From the Guidelines
Lifestyle management, including a balanced diet and regular exercise, is the first-line treatment for PCOS, and natural products such as inositol supplements, omega-3 fatty acids, and vitamin D may be beneficial in managing symptoms, but should complement rather than replace conventional medical treatment. According to the international evidence-based guideline for the assessment and management of polycystic ovary syndrome, lifestyle management is central to PCOS management, with a focus on weight and healthy lifestyle behaviors 1. The guideline recommends a multicomponent lifestyle intervention, including diet, exercise, and behavioral strategies, to improve insulin sensitivity, ovulation, and overall health outcomes.
Some key dietary recommendations for PCOS management include:
- A variety of balanced dietary approaches to reduce dietary energy intake and induce weight loss in women with PCOS and overweight or obesity 1
- General healthy eating principles, such as a balanced diet low in refined carbohydrates, should be followed for all women with PCOS across the life course 1
- An energy deficit of 30% or 500-750 kcal/day may be prescribed for women with PCOS to achieve weight loss, considering individual energy requirements, body weight, and physical activity levels 1
In addition to dietary changes, regular exercise and physical activity are essential for managing PCOS symptoms. Some natural products that may be beneficial in managing PCOS symptoms include:
- Inositol supplements, particularly myo-inositol (2-4g daily) and D-chiro-inositol (50-100mg daily), which can improve insulin sensitivity and ovulation
- Omega-3 fatty acids (1-2g daily from fish oil or flaxseed), which may reduce inflammation and improve hormone balance
- Vitamin D supplementation (1000-2000 IU daily), which is beneficial for many PCOS patients who are often deficient
- Spearmint tea (2 cups daily), which has shown modest anti-androgenic effects that may reduce hirsutism
- Cinnamon (1-2g daily), which may help improve insulin sensitivity
- N-acetylcysteine (NAC, 600mg three times daily), which might improve insulin resistance and promote ovulation
It is essential to note that while these natural products may be beneficial, they should not replace conventional medical treatment, and women with PCOS should consult with a healthcare provider before starting any supplement regimen, especially if taking medications, as some natural products may interact with conventional treatments 1.
From the FDA Drug Label
Hydrastis canadensis 1M Less than 10 -12 mg hydrastine, berberine alkaloids per pellet (**contains 0.443 mg of the active ingredient per pellet) The FDA drug label does not answer the question.
From the Research
Natural Products for PCOS Treatment
- Omega-3 fatty acids have been shown to promote indirect benefits in the treatment of women with PCOS, including improvements in glycemic profile, lipid profile modulation, and regulation of the androgenic profile 2.
- Herbal remedies such as aloe vera, chamomile, Vitex agnus-castus, and octane have been found to improve fertility, reduce hirsutism, and lower lipid and blood glucose levels in women with PCOS 3.
- Natural molecules like inositols, resveratrol, flavonoids, and flavones, as well as vitamins C, E, and D, and omega-3 fatty acids, may contribute to alleviating PCOS symptoms, including immature oocyte, insulin resistance, hyperandrogenism, oxidative stress, and inflammation 4.
Comparison of Natural Products
- A network meta-analysis compared the efficacy of oral insulin sensitizers, including metformin, thiazolidinediones, inositol, and berberine, in improving endocrine and metabolic profiles in women with PCOS, and found that myo-inositol combined with D-chiro-inositol was associated with a greater improvement in menstrual frequency compared to metformin 5.
- The same study found that thiazolidinediones, metformin combined with thiazolidinediones, and myo-inositol combined with D-chiro-inositol were associated with a lower insulin resistance index compared to metformin alone 5.
Potential Benefits and Limitations
- Natural products may offer a safer and more convenient alternative to traditional treatments for PCOS, with minimal side effects and a longer treatment cycle 3.
- However, further studies are needed to reveal well-defined standards for dosage and supplementation time, as well as to fully understand the mechanisms of action and potential interactions with other treatments 2, 4.