Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. Symptoms may include ovarian cysts, irregular menstrual cycles, acne, thinning hair, and weight gain, particularly around the abdomen. While researchers indicate that the causes of PCOS are complex, insulin resistance and hormone regulation are primary factors. Hormonal disruptions in PCOS can lead to insulin resistance, prompting the body to store more fat. PCOS often triggers weight gain due to hormonal imbalances, notably elevated levels of insulin. In turn, elevated insulin levels stimulate the ovaries to produce excess androgens, contributing to weight accumulation, especially around the abdominal region.
Lifestyle changes and dietary adjustments may help manage these factors and alleviate symptoms. Eating the right foods while avoiding certain ingredients may help manage PCOS symptoms. A nutritious diet may aid in regulating hormones and menstrual cycle. Consuming processed foods and those high in preservatives may contribute to inflammation and insulin resistance.
It is important to note that treatments for PCOS may differ from person to person. It is also crucial to consult with a physician before taking any dietary supplements, as only certain supplements are approved for use in treatments and medications for PCOS. Despite a large amount of research on natural treatments for PCOS, more specific information is needed to support many of the alternatives. You should always check with your doctor before starting any alternative therapy. Some treatments that are hyped as a "miracle" for PCOS can actually affect fertility or lead to other complications. Be wary of supplements and other therapies such as progestin, systemic enzyme therapy, and functional foods and herbs that promise a cure for all diseases and immediate effects.
This article aims to provide a comprehensive overview of vitamins and supplements that may aid in managing weight loss and alleviating other symptoms associated with PCOS. For example, women with PCOS have a high prevalence of vitamin D deficiency, leading to the high preference for dietary supplementation.
Dietary Adjustments for PCOS Management
Focus on whole foods that are free from artificial sugars, hormones, and preservatives. Incorporate fruits, vegetables, whole grains, and legumes into the daily diet. These additive-free foods may support the endocrine system in better regulating blood sugar levels.
Read also: Keto Deficiency Guide
Both carbohydrates and protein are essential for the body’s energy levels and hormone production. Protein intake may stimulate insulin production, while unprocessed, high-carb foods improve insulin sensitivity. Rather than following a strict low-carb diet, individuals with PCOS should prioritize including adequate healthy protein in their meals. Plant-based protein sources, such as nuts, legumes, and whole grains, are excellent options.
Some studies classify PCOS as a mild, chronic inflammatory condition. Incorporating anti-inflammatory foods into the diet may alleviate PCOS symptoms. Foods like olive oil, tomatoes, leafy greens, mackerel, tuna, and nuts are known for their anti-inflammatory properties. The basis of a Mediterranean diet is fresh food such as fruit, vegetables, whole grains, nuts, spices, legumes and olive oil. Extra virgin olive oil has the added benefit of being rich in healthy fats and helping to absorb fat-soluble vitamins.
Women with PCOS may experience heavy menstrual bleeding, which may increase the risk of iron deficiency or anemia. If an individual is diagnosed with anemia or iron deficiency, a physician may recommend methods to increase iron intake. Iron-rich foods such as spinach, eggs, and broccoli may be beneficial. However, excessive iron intake may lead to complications, so moderation is important.
Magnesium-rich foods such as almonds, cashews, spinach, and bananas are particularly beneficial for individuals with PCOS.
A high-fiber diet may greatly improve digestion. Foods rich in fiber include lentils, lima beans, broccoli, Brussels sprouts, pears, and avocados.
Read also: Prenatal Vitamins: A Detailed Review
Caffeine consumption may be linked to fluctuations in estrogen levels and hormone expression. Consider caffeine-free alternatives, such as herbal tea. Green tea may aid in improving insulin resistance and managing weight for women with PCOS.
Soy contains proteins that may mimic estrogen in the body, which may help balance hormones in individuals with PCOS. However, there is also evidence suggesting that soy may disrupt the endocrine system. Individuals with a family history of estrogen-related cancers, such as certain breast cancers, should consult their physician before adding soy to their diet.
Key Vitamins and Supplements for PCOS
Several dietary supplements are known to cause metabolic changes and hormonal regulation and have a potential impact on increasing pregnancy rates. The selected articles were critically and qualitatively assessed to provide reports and graphical descriptions that offered valuable insights to researchers. This review focuses on supplements such as vitamin D, Myo-inositol, selenium, probiotics, or synbiotics. Non-pharmacological therapies, such as food, dietary supplements, and herbal medicines, are frequently chosen over pharmacological treatments despite their potential adverse effects. Mechanistic studies based on biochemistry are needed to distinguish these supplements and understand their potential in combination therapy.
Inositol
Inositol is a naturally occurring compound that belongs to the vitamin B complex group, although it is not officially recognised as a vitamin. Inositol is also synthesised in the human body and plays a crucial role in cellular signalling, insulin sensitivity and neurotransmitter modulation. Inositol is believed to improve insulin sensitivity, addressing one of the key factors contributing to weight gain in PCOS. As inositol is found both in the body and in many foods, there are a couple of ways in which you can incorporate inositol into your daily routine.
Inositol, a B vitamin, may improve insulin resistance and enhance fertility in some cases of PCOS. Although inositol is a natural sugar, inositol supplements, contain a much higher quantity of myo-inositol than diet alone. The most common supplement recommendation is myo-inositol, like Inofolic Alpha and Inofolic AlphaPlus which are known for their potential benefits in addressing insulin resistance, a factor in PCOS-related weight gain. Another way you can incorporate inositol into your daily routine is to consume it through inositol-rich foods. Opt for nutritious choices like beans, lentils, nuts, seeds, and citrus fruits, which are naturally high in inositol. Whole grains, especially oats and wheat bran, also provide a good dietary source.
Read also: Comprehensive Keto Guide
Myo-inositol and D-chiro-inositol are the two most clinically important isoforms of inositol; as secondary messengers of insulin, an imbalance between them is key to IR. Myo-inositol is a natural molecule present in fruits and vegetables that participates in FSH signaling, which orchestrates ovulation. Oral supplementation with myoinositol has been shown to improve hyperandrogenism and menstrual cycles, and restore spontaneous ovulation in women with PCOS. Myo-inositol effectively reduced postprandial triglyceride (TC) levels, glutathione peroxidase (GSH-Px) activity, liver fat accumulation, and aspartate aminotransferase (AST) levels. Furthermore, accumulating evidence suggests that myo-inositol has a beneficial effect on folliculogenesis, with improved oocyte maturation and embryo quality in women with PCOS undergoing in vitro fertilization (IVF). Despite the conflicting fertility outcomes, myo-inositol has been found to shorten the duration of controlled ovarian hyperstimulation during IVF procedures. However, physicians remain unconvinced of its effectiveness in improving clinical pregnancy and live birth rates. Therefore, large-scale clinical trials are needed to explore the potential benefits of myoinositol in women with PCOS.
Chromium
Chromium supplements may improve body mass index (BMI) and reduce insulin resistance by assisting the body in metabolizing sugar. Recent studies have suggested that Cr supplementation can lower BMI, free testosterone concentration, and fasting blood insulin.
Cinnamon
Cinnamon, derived from the bark of the cinnamon tree, has been shown to positively affect insulin resistance and may help regulate menstrual cycles in women with PCOS. The significant reduction in body weight and BMI associated with cinnamon demonstrates its effect on anthropometric indices in women with PCOS. Moreover, oral cinnamon supplementation improved the metabolic parameters.
Curcumin
The active ingredient in turmeric, called curcumin, may help reduce insulin resistance and possesses anti-inflammatory properties.
Zinc
Zinc is a trace mineral that may boost fertility and support the immune system. It may also help improve excessive hair loss. Foods rich in zinc include red meat, beans, nuts, and seafood. In women with PCOS, Zn supplementation has beneficial effects on numerous parameters, particularly those associated with insulin resistance and lipid balance.
Evening Primrose Oil
Evening Primrose Oil has been used to relieve symptoms of dysmenorrhea and irregular periods. It may also improve cholesterol levels and reduce oxidative stress, both of which are linked to PCOS.
Vitamin D
Vitamin D is crucial for the endocrine system, and deficiency is common in women with PCOS. Combining vitamin D with calcium may improve menstrual regularity and increase ovulation. Vitamin D improves insulin metabolism, increases total antioxidant capacity (TAC), reduces hirsutism, and reduces C-reactive protein (CRP) and total serum testosterone levels. It regulates ovulation dysfunction, hyperandrogenism, and IR in the ovaries through the 1 α-hydroxylase (CYP27B1) and vitamin D receptor (VDR) genes. Due to the anti-inflammatory and immunomodulatory properties of vitamin D, vitamin D deficiency may lead to the pathogenesis of endometriosis, which is another important cause of female infertility besides PCOS.
In humans, 25 OH-D is positively correlated with anti-Müllerian hormone (AMH) and appropriate levels of vitamin D. Normalization of abnormal AMH levels indicates improves folliculogenesis and protects against endometriosis. Moreover, vitamin D regulates metabolism by reducing malondialdehyde (MDA) and high-sensitivity CRP levels while increasing TAC.
Fish Liver Oil
Fish liver oil is rich in vitamins D and A, along with high levels of omega-3 fatty acids, which may help improve menstrual regularity and reduce belly fat. Omega-3 PUFAs improve HOMA-IR, insulin levels, TC, TG, very low-density lipopolysaccharide cholesterol (VLDL-C), LDL-C, and HDL-C.
Berberine
Berberine, an herb used in Chinese medicine, may help reduce insulin resistance. It may boost metabolism and balance hormonal responses in individuals with PCOS.
Selenium
Selenium has antioxidant and anti-inflammatory properties and is an essential trace element. Selenium supplementation can effectively reverse biochemical disorders and serve as a biochemical marker in women with PCOS. Selenium supplementation reduces fasting plasma glucose (FPG), cholesterol, insulin, and TC levels. Considering its antioxidant properties that enhance follicle quality, selenium can be recommended for patients with PCOS undergoing IVF.
Probiotics
Probiotics are not only beneficial for the digestive tract and gut health, but they can also play an important role in the treatment of PCOS. They can also reduce inflammation and regulate sex hormones like androgens and estrogens. Consider taking a probiotic supplement and eating probiotic foods, like kimchi and kombucha. Modulation of the gut microbiota improves lipid metabolism, hormonal profiles, and inflammatory indicators in adolescents with PCOS. Probiotic supplementation has been associated with protective effects on fertility-related factors such as body weight normalization, BMI regulation, insulin control, and HOMA-IR improvement in women with PCOS. Overall, improved hormonal indices such as the free androgen index (FAI) and sex hormone-binding globulin (SHBG) are possible with probiotics, prebiotics, and synbiotics, as well as the regulation of inflammatory markers such as nitrogen oxide (NO) and MDA. Moreover, the effects of probiotics and synbiotics on metabolic, inflammatory, and hormonal parameters led to improved fertility in women with PCOS.
Other Supplements
CoQ10, an antioxidant, has been shown to be effective in women with PCOS who underwent assisted reproductive technologies (ART). Flaxseed supplementation, which is rich in dietary fiber, phytoestrogens, lignans, and α-linolenic acid (ALA) have the potential to improve metabolic, anthropometric and hormonal parameters. Folic acid supplementation can reduce BMI, especially in patients with PCOS and high homocysteine levels. Although L-carnitine has been shown to improve BMI and LDL-C, TG, and TC levels in women with PCOS, it has not demonstrated positive effects in patients with PCOS-related infertility. Choline supplementation improved ovarian function in a pig model. Increasing evidence suggests that estrogen supplementation positively affects the quality of immature oocytes for maturation in stimulated IVF cycles. Recently, the potential role of Cr supplementation has received increasing consideration in improving or preventing PCOS.
Adaptogenic Herbs for PCOS
When the body struggles to regulate insulin, hormones may accumulate, leading to elevated levels of male hormones known as androgens. Some adaptogenic herbs may alleviate other symptoms of PCOS, such as irregular menstrual cycles, by reducing androgens. It is advisable to consult a physician before using herbal supplements, as these have not been evaluated by the FDA.
Maca Root
Maca root is a traditional herb used to enhance fertility and libido. It may help balance hormones and reduce cortisol levels, and it may also address depression, a common symptom of PCOS.
Ashwagandha
Ashwagandha, also referred to as Indian ginseng, may help balance cortisol levels, which may improve stress and symptoms associated with PCOS.
Holy Basil
Holy basil, known as tulsi, may help reduce chemical and metabolic stress. It may lower blood sugar, prevent weight gain, and reduce cortisol levels.
Licorice Root
Licorice root contains glycyrrhizin, which has anti-inflammatory properties. This herb may assist in metabolizing sugar and balancing hormones.
Tribulus Terrestris
Tribulus terrestris helps to stimulate ovulation and support menstruation. It can also reduce the number of ovarian cysts.
Chasteberry
Chasteberry has been used for centuries as a fertility aid.
Lifestyle Modifications for PCOS Weight Loss
Managing PCOS symptoms and supporting weight loss involves a multifaceted approach.
Exercise
Regular exercise is absolutely essential in managing PCOS and facilitating weight loss. Simply, incorporate a mix of aerobic exercises, such as brisk walking or cycling, and strength training into your routine. Exercise is important for maintaining a healthy weight. But too much exercise can mess with hormone levels, so talk to your doctor about a balanced exercise regimen. Gentle, low-impact exercises like yoga or Pilates can be chosen. Swimming and aerobics are also recommended.
Diet
Of course, maintaining a healthy diet is vital for managing PCOS and supporting weight loss. Try to eat nutrient-dense foods such as fruits, vegetables, lean proteins and whole grains. You should also practise portion control and limit refined sugars and processed foods.
Stress Management
High stress levels can lead to increased weight gain and make it much harder for someone with PCOS to lose abdominal weight. That said, try to incorporate stress-reducing practices such as yoga, meditation, or deep breathing exercises into your routine. Reducing stress not only aids in weight management but also helps balance hormonal levels, alleviating PCOS symptoms.
Sleep
Finally, you should be making sure that you get enough sleep each night. Aim for 7-9 hours of quality sleep each night to regulate hormonal balance and reduce stress. You should also establish a consistent sleep routine by going to bed and waking up at the same time daily. To do this, you must create a conducive sleep environment, minimising light and noise. Sleep helps reduce stress levels and helps regulate cortisol for hormone balance. But sleep disturbances are twice as common in women with PCOS.
Minimize Endocrine Disruptors
Endocrine disruptors are chemicals or ingredients that interfere with or block the natural response of hormones. Some endocrine disruptors resemble female and male sex hormones, disrupting the reproductive system. This can increase your risk of PCOS symptoms. They are commonly found in canned foods, soaps and makeup.
Additional Therapies
Studies show acupuncture as an alternative treatment for PCOS.