The Ten Best Supplements for PCOS
Polycystic Ovarian Syndrome (PCOS) is the most common cause of female infertility, accounting for roughly 20-25% of all cases. PCOS symptoms vary for each individual, but several of the main characteristics directly affect a woman’s ability to get pregnant. PCOS can cause hormonal imbalances that disrupt ovulation patterns and, in more extreme cases, anovulation (absence of ovulation). Fortunately, research has shown that several different vitamins and supplements may help to regulate hormonal imbalances, promote ovulation and improve female fertility for women with PCOS.
In this article, we will review the ten best supplements for PCOS and improving fertility!
Inositol
Inositol is likely the single most important supplement to take if you’re trying to get pregnant with PCOS. Whether you’re trying naturally or with treatments like IVF it doesn’t matter. Inositol is an important supplement to consider even if you’re not trying to get pregnant. Here’s why.
Approximately 70% of those with PCOS have diagnosable levels of insulin resistance. Insulin resistance may sound like it has nothing to do with PCOS or infertility, but it does.
Insulin resistance can cause the body to produce excess insulin levels, which in turn causes the ovaries to make more androgen hormones like testosterone and alter the ratio of luteinizing hormone (LH) to follicle-stimulating hormone (FSH). Hormonal imbalances like this can impair egg development and disrupt ovulatory patterns.
Inositol as it turns out is well known for its ability to improve insulin-receptor activity and restore insulin resistance. This is even more important as those with PCOS have naturally lower inositol levels.
One Study showed myo-inositol may decrease insulin resistance by approximately 70%. As mentioned, this helps restore hormones to a ratio required for ovulation to occur.
In another study, though relatively small, inositol was shown to be capable of restoring ovarian activity to help improve fertility for women with PCOS.
Inositol supplementation has also been shown to affect oocyte and embryo quality. In one study, researchers split patients with PCOS undergoing IVF into a control and inositol treatment group. Out of the 233 oocytes collected in the inositol group, 136 were fertilized (58.3 %). Out of the 300 oocytes produced for the control group, only 128 were fertilized (42.6%).
The number of grade I embryos obtained was also higher for the inositol treatment group. Thus, researchers concluded that inositol therapy in women with PCOS results in better fertilization rates and better embryo quality.
As you would assume, better embryo quality is associated with higher pregnancy rates. A meta-analysis of many studies has shown that inositol supplementation is indeed associated with significantly improved clinical pregnancy rates.
Fish Oil
Fish oil supplements are associated with a laundry list of health benefits for all women, including PCOS patients. Studies have demonstrated that fish oil supplementation is capable of improving ovulation, ovarian reserve, and overall fertility. Similar to inositol, fish oil is a useful supplement for PCOS patients because it can help to improve insulin resistance.
Inflammation is another key feature of PCOS that negatively impacts fertility. Fish oil is an important supplement for PCOS patients because it has anti-inflammatory properties . Fish oil supplements can also help to lower bad cholesterol for women with PCOS.
Vitamin D Supplements for PCOS
67 to 85% of women with PCOS suffer from vitamin D deficiency. Low vitamin D levels may intensify PCOS symptoms, including insulin resistance, ovulatory, menstrual irregularities, infertility, hyperandrogenism, and obesity. Supplementing vitamin D has been shown to have beneficial effects on menstrual regularity and ovulation.
In one study, women with adequate levels of vitamin D had a 52.5% chance of achieving pregnancy per IVF cycle compared to a 34.7% chance for women with inadequate levels.
N-Acetyl-Cysteine (NAC)
N-Acetyl-Cysteine (NAC) is used by the body to build anti-oxidants. Antioxidants produced from NAC help to protect and repair our cells from cell damage. By reducing cell damage, NAC helps to fight inflammation and oxidative stress that can harm fertility. NAC is not found naturally in any foods, so it must be taken in the form of a supplement.
For women with PCOS, NAC can help to reduce insulin sensitivity, lower testosterone levels, regulate ovulation, and improve fertility. In fact, research has shown that NAC is even more effective than metformin (a medication commonly prescribed to treat PCOS) for improving insulin resistance. By reducing testosterone levels, NAC may help to induce ovulation and regulate your menstrual cycle. Reducing testosterone also helps to combat common secondary PCOS symptoms like acne and facial hair growth.
As far as improving fertility goes, NAC has been demonstrated to significantly increase PCOS patients’ chances of getting pregnant. Researchers performed a review of several studies measuring the effects of NAC supplementation on PCOS patients (over 910 women). They concluded that PCOS patients treated with NAC had greater odds of having a live birth, getting pregnant, and ovulation as compared to the placebo group.
Carnitine Supplements for PCOS
Acetyl L-Carnitine (ALC) is an antioxidant that is naturally produced by the body. ALC helps the body turn fat into energy. A clinical study found that non-obese women with PCOS have significantly lower levels of L-carnitine when compared to women without PCOS. Low ALC levels may be linked to hyperandrogenism and insulin resistance, two common traits of PCOS patients.
A clinical trial in women with PCOS found that supplementing ALC with clomiphene (a common fertility drug used to induce ovulation in PCOS patients) provided a thicker endometrium and higher pregnancy rates.
Magnesium
Magnesium plays a role in over 300 enzyme reactions in the human body, including glucose metabolism. Rather unbelievably, more than 50% of American’s fail to meet the daily magnesium requirement through their diet. What’s more is those with PCOS have been shown to be 19 times more likely to be magnesium deficient than the general population.
Low magnesium levels may worsen insulin resistance, and as a result, it can affect hormonal balancing and signaling. As previously mentioned, hormonal imbalances are extremely common with PCOS patients, and they interfere with several aspects of reproduction.
Magnesium supplements for PCOS patients may help to improve insulin resistance, reduce inflammation, and ease PMS symptoms.
Probiotics
Research suggests that many of the common symptoms of PCOS, including insulin resistance, sex hormone concentrations, and obesity, may negatively affect the diversity and composition of gut microbiota. Gut microbiota are critical to nutrient metabolism and maintenance of the structural integrity of the gut.
Probiotics are live microorganisms that can help to restore and improve gut health. Gut health is vital for controlling inflammation. Inflammation is a common symptom of PCOS and a key contributor to insulin resistance.
Research has shown that probiotic supplements can help to improve gut health, reduce inflammation, and correct hormonal imbalances for PCOS patients.
Taking probiotic supplements may also help to combat other symptoms of PCOS by normalizing the menstrual cycle and lowering androgen levels.
Zinc
Zinc is a strong antioxidant that helps to regulate the function of different enzymes. Zinc also helps to regulate cell growth, hormone release and impacts reproduction.
Although Zinc deficiency is fairly uncommon in the United States, it is more prevalent in women with PCOS. Zinc deficiency may be associated with common PCOS symptoms like insulin resistance and abnormal cholesterol levels.
In women with PCOS, zinc supplementation has a positive effect on many parameters, especially those related to insulin resistance . In addition, zinc may help to improve hormonal imbalances and ovulation.
Zinc supplementation may also help to improve other common PCOS symptoms like acne, hair growth, weight management, and hair loss .
B Vitamin Supplements for PCOS
There are several types of B vitamins, but the most important for PCOS patients are vitamin B12 and folate (B9). Both B vitamins help to lower inflammation by breaking down the amino acid homocysteine. Homocysteine levels are commonly elevated in PCOS patients .
High homocysteine levels are associated with reduced fertility in many ways including, poor oocyte quality, miscarriage, hypertension, and low birth weight.
B vitamins can also help to correct hormonal imbalances and improve fertility in other ways. Folate supplementation can increase progesterone levels and lower the risk for anovulation. Other studies on how nutrients affect reproduction have shown that folate is essential to oocyte quality and growth, implantation, fetal growth, and organ development.
Coenzyme Q10 (Co-Q10)
Co-Q10 is known to have many positive effects on female fertility for both PCOS and non-PCOS patients. Research has shown that pre-supplementation with Co-Q10 can improve ovarian response for women undergoing IVF treatment. Co-Q10 has also been shown to combat the age-related causes of infertility like reduced oocyte quantity and quality.
In addition to supporting overall fertility, Co-Q10 has specific benefits for PCOS patients. Co-Q10 has been shown to have a positive effect on insulin and testosterone levels.
The Bottom Line About Supplements for PCOS
Although PCOS is the most common cause of infertility, getting pregnant with PCOS is not impossible! Following a fertility-friendly diet and supplementing with key nutrients like inositol, vitamin D, fish oil, magnesium and others mentioned above can help improve fertility naturally.
In addition to taking the supplements included in this article, PCOS patients can also increase their chances of getting pregnant by undergoing a fertility consultation and discussing the available medications (like Letrozole and Clomid), IUI, IVF, and other treatment options with a fertility specialist.
