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The 7 Best Research-Backed Supplements for PCOS

Written by Dr. Ruscio on January 14, 2021

Written by Dr. Ruscio on January 14, 2021 — Reviewed by Hilary Watts

Dr. Michael Ruscio is a DC, Naturopathic Practitioner, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.

Use Supplements as Part of Your Plan to Beat PCOS

• What Is PCOS|
• What Causes PCOS|
• PCOS Treatment Options|
• Supplements for PCOS|
• Choosing Supplements|
• How To Beat PCOS|
• Bottom Line|
• Recommended Products|

Polycystic ovary syndrome, or PCOS, is a hormonal condition that affects women of reproductive age. PCOS symptoms are especially troubling for women and include hair growth in all the wrong places, thinning scalp hair, acne, weight gain, and missed periods. PCOS is also one of the leading causes of infertility in women [1]. One treatment option we’ll discuss is supplements for PCOS.

The great news about PCOS is it’s very treatable. Managing insulin resistance and inflammation is fundamental for rebalancing hormones and getting PCOS symptoms in check. 

Supplements for PCOS can play an important role in your comprehensive treatment strategy. However, supplements alone won’t have a big impact without dietary and lifestyle changes.

In this article, we’ll discuss the best supplements for PCOS and other natural treatment options. The seven best supplements for PCOS, based on research, are:

1. Probiotics
2. Herbal blends to balance hormones
3. Resveratrol
4. Inositol
5. Fish oil
6. Mineral supplements
7. Spearmint tea

Taking dietary supplements for PCOS can help to support a full recovery, restoring fertility and hormone balance, regulating menstrual cycles, improving skin and hair, and also reducing the risk for other serious illnesses.

What Is PCOS?

PCOS is an endocrine (hormonal) condition that affects between 5% to 15% of reproductive-age women [2], making it one of the most common female hormone conditions.

While it may be common, it’s not always easy to diagnose. In fact, one-third of PCOS patients worldwide report at least a two-year delay in receiving a diagnosis [3].

Symptoms of PCOS include:

• Infrequent or absent periods, and other menstrual irregularities
• Acne
• Abnormal facial or body hair growth
• Hair loss
• Ovarian cysts
• Excess abdominal fat (apple-shaped)
• Infertility, lack of ovulation, and miscarriage 

Obesity is found in about 80% of patients with PCOS [4], but a lean PCOS variant also exists in about 20% of patients [5].

PCOS is a serious condition and a sign that your body’s metabolic and hormonal systems are badly unbalanced. Patients with PCOS have increased risk for type 2 diabetes, heart disease, stroke, depression, anxiety, and endometrial cancer [6, 7].

What Causes PCOS?

A diet high in sugars and refined carbohydrates, lack of exercise, poor gut health, and chronic stress all contribute to PCOS. 

PCOS develops as a result of metabolic syndrome, insulin resistance, and chronic, low-grade inflammation [8]. These conditions lead to hormonal imbalances and an excess of androgens, or male hormones [9].

While a small amount of male hormones like testosterone is normal for women, high androgen levels are the reason why PCOS patients may experience hirsutism (facial/body hair growth), a deeper voice, and male-pattern hair loss.

PCOS and Gut Health

One factor in the development of PCOS is poor gut health.

Several studies have found that women with PCOS tend to have gut dysbiosis (an imbalance in gut microorganisms) [10, 11] and lower levels of bacterial diversity in their gut [12, 13, 14]. One study found that the higher the excess androgens and male-pattern hair growth in PCOS patients, the lower the gut microbial diversity [15]. 

Research also shows that PCOS patients tend to have signs of gut inflammation and leaky gut syndrome [16]. This means that the inflammatory process, started in the gut by bad bacteria, leaks into the bloodstream and affects insulin receptor function and hormone balance [17].

Treatment Options for PCOS

Standard medical advice for PCOS often leads to treatment with a long list of prescription drugs that may include birth control pills for hormonal balance, metformin for insulin resistance, eflornithine to stop unwanted hair growth, and much more. These medications often come with significant side effects and don’t address the fundamental lifestyle issues that contribute to the development of PCOS.

A functional medicine approach to PCOS recognizes that PCOS can be treated very effectively by managing diet, sleep, and stress levels, getting moderate exercise, and ultimately improving gut health. Popping pills to mask symptoms may be an easier choice, but it doesn’t lead to wellness. 

The Best Supplements for PCOS

When it comes to dietary supplements, less is often more effective. Taking handfuls of supplements every day is expensive and unnecessary. It’s better to hone in on the most effective PCOS supplements.

Here our list of the best supplements for PCOS, based on an extensive review of the research:

1. Probiotics

Probiotics are important for PCOS because they restore balance to the gut ecosystem and repopulate your gut with healthy bacteria. This helps to stop the leaky gut/inflammatory cycle at its source.

Research supports the use of probiotics for improving hormonal balance and reducing inflammation in PCOS patients. A large 2020 systematic review and meta-analysis (the highest quality of research evidence) found that probiotic supplements improved hormonal and inflammatory markers for women with PCOS [18].

When it comes to improving your metabolic health, probiotics have more modest effects. Two systematic reviews and meta-analyses found that probiotics somewhat improved insulin sensitivity but did not improve fasting blood glucose or body weight in PCOS patients [19, 20]. This is consistent with studies of probiotics in other populations that mostly show small improvements for weight loss and blood sugar levels [21, 22, 23, 24].

While probiotics can be very effective for restoring gut health, balancing hormones, and reducing inflammation, they are best taken in combination with dietary and lifestyle improvements that better address weight loss and insulin resistance.

2. Herbal Blends to Balance Hormones

Several types of herbs have been studied and found effective for PCOS as well as other female hormonal imbalances involving progesterone and estrogens.

Based on a 2014 systematic review of eight clinical trials, chasteberry (also known as chaste tree or vitex) and black cohosh showed the strongest evidence for helping to manage infrequent or absent periods in PCOS [25]. Both of these herbs have been shown to be effective for a range of female hormonal imbalances [26, 27, 28, 29]

Chasteberry has also been shown to help with infertility [30], reduce testosterone levels [31], and improve obesity and insulin levels [32] in women with PCOS.

Other herbs that have been shown to be effective for PCOS include:

• White peony (also known as Chinese peony) [33]
• Cinnamon [34, 35, 36], although one systematic review suggests that it is not effective for restoring menstruation and may have mild adverse effects [37].
• Licorice [38]
• Fenugreek [39, 40]

A combination supplement that combines the best-studied herbal supports is the simplest way to include herbal hormonal supports in your daily routine. For PCOS, I recommend Progest-Harmony, a combination of chasteberry, white peony, and licorice.

3. Resveratrol

Resveratrol is an antioxidant plant compound found in the seeds and skins of grapes and berries. 

Clinical trials suggest that resveratrol is effective for women with PCOS and can:

• Reduce inflammatory markers (800 mg/day) [41] 
• Improve hormone balance (800 mg/day) [42]
• Significantly reduce testosterone, DHEA, and fasting insulin, and significantly improve insulin resistance [43]

4. Inositol 

Inositol is a vitamin-like type of sugar sometimes called vitamin B8. There are two forms of inositol that are both well studied in women with PCOS: myo-inositol and d-chiro inositol. Both forms of inositol have been shown to be effective in patients with PCOS, although myo-inositol showed the best effect on metabolism, whereas D-chiro-inositol reduced androgen levels better [44].

A 2019 systematic review and meta-analysis found that myo-inositol was as effective as the standard drug metformin at improving fasting insulin, insulin resistance, and testosterone [45]. Since metformin can have adverse side effects, researchers suggest that myo-inositol is a more acceptable treatment for improving hormonal and metabolic profiles in PCOS [46].

Two earlier systematic reviews also show that inositol improves insulin resistance, increases estradiol (a female hormone), and may reduce testosterone [47, 48].

5. Fish Oil

Fish oil contains vitamin D and omega 3 fatty acids, both of which may be helpful for women with PCOS.

Research has shown that Vitamin D can lower fasting blood sugar, reduce insulin resistance, and reduce testosterone in women with PCOS and vitamin D deficiency [49, 50] but may not improve menstrual regularity [51].

A significant number of studies suggest that omega 3 supplements can help women with PCOS improve inflammatory and antioxidant markers, insulin resistance, total cholesterol, and testosterone [52, 53, 54].

For those who prefer a vegan supplement, flaxseed oil or ground flaxseed is a good source of omega 3 fats and can be taken with vitamin D drops.

6. Mineral Supplements

Preliminary research suggests that zinc, selenium, and magnesium may be helpful for PCOS. However, results are mixed. 

• Zinc: Women with PCOS tend to have lower circulating zinc than healthy controls [55]. Zinc supplementation may help PCOS patients with hair loss and excessive facial/body hair [56]. Another study suggests that zinc may help PCOS patients to lower fasting blood sugar, insulin resistance, and triglycerides [57]. When it comes to lowering markers of inflammation and oxidative stress, results were less conclusive [58, 59].
• Selenium: Preliminary evidence suggests that PCOS patients may have lower selenium levels than healthy controls [60, 61] and some studies suggest that selenium supplements can improve hormone levels, inflammatory markers, hair loss, acne, unwanted hair growth, and cholesterol levels [62, 63, 64]. 

However, a 2016 clinical trial found that selenium significantly increased insulin resistance in women with PCOS. And a 2018 systematic review concluded that the available data do not yet support selenium supplementation as a protective treatment in PCOS [65].

• Magnesium: One randomized, placebo-controlled trial of PCOS patients who supplemented with magnesium oxide and zinc for 12 weeks found significant reductions in markers of inflammation and oxidative stress when compared to a placebo group [66].

Other minerals should probably be avoided by women with PCOS:

• Iron: PCOS patients tend to have high serum ferritin, a measure of the body’s iron storage [67]. Iron supplementation is not recommended in PCOS if blood levels of ferritin are around 57 ng/mL and/or insulin resistance is present.
• Copper: PCOS patients may already have higher copper levels than healthy controls [68].

7. Spearmint Tea

One study showed that drinking two cups of spearmint tea a day for 30 days was clearly effective for reducing androgen levels in women with PCOS when compared with placebo [69]. This is great news since spearmint tea is delicious, too.

Choosing the Right Supplements for You

When it comes to incorporating supplements for PCOS management, it’s important to keep things simple. For women with hormonal imbalances, I usually recommend starting with probiotics and an herbal supplement formulated to balance hormones. If you want to take a vitamin/mineral supplement, choose one without iron and copper. This combination of supplements and attention to diet and lifestyle, are very helpful for the majority of patients.

After 30 days of following these fundamental practices, you may wish to incorporate additional supplements into your program, if needed. Try each supplement one at a time for 30 days to see if your symptoms improve. 

How To Beat PCOS

While supplements can be very helpful in treatment of PCOS, it’s important to recognize that lifestyle improvements are the cornerstone for managing PCOS [70, 71]. Stress, lack of sleep, poor diet, and poor gut health can both cause and worsen PCOS.

Following an anti-inflammatory diet is one of the foundational steps in managing PCOS. An anti-inflammatory diet focuses on whole, fresh foods and minimizes sugars and  processed foods is recommended. The paleo diet and Mediterranean diet are both excellent choices.

Of special importance to women with PCOS is incorporating healthy fats into your diet. That’s because dietary fats are essential for healthy hormone production. Olive oil, coconut oil, and MCT oil are excellent choices for everyday dietary fats. It’s also important to find a good source of omega 3 fatty acids, whether in the form of a daily fish oil supplement, or by consuming flaxseed oil, ground flax seeds, and fish and/or nuts on a regular basis

Also important for PCOS patients are simple lifestyle improvements like getting 7-8 hours of sleep every night, regular moderate exercise such as walking, and finding ways to lower stress. As much as possible, spend time outdoors, and take time out for activities you enjoy. Finding joy in life is truly a health practice!

The Bottom Line on Supplements for PCOS

Natural treatments for PCOS are effective and can help to restore hormonal balance and fertility. Lowering insulin resistance and inflammation through better diet and lifestyle is the key to getting PCOS symptoms in check. 

Supplements can play an important role in your healthcare plan for PCOS. Probiotics can help to restore gut health, and herbal blends can help to balance hormones. Other supplements can provide additional support for calming inflammation and improving insulin sensitivity.Choose to take steps towards a healthier lifestyle on your own, or reach out to a health coach for additional support.