood sugar, letting your body metabolize sugar and carbohydrates more efficiently.

Dietary Supplements

Saw Palmetto

Saw palmetto can reduce 5-alpha-reductase activity, which is the enzyme that makes DHT.  DHT is the androgen that enhances the effects of testosterone. DHT can cause PCOS symptoms like hair loss, facial hair growth, acne, and menstrual irregularities. Inhibiting this conversion of testosterone to DHT can help reduce the intensity of PCOS symptoms. Most studies found that 450 mg daily.

Zinc

Research studies have found that 220 mg zinc sulfate supplementation per day for 8 weeks among PCOS women had beneficial effects on metabolic profiles. Zinc reduces DHT levels and hence it hairiness, acne, mood disturbances, and weight gain in women suffering from PCOS related to excess testosterone. Hence,  zinc has a positive impact on the metabolic profiles of PCOS women. [10]

NAC

A study showed that using NAC 1800 mg/day, orally divided in three doses for 3 months showed improvement in pregnancy and ovulation rate as compared to placebo. It did not affect miscarriage, menstrual regulation, acne, hirsutism, and adverse events, or change in body mass index, testosterone, and insulin levels. [11]

Magnesium

One study concluded that 300mg of magnesium at bedtime had a significant improvement in fasting blood glucose and insulin levels. Thus, increasing magnesium can help improve insulin resistance—and thus PCOS as well.[12] 

Vitamin D

 It is useful in the maturation and development of eggs in the ovaries. To produce fertile eggs ovaries need vitamin D. Vitamin D supplements can help to produce healthy ovarian follicles. One study concluded that when  Calcium 1000 mg/day and Vitamin D 100000 IU/month for 6 months had a positive influence on weight loss, follicle maturation, menstrual regularity, and improvement of hyperandrogenism, in infertile women with PCOS.  [13].

Myoinositol and Folate

Insulin resistance may involve faulty signaling between the interior and exterior of the cell in its acceptance of insulin. Inositol-containing phosphoglycan molecules are involved in this signaling process. Using different forms of inositol may increase insulin sensitivity and so it is a great supplement for women with PCOS who have insulin resistance. Inositol can be found in the form of pinitol, which is found naturally in legumes and buckwheat. D-chiro-inositol is a type of inositol that has shown the ability to aid in treating metabolic syndrome by decreasing triglycerides, lowering blood pressure (Stansbury 2012). D-chiro-inositol is a supplement that can provide this action as well (Thatcher 2000). Lecithin is also very rich in D-chiro-inositol and can be used in the form of soy lecithin (organic) and added to smoothies and other foods.

In a large study, Myoinositol and folic acid were given in a dose of  2 × 2000 mg myoinositol + 2 × 200 μg folic acid per day or 12weeks. 70% of these women in the study had restored ovulation, and 15% obtained pregnancies. [14]

References:

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2. Yildiz B. O., Bozdag G., Yapici Z., Esinler I., Yarali H. Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria. Human Reproduction. 2012;27(10):3067–3073. doi: 10.1093/humrep/des232. [PubMed] [CrossRef] [Google Scholar]

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6.A. Dunaif, K. R. Segal, W. Futterweit, and A. Dobrjansky, “Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome,” Diabetes, vol. 38, no. 9, pp. 1165–1174, 1989

7. A. Dunaif, K. R. Segal, W. Futterweit, and A. Dobrjansky, “Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome,” Diabetes, vol. 38, no. 9, pp. 1165–1174, 1989.

8.J. S. E. Laven, A. G. M. G. J. Mulders, E. J. P. van Santbrink, M. J. C. Eijkemans, and B. C. J. M. Fauser, “PCOS: backgrounds, evidence and problems in diagnosing the syndrome,” International Congress Series, vol. 1279, pp. 10–15, 2005. 

9.J. E. Nestler, “Role of hyperinsulinemia in the pathogenesis of the polycystic ovary syndrome, and its clinical implications,” Seminars in Reproductive Endocrinology, vol. 15, no. 2, pp. 111–122, 1997. 

 

10. Exp Clin Endocrinol Diabetes. 2015 Apr;123(4):215-20. doi: 10.1055/s-0035-1548790. Epub 2015 Apr 13.

Effects of zinc supplementation on markers of insulin resistance and lipid profiles in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial.

Foroozanfard F1, Jamilian M2, Jafari Z3, Khassaf A3, Hosseini A3, Khorammian H3, Asemi Z3.

 

 

11. Obstet Gynecol Int. 2015; 2015: 817849. N-Acetylcysteine for Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials. Divyesh Thakker, 1 Amit Raval, 2 , * Isha Patel, 3 and Rama Walia 4. Published online 2015 Jan 8. doi: 10.1155/2015/817849

12.Diabet Med. 2014 Nov; 31(11): 1301–1309. Dietary magnesium intake and risk of metabolic syndrome: a meta-analysisD. T. Dibaba,1 P. Xun,1 A. D. Fly,1 K. Yokota,2 and K. He1. doi: 10.1111/dme.12537

13. Complementary Therapies in Clinical Practice

Volume 18, Issue 2, May 2012, Pages 85-88. herapeutic effects of calcium & vitamin D supplementation in women with PCOS. Raziah dehghani FirouzabadiaAbbasAflatoonianaSeyedehzalfaModarresibLeilaSekhavatcSomayehMohammadTaherid. https://doi.org/10.1016/j.ctcp.2012.01.005

 

14. 14. Int J Endocrinol. 2016; 2016: 9537632. Published online 2016 Aug 23. Myoinositol as a Safe and Alternative Approach in the Treatment of Infertile PCOS Women: A German Observational Study.Pedro-Antonio Regidor 1 , * and Adolf Eduard Schindler 2. doi: 10.1155/2016/9537632

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