Managing PCOS Naturally with Diet and Supplements

Polycystic ovarian syndrome (PCOS) is often characterized by elevated male hormone levels in females, irregular menstrual cycles, or small cyst-like findings on the ovaries. [1] 

PCOS is the most typical endocrine disorder among women of reproductive age, affecting 7% of adult women of childbearing age on average. It is a common cause of ovulation disorders. The cause of PCOS remains unknown; therefore, there is still no cure. Excess male sex hormone levels can be determined through a blood test or physically by increased facial hair, jawline acne, changes in female body shape, decrease in breast size, amenorrhea, and oily skin. 

Unfortunately, those suffering from PCOS also have a higher risk of suffering from endometrial cancer, heart disease, high cholesterol levels (due to altered lipid profiles, including high triglyceride levels, low HDL levels, and higher LDL levels), hypertension, sleep apnea, anxiety, depression. Studies show that over 50% of women with PCOS also develop pre-diabetes or diabetes. [2-3]

Pregnant women with PCOS have an increased risk of miscarriage, gestational diabetes, pre-eclampsia, and premature delivery.

Many doctors prescribe oral contraceptives to women with PCOS because it helps normalize hormone levels. However, many women suffer from the common drawbacks of long-term oral contraceptive pills, including nausea, mood swings, and weight gain. 

Fortunately, there are other ways to manage PCOS and its symptoms, including methods that correct the lack of ovulation, inhibit male hormone production, and reduce insulin resistance.

1. Weight Loss

Weight reduction for overweight people with PCOS is helpful because weight loss helps regulate ovulation, decreases male sex hormone production, and reduces blood sugar imbalances. [4] I recommend joining the Guerrilla Diet 12-Week Health and Weight Loss program based on scientific evidence to lose weight most healthily. Weight loss is crucial for the management of PCOS symptoms. It is vital to achieve your ideal weight as soon as possible.

2. Decrease intake of AGEs

Advanced glycation end products (AGEs) are harmful compounds that form in a process called glycation. Cooking processes that introduce AGEs into the foods we eat include grilling, barbecuing, frying, and searing. Women with PCOS already suffer from hormonal, metabolic, and oxidative stress, and consuming AGEs impacts antioxidant and enzymatic activity. A study on diet modification for women with PCOS showed that a low-AGE diet could improve hormonal, metabolic, and oxidative stress levels. [5]

Meat has the highest levels of AGEs. In second place are processed foods, as these are primarily heat processed. An excellent way to remove AGEs from your diet would be to reduce meat and processed food consumption to a minimum and follow healthier cooking methods for all other foods you consume (especially avoiding frying). [6]

3. Increase DIM (diindolylmethane) in your diet

Diindolylmethane (DIM) is a potent phytonutrient found in cruciferous vegetables (Brussel sprouts, broccoli, cabbage, cauliflower, kale, and maca), bearing anti-androgenic activity by blocking androgen receptors. [7] 

Although data on the effects of DIM on women with PCOS are lacking, DIMs anti-androgenic effects are seen in other disease states such as prostate cancer. [8] In any case, there is no damage caused by consuming cruciferous vegetables daily. But quite the opposite is true, as they are also rich in the chemical sulforaphane, which has potent antioxidant, antimicrobial, anticancer, anti-inflammatory, anti-aging, and neuroprotective qualities. [9] I recommend consuming at least one portion of a cruciferous vegetable daily.

4. Increase Omega-3s in Your Diet

Omega-3 fatty acids reduce oxidative stress, decrease hypertension, and improve lipid profiles and anti-inflammatory activityResearchers observed changes in insulin resistance, total cholesterol, and triglyceride levels in a study that assessed the usefulness of omega-3 fatty acids for people with PCOS. The results of the trials led scientists to conclude that omega-3 fatty acids are an effective and safe treatment for women with PCOS and insulin resistance. [10] In another study involving women with irregular periods due to PCOS, a trial on seventy-eight patients showed omega-3 supplementation could reduce testosterone levels and help regulate the menstrual cycle. [11]

Another study showed that testosterone levels decreased after six months of therapy and concluded that omega-3 might also improve excess facial hair growth and insulin resistance in people with PCOS. [12]

I recommend omega-3 fatty acid supplementation in plant form as alpha-linolenic acid (ALA). Walnuts, tofu, Brussels sprouts, and seeds, including chia seeds, hemp seeds, and flax seeds, are rich in ALA. Also, sea vegetables are rich in ALA. I recommend adding these foods to your salads, oatmeal, and topping to other dishes daily. 

5. Increase Melatonin Rich Foods In Your Diet

The melatonin concentration in pre-ovulatory follicular fluid is lower in women with PCOS. One study examined the effects of six months of melatonin intake on women affected by PCOS. After six months of melatonin treatment, it significantly decreased androgen levels and low-density lipoprotein cholesterol. Almost 95% of participants experienced an improvement in menstrual cycles. [13]

Other studies reported that supplementing melatonin at low concentrations might improve oocyte quality and increase pregnancy rates. [14-17]

You can take the hormone melatonin in supplement form, but I do not recommend doing this. Melatonin interacts with some medications and may have short-term side effects. It is better to consume melatonin-rich foods as part of your last meal of the day.

 Foods richest in melatonin include tart cherries, goji berries, bananas, oats, and nuts, including pistachios, walnuts, and almonds. 

6. Take Anti-Androgenic Herbs

There are herbs with active compounds that block or suppress the action of testosterone within the body. These herbs include red reishi mushroom, licorice, white peony, green tea, spearmint, and chaste berries. [18] I recommend buying these herbs as tinctures and putting them all together in a glass of water to be consumed five times a week or in the form of tea. Licorice may raise blood pressure, so I suggest avoiding this herb if you suffer from blood pressure issues. In any case, limit all herb consumption to no more than six consecutive months.

7. Supplement with Inositol

Inositol is commonly called myo-inositol, and while it is often also referred to as Vitamin B8, it is not a vitamin. Instead, inositol is a carbohydrate.

According to a study by a team from the Fertility and ART Department at Brest University Hospital in France, myo-inositol supplementation effectively normalizes ovarian function in patients with PCOS. It even improves embryo quality when taken three months before ovarian stimulation. [19] Other studies have also found that myo-inositol heals high androgen levels and insulin resistance and improves lipid profiles. [20-27]

More importantly, myo-inositol was not only cost-effective and showed no side effects, even at high levels. I recommend supplementing with 1500 mg of myo-inositol five times a week, with a B-complex or 400 mcg of folic acid. You may also consume myo-inositol through natural foods containing this substance, including citrus fruit, beans, cantaloupe, corn, and other fiber-rich foods.

8. Supplement with B vitamins

Homocysteine has a leading role in the pathogenesis of PCOS. Homocysteine leads to reproductive symptoms in PCOS. There is a positive correlation between insulin resistance and elevated homocysteine levels. [28-30] Therefore, vitamin B supplementation is crucial. I recommend taking a B-complex supplement three times a week in the mornings, along with myo-inositol. 

9. Supplement with zinc

Research shows that women with PCOS have lower zinc levels. [31] Zinc deficiency increases insulin resistance in people with PCOS. [32-33]

Sufficient zinc levels improve ovarian function, decrease androgens and increase progesterone, a natural androgen blocker.

A study on women with PCOS supplemented with zinc sulfate showed a significant reduction in cholesterol, LDL, and triglyceride levels. [33] Therefore, I recommend supplementation with 20 mg zinc sulfate as an effective therapy for improving lipid metabolism and insulin resistance in women with PCOS. You may take this supplement with a cup of green tea to help zinc absorption into the cells.

10. Exercise

Physical activity is recommended for people with PCOS for several reasons, including weight loss, prevention of insulin resistance, and its effect on homocysteine levels.

According to the study by Randeva et al. [34], regular exercise for six months was found to significantly lower homocysteine levels in young obese, and overweight women with PCOS. I recommend walking daily for 20-30 minutes.

To conclude

A whole food plant-based diet low in animal products and processed foods (such as the Guerrilla Diet), along with exercise and consumption of anti-androgenic, melatonin, and omega-3 rich foods and cruciferous vegetables, along with supplementation with myo-inositol, B vitamins, zinc, and anti-androgenic herbs, is very beneficial for improving androgen levels and managing PCOS.

All references are found at this link: — I keep this list updated. 

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Dr. Galit Goldfarb


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