For women suffering from PCOS, treatment options can seem difficult to navigate, and because PCOS can present very differently in women, treatment goals may differ.
Understanding the type of PCOS you have and identifying underlying imbalances will help point you in the right direction for treatment options. From a naturopathic perspective, PCOS, like anything else requires a holistic approach including dietary & lifestyle interventions along with appropriate therapeutic supplements and herbal therapies. Herbal treatments can be an amazing component of any PCOS treatment plan, but it is important to understand which options (or combination of treatment options) work best for your individual needs.
One of the underlying physiological drivers of PCOS is the insulin resistance about 60-70% of women diagnosed experience. Currently, the main pharmaceutical intervention for insulin resistance and glucose intolerance of women with PCOS is metformin, but some research has cautioned against using this for fertility purposes (1). Another drug prescribed is Clomiphene Citrate (CC), and although it has efficient stimulation on ovulation, the pregnancy rate is not satisfactory. Due to side effects of these drugs, more and more women are searching for alternative treatment options including herbal therapies.
Here is a review of some of the current evidence with respect to herbal therapies in PCOS:
A component in aloe vera, known as phytosterols have the ability to alter hormones which can reduce androgens and increase estrogens. Further, phytosterols can lower serum cholesterol levels.
In one study , Aloe vera was administered to rats of each group at different doses for 60 days.
Aloe vera was found to (1).
- Improve glucose tolerance
- Reduce Serum insulin levels
- Reduce insulin resistance
- Decrease testosterone levels
Other studies have shown that aloe vera can can also reduce Triglyceride (TG) and low-density lipoprotein (LDL-C) levels (unhealthy cholesterol) (1).
Cinnamon is an amazing herb used in many of our everyay recipes.
Research has shown that cinnamon can:
- Improve insulin sensitivity
- Lower Fasting blood glucose
- Lower Insulin
- Lower total cholesterol
One study carried out on 66 women that were diagnosed as PCOS. The intervention group was treated by cinnamon powder capsules for 3 months and the control group received a placebo (1). Results found that cinnamon significantly decreased insulin resistance and fasting insulin levels in women with PCOS (1).
Another study compared cinnamon treatment to treatment with metformin. Results found reported that the metformin group had a lower anti-Müllerian hormone level, which is related to PCOS and fertility, compared to the cinnamon group, however, the metformin group experienced more side effects than the PCOS group (1).
Camellia Sinensis (green tea)
We’ve all heard of the amazing benefits that green tea has to offer, but turns out it can benefit your PCOS as well! Green tea is one of the richest sources of flavonoids and although enjoyed as a casual beverage, can also be used as a medicinal plant(1).
Studies have indicated that green tea consumption (1):
- Can decrease Fasting blood sugar levels in diabetic
- Reduces the risk of cardiovascular disease, cancer, and metabolic syndrome.
In one study, 340 Chinese obese women with PCOS were randomly divided into the intervention and placebo groups. The intervention group received green tea capsules for 3 months and the control group received a placebo. At the end of the study, there was no significant change in BMI, weight, waist-hip ratio. However, the level of triglyceride in the intervention group increased significantly.
- Inhibited testosterone production
- Reduced LH level
- Reduced blood pressure
- Reduced body and ovarian weight.
The use of green tea in PCOS patients comes with mixed data, however, as some studies indicate that green tea can actually increase testosterone levels. This treatment option should only be recommended to PCOS patients without elevated testosterone levels (1).
Fenugreek is a herb similar to clover that is native to the Mediterranean region, southern Europe, and western Asia. Fenugreek has anti-diabetic and cholesterol- lowering effects and has been shown to decrease insulin resistance in women with PCOS (1). Fenugreek extracts contain fibre which help to decrease blood sugar by reducing enzymatic digestion and absorption of carbohydrates (1). Fenugreek as also been shown to exhibit hypoglycemic effects through stimulating insulin synthesis, insulin secretion from beta-pancreatic cells, and inhibiting alpha-amylase and sucrose.
In one study, the intervention group received 3 tablets of metformin and 2 tablets of fenugreek, and the control group received 3 tablets of metformin and 2 tablets of placebo for 2 months.
A significant reduction was seen in ovarian cysts after 2 months. However, there was no change in fasting glucose, insulin sensitivity, and hormonal concentrations between the two groups.
Another study on reported 46% reduction in cyst size and 71% of women reported the return of regular menstrual cycle after completion of the treatment (1).
Conclusions on the research available on, fenugreek suggest that it should be recommended to women with irregular periods but not necessarily if impaired glucose tolerance is the chief concern (1).
Silymarin is extracted from the milk thistle is known to be. (1)
- hepatoprotective (protective of the liver)
- an anti-oxidant
Silymarin can also lower testosterone level, increase sex hormone binding globulin (SHBG) protein synthesis, and inhibit inflammation (1). Testosterone levels tend to be elevated in those diagnosed with PCOS. SHBG is a protein that holds on to hormones, not allowing them to be used by the body. Increased levels of this protein can be beneficial in someone suffering from excess testosterone. Silymarin has also beens shown to reduce blood glucose level, and thereby decreases the symptoms of the PCOS.
In one study on rats- Silymarin was administered at different doses for 14 days (1). Results found the treatment group had decreased body weight, abdominal size, number and size of cysts (1) . Other findings were (1).
- Decreased estrogen
- Decreased testosterone
- Decreased LH
Chamomile is a herb native to Western Europe and North Africa.
Chamomile is known to be :
One study found chamomile significantly decreased
- Hemoglobin A1c (HbA1c) [Diabetes risk factor]
- Insulin levels
- Total cholesterol
Another study in rats found (1)
- Cysts disappeared
- Decreased LH & FSH
- Decreased testosterone
Mentha (peppermint) is a medicinal plant native to East India and Asia. Essential oils of mentha are used often in the food and beverage industries.
One study investigated the effect of peppermint tea on the level of androgen in women with hirsutism (excess hair growth). In this study, the intervention group received a cup of peppermint tea, containing 5 grams of dried mentha leaves in 250 ml of boiling water (5 days, twice a day) during the follicular phase of menstrual period (1).
The intervention group had a significant decrease in the level of free testosterone, triglyceride, and significant increase in the levels of LH, FSH, and Prostaglandin E2 (1) .
In another clinical trial, the intervention group received peppermint tea or chamomile tea twice a day for 30 days and covered one complete menstrual cycle (1). Peppermint tea caused a significant decrease in testosterone levels and an increase in LH and FSH levels (1). It is important to note that some women with PCOS suffer from increased LH levels, so this my not be a good treatment option if this is you.
One study in rats injected different doses of Foeniculum vulgare (fennel) for 10 days.
- FSH significantly increased
- Testosterone and LH levels were decreased
Another study indicated that Foeniculum vulgare, as well as metformin, decreased the days between two menstrual cycles and painful periods in PCOS patients (1).
The results of this study should be interpreted cautiously, as the injected fennel treatments may not be able to be replicated in humans from a dosing perspective.
Licorice is one of my favourite herbs for adrenal support and in women with low blood pressure. Licorice has also been shown to reduce excess hair growth due to enzymatic effects on the melatonin production cycle and possibly inhibits tyrosinase activity.
One study found that the combination therapy of licorice gel and laser are much more effective than laser alone for excess hair growth (1). Another study found that licorice extract inhibits the symptoms of PCOS by regulating controlling levels of serum FSH, LH/FSH ratio, and irregular ovarian follicles (1) .
Marrubium vulgare (white horehound)
Marrubium vulgare contains polyphenols and flavonoids that have shown to produce hypoglycemic effects, reduce cholesterol, triglyceride, and oxidative stress (1). Some flavonoids, such as apigenin, competitively inhibit the binding of flunitrazpam, thereby reduce the secretion of LH
There are plenty of alternative treatment options for your PCOS, but it is important to find the one right for you.
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