Polycystic ovary syndrome (PCOS) is the most prevalent hormonal disorder affecting women of reproductive age across the globe. The CDC estimates PCOS may be one of the most common causes of infertility, impacting 6-12% of reproductive aged women.¹In around 75% of cases, PCOS is the underlying cause in cases of amenorrhea (the absence of menstruation) in reproductive age women.

PCOS occurs when the ovaries produce excess androgens causing irregular ovulation and multiple ovarian cysts. Some of the symptoms of PCOS include menstrual irregularity or absent cycles, weight gain, fertility issues, fatigue, depression and abdominal pain. The overproduction of androgens associated may also lead to acne, hirsutism (abnormal growth of facial and body hair, notably in women) and male-pattern baldness.

Other risks are associated with this condition as well. Insulin resistance affects 50-70% of women with PCOS.²And it is estimated that more than half of the women with PCOS will develop type 2 diabetes by the age of 40.¹Women with PCOS are at higher risk of cardiovascular disease.³PCOS can also increase the risk of endometrial cancer.4

Managing PCOS

Although no official cure for PCOS exists, there are many ways to help manage PCOS including surgeries, pharmaceutical options, lifestyle changes and through nutrition.

In managing PCOS, some of the main goals are to reduce the risks of developing certain cancers, reduce androgen levels, reduce body weight and long-term cardiovascular risks, manage blood sugar and risk of diabetes, and to maintain healthy ovulation cycles.

In many cases, oral contraceptives may be prescribed to aid in inducing regular cycles. An example may include progesterone capsules if a patient has low progesterone levels. Anti-androgen medications such as Aldactone® or Tagamet® may be prescribed. It is common to utilize medications such as statins to help control blood sugar and lipids. Since statin medications deplete the body of coenzyme Q10 (COQ10), patients on statins may benefit from adjunct supplementation of COQ10. There are also natural therapies available that can be utilized in combination with medications or as an option to possibly prevent medications from becoming a necessity.

Although not all women with PCOS are overweight, maintaining a healthy weight is one of the best natural tools to help combat the condition. Regular exercise helps maintain a healthy weight and increase the body’s sensitivity to insulin. Adhering to a regular exercise regimen of 150 minutes of activity per week can reduce risks of cardiovascular disease and diabetes in women with PCOS. Regular exercise can also help alleviate symptoms of mood disorders associated with PCOS.⁵Of course, exercise works best in combination with a healthy diet.

A low-carbohydrate diet with a greater intake of fruits and vegetables, natural fibers, healthy fats and clean proteins is helpful in managing blood sugars, weight and overall cardiovascular health in women with PCOS.^6,7,8Lower carbohydrate intake helps reduce simple sugars in the diet, assist in insulin sensitivity and maintain a healthy weight. Adding fiber to the diet can also help manage weight, as well as improve dyslipidemia and insulin sensitivity.^6,7And replacing carbohydrates with clean proteins has been shown to improve glucose metabolism.⁸

Other dietary ingredients have shown promise for PCOS and blood sugar control. Vitamin D is important for reproductive hormones, inflammation, mood balance and for glucose homeostasis. Low vitamin D levels are quite common today. PCOS patients with low vitamin D levels may benefit from the addition of a high-quality D3 dietary supplement.

Inositol has also been shown to help improve endocrine and metabolic issues found in PCOS patients. Inositol is structurally similar to glucose and can influence hormones and insulin response. Myo-inositol and d-chiro-inositol work together as secondary messengers, relaying signals to support optimal blood glucose balance.^9,10The inositol pathway also plays a critical role in ovulation by promoting regular cycles, reducing androgen levels and improving fertility.^9,10,11 A 40:1 ratio of myo- to d-chiro-inositol has been shown to aid the body in restoring healthy follicle-stimulating hormone, testosterone synthesis and balanced androgen.^9,10,11,12

Another natural ingredient that shows promise in alleviating PCOS symptoms is chromium picolinate. Chromium is foundational for its powerful ability to promote reproductive health by supporting ovulation, optimal blood glucose, a healthy body mass index (BMI) and balanced hormones.^13,14Studies showed chromium picolinate works similarly to metformin to decrease fasting blood sugar, has beneficial effects on decreasing BMI and free testosterone in PCOS patients.¹³

Another natural ingredient that may be beneficial is cinnamon, a common spice known for use in cuisines around the world. Cinnamon has also been used in ayurvedic and other traditional medicines as a means to assist in glucose control. Some studies showed a reduction in glucose and triglycerides using 3-6 grams of cinnamon per day.¹⁵Adding cinnamon in teas, cooking and with dietary supplements may be an added benefit for PCOS patients. Fenugreek and cinnamon are both backed by clinical studies showing their ability to help support optimal blood glucose balance and promote healthy menstrual cycles. Some studies have also shown a decrease in polycystic appearing ovaries after combination therapies with metformin and fenugreek seed extract.¹⁶

Wellness Works Options for Women with PCOS

A combination of myo- and d-chiro-inositol in the optimum 40:1 ratio combined with chromium, cinnamon and fenugreek is now available in one product from Wellness Works. The new Wellness Works Women’s Health line features PCOS Support (WW #10421), which provides all ingredients supported by studies in an easy-to-use capsule and a month supply per bottle. Wellness Works also offers vitamin D3 supplements in 1,000-5,000 IU options, dietary fiber supplementation with Colon Health Support (WW #10370) and several high-quality omega-3 supplements to help improve the nutritional status of PCOS patients.

View additional products in Wellness Works Women’s Health Line.

A version of this article originally appeared entirely in PCCA’s members-only magazine, the Apothagram.

References

1. CDC. (last reviewed 2022 30 December). PCOS (Polycystic Ovary Syndrome) and Diabetes. Accessed 03.01.2023 at https://www.cdc.gov/ diabetes/basics/pcos.html

2. Sirmans, S.M., Pate, K.A. (2013). Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clinical epidemiology, 6, 1–13. Accessed 03.01.2023 at https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC3872139

3. The Johns Hopkins University, Hospital and Health System. (2023, reviewed by Michos, E.D.) Polycystic Ovarian Syndrome: How Your Ovaries Can Affect Your Heart. Accessed 03.01.2023 at https://www.hopkinsmedicine.org/ health/conditions-and-diseases/polycystic-ovarian-syndrome-how-your-ovaries-can-affect-your-heart

4. Barry, J.A., Azizia, M.M., Hardiman, P.J. (2014). Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis. Human reproduction update, 20(5), 748–758. Accessed 03.01.2023 at https://pubmed.ncbi.nlm.nih.gov/24688118

5. Woodward, A., Klonizakis, M., Broom, D. (2020). Exercise and Polycystic Ovary Syndrome. Advances in experimental medicine and biology, 1228, 123–136. Accessed 03.03.2023 at https://pubmed.ncbi.nlm.nih. gov/32342454

6. Perelman, D., Coghlan, N., Lamendola, C., Carter, S., Abbasi, F., McLaughlin, T. (2017). Substituting poly- and mono-unsaturated fat for dietary carbohydrate reduces hyperinsulinemia in women with polycystic ovary syndrome. Gynecol Endocrinol, 33(4), 324–327. Accessed 03.03.2023 at https://pubmed.ncbi.nlm.nih.gov/27910718

7. Soliman, G.A. (2019). Dietary Fiber, Atherosclerosis, and Cardiovascular Disease. Nutrients, 11(5), 1155. Accessed 03.03.2023 at https://pubmed. ncbi.nlm.nih.gov/31126110

8. Sorensen, L.B., Soe, M., Halkier, K.H., Stigsby, B., Astrup, A. (2012). Effects of increased dietary protein-to-carbohydrate ratios in women with polycystic ovary syndrome. Am J Clin Nutr. 95(1), 39–48. Accessed 03.03.2023 at https://pubmed.ncbi.nlm.nih.gov/22158730

9. ClinicalTrials.gov. (first posted 2009, last update posted 2017). Vitamin D for the Treatment of Women with Polycystic Ovary Syndrome (PCOS). Accessed 03.03.2023 at https://clinicaltrials.gov/ct2/show/NCT00907153

10. Kalra, B., Kalra, S., Sharma, J.B. (2016). The Inositols and Polycystic Ovary Syndrome. Indian J Endocrinol Metab., 20(5), 720-724. Accessed 03.03.2023 at https://pubmed.ncbi.nlm.nih.gov/27730087

11. Benelli, E., Del Ghianda, S., Di Cosmo, C., Tonacchera, M. (2016). A Combined Therapy with Myo-Inositol and D-Chiro-Inositol Improves Endocrine Parameters and Insulin Resistance in PCOS Young Overweight Women. Int J Endocrinol, 2016, 3204083. Accessed 03.03.2023 at https:// pubmed.ncbi.nlm.nih.gov/27493664

12. Unfer, V., Nestler, J.E., Kamenov, Z.A., Prapas, N., Facchinetti, F. (2016). Effects of Inositol(s) in Women with PCOS: A Systematic Review of Randomized Controlled Trials. Int J Endocrinol, 2016, 1849162. Accessed 03.03.2023 at https://pubmed.ncbi.nlm.nih.gov/27843451

13. Fazelian, S., Rouhani, M.H., Bank, S.S., Amani, R. (2017). Chromium supplementation and polycystic ovary syndrome: A systematic review and meta-analysis. J Trace Elem Med Biol, 42, 92–96. Accessed 03.03.2023 at https://pubmed.ncbi.nlm.nih.gov/28595797

14. Amooee, S., Parsanezhad, M.E., Ravanbod Shirazi, M., Alborzi, S., Samsami, A. (2013). Metformin versus chromium picolinate in clomiphene citrate-resistant patients with PCOs: A double-blind randomized clinical trial. Iran J Reprod Med, 11(8), 611–618. Accessed 03.03.2023 at https://pubmed. ncbi.nlm.nih.gov/24639797

15. Khan, A., Safdar, M., Ali Khan, M.M., Khattak, K.N., Anderson, R.A. (2003). Cinnamon Improves Glucose and Lipids of People With Type 2 Diabetes. Diabetes Care, 26 (12): 3215-3218. Accessed 03.03.2023 at https:// diabetesjournals.org/care/article/26/12/3215/21858/Cinnamon- Improves-Glucose-and-Lipids-of-People

16. Hassanzadeh Bashtian, M., Emami, S.A., Mousavifar, N., Esmaily, H.A., Mahmoudi, M., Mohammad Poor, A.H. (2013). Evaluation of Fenugreek (Trigonella foenum-graceum L.), Effects Seeds Extract on Insulin Resistance in Women with Polycystic Ovarian Syndrome. Iran J Pharma Resea, 12(2), 475–481. Accessed 03.03.2023 at https://pubmed.ncbi.nlm.nih.gov/24250624