More than 70% of women with PCOS in Australia use natural and complementary therapies to improve one or more aspects of their health. Research reports that women with PCOS use these therapies most commonly to improve their general wellbeing and to treat the PCOS symptoms of infertility and depression. The natural remedies most often used include supplements, such as vitamins, minerals and fish oils, and herbal medicine in the forms of teas, tablets or liquid.
The types of treatments and remedies used in natural and complementary therapies are often influenced by the main concern(s) of the woman; for example, the treatment for excess hair growth might be different from a treatment used to improve fertility.
There is some emerging research on some natural therapies for the management of PCOS. It’s important to note that many of these research findings are preliminary. This means that larger – and more robust – studies are needed before any conclusions can be made in regard to the treatments’ effectiveness in women with PCOS.
Managing insulin resistance and menstrual cycles
Managing excess hair (hirsutism) and acne
Things to keep in mind
The treatments outlined here should only be prescribed by an experienced qualified practitioner, preferably with a special interest in PCOS and women’s health.
There are important safety considerations when it comes to using natural therapies. It is important to remember that because a product is ‘natural’, or used safely by your friend/family member/neighbour, it doesn’t necessarily mean it is safe for you.
Being guided by a professional also increases the likelihood of effective dosing, and often gives you access to higher quality ‘practitioner-only’ products, which can improve your chance of successful treatment.
Remember, it’s important to tell your doctor and specialist about all the natural and complementary therapies you are using.
Insulin resistance is thought to be a key part of the development of PCOS.
Insulin resistance means that the body doesn't respond normally to insulin, the hormone responsible for keeping blood glucose levels in a safe range. Some parts of the body might be 'resistant' to insulin, and higher levels of this hormone are often produced to keep blood glucose in the normal range.
Higher levels of insulin in the body increase the production of androgens (male-type hormones), such as testosterone, in the ovaries. This can affect the function of the ovaries, including ovulation (the release of a mature egg from an ovary), making managing insulin resistance a key part of managing PCOS.
The greatest amount of research into any natural therapy in PCOS management has been on inositol, a vitamin-like substance.
Available as a supplement, inositol occurs naturally in the human body, but is also present in many foods, particularly grains, nuts and fruit.
Inositol has a role in blood glucose control and can make body cells more sensitive to insulin.
A 2018 review of research found that ovulation rates and menstrual cycles appear to improve with inositol in women with PCOS.
Many of the studies in the review tested nutrient combinations, such as inositol and folate. Studies that tested inositol by itself were not available.
Overall, the research in this area is still limited. Many key questions remain.
Seek professional guidance on the usage and dosing of this therapy.
There are only very small studies that look at cinnamon specifically in the treatment of PCOS (for insulin resistance and menstrual cycles), and results are not conclusive.[4, 5]
Cinnamon (Cinnamomum cassia or Cinnamomum burmanni) is a herb that seems to improve the way insulin works by keeping blood glucose levels in a healthier range.
There is some research to support its use in managing insulin resistance in type 2 diabetes.
Chromium is a mineral that humans need in trace (small) amounts. It is found naturally in low doses in foods such as broccoli, beef, green beans and potatoes.
Chromium picolinate is the form of chromium often used in supplements. It is thought to be the form best absorbed by the digestive system.
It is generally agreed that chromium improves the action of insulin in the body, but there are only a few small studies into the effects of chromium in women with PCOS.[6, 7]
One of the studies found that at least six months of treatment was needed for positive outcomes to occur.
But in conclusion, larger and more robust studies are needed to confirm the effectiveness of chromium picolinate.
Currently, there are only very small studies looking at the effects of omega-3 fatty acids in improving insulin sensitivity in women with PCOS.[8, 9]
Further studies are needed to understand if they are effective and how they might work.
In women with PCOS, high levels of androgens and insulin can affect the menstrual cycle and prevent ovulation. Ovulation can stop completely (anovulation), or it can occur irregularly. This can make it more difficult for women with PCOS to become pregnant naturally. However, it is important to know that women with PCOS give birth to the same number of children as women without PCOS, but it can take longer to get pregnant.
A traditional Chinese medicine of peony (Paeonia lactiflora) and licorice (Glycyrrhiza glabra), also known as the herbal formula TJ-68 (shakuyaku kanzo-to), is often prescribed by herbalists for the management of infertility in women with PCOS.
More research is needed in this area; however, it is thought that the herbal formula helps to convert testosterone (which is increased in PCOS) to oestrogen.
This formula (and all herbal medicines) should be prescribed only by a registered traditional Chinese medicine practitioner or a qualified herbalist for safety, and to avoid potential side effects and interactions with other medications. Tell your doctor about any natural therapies and supplements you are taking.
The herbal medicine black cohosh (Cimicifuga racemosa or Actaea racemos) has a small amount of research to support its use in treating problems with fertility in women with PCOS.
There are strong safety considerations with this herbal medicine, so its use should be discussed with a health professional qualified in herbal medicine.
Hirsutism is excess hair growth on the face and body due to high levels of androgens stimulating the hair follicles. This excess hair is thicker and darker than normal. The hair typically grows in areas where it is more usual for men to grow hair. Up to 60% of women with PCOS have hirsutism.
The higher level of androgens in women with PCOS can also increase the size of the oil production glands on the skin. This can lead to increased acne. Acne is common in adolescence, but young women with PCOS also tend to have more severe acne.
There is conflicting evidence as to whether chromium supplementation improves acne or hirsutism in women with PCOS.[13, 14]
Some researchers suggest the poor findings were due to the trials being too short in length. They suggest that a minimum of 16 weeks of treatment with chromium is needed to assess its effects on hirsutism and acne. Further investigation is needed.
Spearmint (Mentha spicata) is commonly used as a herbal tea by Middle Eastern women to reduce excess hair growth.
Two small studies investigating this treatment produced inconclusive results, so more research, with more participants, is needed.[16, 17]
Spearmint tea is considered safe for general consumption.
Skin washes containing tea tree oil can be useful for reducing acne. Some limited research shows that the essential oil of tea tree can prevent growth of bacteria that is found in acne. In another study, application of a tea tree oil gel was shown to reduce the number of acne lesions.(19)
Note: tea tree oil is for topical use only (application to the skin). It is poisonous if swallowed.
When it comes to management of PCOS with natural therapies:
This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at September 2019.
© Jean Hailes Foundation. All rights reserved. This publication may not be reproduced in whole or in part by any means without written permission of the copyright owner. Contact: firstname.lastname@example.org