Polycystic Ovary Syndrome
Polycystic ovary syndrome (PCOS) is a chronic endocrine disorder in women. It is characterized by elevated levels of male hormones (androgens), infertility, obesity, insulin resistance, hair growth on face and body, and anovulation—a condition in which the ovaries produce few or no eggs.
Ovaries normally produce follicles that develop into eggs. In women with PCOS, the ovaries produce the follicles, but the eggs may not mature or leave the ovary. The immature follicles can develop into fluid-filled sacs called cysts. Most women with PCOS have cysts, but all women with ovarian cysts do not necessarily have PCOS.
The cause of PCOS is unknown, though genetics may play a role. Some evidence suggests the problem is related to insulin resistance with elevated levels of insulin. These high insulin levels may stimulate excess production of androgens from the ovaries. This could prevent ovulation and lead to enlarged, polycystic ovaries.
Treatments for PCOS include drugs to improve insulin sensitivity, as well as hormonal treatments and, when pregnancy is desired, fertility drugs.
Proposed Natural Treatments for PCOS
The supplement inositol has shown some promise for PCOS. In a
trial, 136 women were given inositol at a dose of 100 mg twice daily, while 147 were given placebo.
For more information, including safety issues, see the full
The supplement N-acetylcysteine (NAC) has shown some promise for treatment of
A double-blind, placebo controlled study evaluated the effectiveness of NAC in 150 women with PCOS who had previously failed to respond to the fertility drug
However, partially negative results were seen in another study. This trial compared NAC at a dose of 1.8 grams daily against the drug metformin in 61 infertile women with PCOS who had, as in the above study, failed to respond to clomiphine.
For more information, including dosage and safety issues, see the full
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2. Rizk AY, Bedaiwy MA, Al-Inany HG et al. N-acetyl-cysteine is a novel adjuvant to clomiphene citrate in clomiphene citrate-resistant patients with polycystic ovary syndrome. Fertil Steril. 2005;83:367-70
3. Lucidi RS, Thyer AC, Easton CA et al. Effect of chromium supplementation on insulin resistance and ovarian and menstrual cyclicity in women with polycystic ovary syndrome. Fertil Steril . 2005;84:1755-7.
4. Chan CC, Koo MW, Ng EH et al. Effects of Chinese green tea on weight, and hormonal and biochemical profiles in obese patients with polycystic ovary syndrome--a randomized placebo-controlled trial. J Soc Gynecol Investig . 2005;13:63-8.
6. Schachter M, Raziel A, Strassburger D, et al. Prospective randomized trial of metformin and vitamins for the reduction of plasma homocysteine in insulin-resistant polycystic ovary syndrome. Fertil Steril . 2007 Mar 3 [Epub ahead of print].
7. Elnashar A, Fahmy M, Mansour A, et al. N-acetyl cysteine vs. metformin in treatment of clomiphene citrate-resistant polycystic ovary syndrome: a prospective randomized controlled study. Fertil Steril . 2007 Feb 28 [Epub ahead of print].
8. Gerli S, Papaleo E, Ferrari A, et al. Randomized, double blind placebo-controlled trial: effects of myo-inositol on ovarian function and metabolic factors in women with PCOS. Eur Rev Med Pharmacol Sci. 2007;11:347-354.
Last reviewed April 2009 by EBSCO CAM Review Board
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