Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women, affecting up to 10 percent of American women, and is associated with both reproductive and metabolic disorders. It is a disease involving enlargement of the ovaries often associated with obesity or excess weight gain, hirsutism, menstrual problems, and infertility. These young women who are obese are at increased risk of developing coronary atherosclerosis, also referred to as "hardening of the arteries." The prevalence of depression and anxiety among patients is high. Some individuals have bouts of low blood sugar and some have insulin resistance.

Diet and polycystic ovary syndrome, role of food
The fertility problems and hormone irregularities that plague women with PCOS may improve on a low-carbohydrate diet. It is a good idea to cut down on sugar and eat more protein. Glucose ingestion causes higher insulin levels than does protein ingestion, and sugar stimulates cortisol which aggravate PCOS. Protein intake suppresses ghrelin production longer than does glucose, which suggests a prolonged satietogenic effect.
   Weight loss is one of the most important things to do to reduce the severity of PCOS. Weight loss should be done by eating a healthy diet and taking a half hour walk each day. Diet can make a significant influence in this condition. Eat more fish and vegetables and exercise as much as you can. To help you eat less, consider Diet Rx.

J Obstet Gynaecol Res. 2014. Effects of raw red onion consumption on metabolic features in overweight or obese women with polycystic ovary syndrome: a randomized controlled clinical trial. Raw red onion consumption appears to be effective as a cholesterol-lowering food agent in women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a condition that involves the excess production of androgens and can lead to the development of acne, hirsutism, and infertility. It has also been associated with coronary heart disease, diabetes, and metabolic syndrome. Over half of the women who are diagnosed with PCOS are overweight or obese. Recommendations are made for overweight/obese women to lose weight via diet and exercise. Women with PCOS should also consider maintaining a diet that is patterned after the type 2 diabetes diet. This diet includes an increase in fiber and a decrease in refined carbohydrates, as well as a decrease in trans and saturated fats and an increase in omega-3 and omega-9 fatty acids. Foods that contain anti-inflammatory compounds (fiber, omega-3 fatty acids, vitamin E, and red wine) should also be emphasized. Nutr Clin Pract. 2008 Feb; Polycystic ovary syndrome (PCOS) and other androgen excess-related conditions: can changes in dietary intake make a difference?Liepa GU, Sengupta A, Karsies D. School of Health Sciences and Department of Chemistry, Eastern Michigan University, Ypsilanti, MI, USA.

Nutrients. 2015. Advanced Glycation End Products: Link between Diet and Ovulatory Dysfunction in PCOS? PCOS is the most common cause of anovulation in reproductive-aged women with 70% experiencing ovulatory problems. Advanced glycation end products are highly reactive molecules that are formed by non-enzymatic reactions of sugars with proteins, nucleic acids and lipids. AGEs are also present in a variety of diet where substantial increase in AGEs can result due to thermal processing and modifications of food. Elevation in bodily AGEs, produced endogenously or absorbed exogenously from high-AGE diets, is further exaggerated in women with PCOS and is associated with ovulatory dysfunction. Additionally, increased expression of AGEs as pro-inflammatory receptors in the ovarian tissue has been observed in women with PCOS.

Natural treatment for polycystic ovary syndrome, supplements, home remedies
In addition to deleterious effects on fertility imparted by PCOS, women with PCOS are at increased risk of obesity, diabetes, cardiovascular disease, depression, and certain cancers.

Weight loss and exercise are key to symptom reduction in those with polycystic ovary syndrome. Supplements may offer additional help.

Acetylcysteine NAC
J Pharmacol Pharmacother. 2013. N-acetyl cysteine in clomiphene citrate resistant polycystic ovary syndrome: A review of reported outcomes. Clomiphene citrate (CC) has been the gold-standard drug for ovulation induction in polycystic ovary syndrome (PCOS), but still CC resistance is seen in approximately 15-40% in women with PCOS. N-acetyl cysteine (NAC), a safe and cheap drug available in the market many years ago as mucolytic agent, was found to have a role in infertility management. Recently, some reports discussed the possible beneficial effects of NAC on ovulation. The biological properties of the NAC make this drug a potential candidate for its use in the infertility treatment, especially in the PCOS in inducing or augmenting ovulation. An updated electronic search was performed through PUBMED, MEDLINE, and COCHRANE and focused on peer-reviewed, full text, randomized controlled trials, and observational cohort or case-control studies for role of NAC in CC-resistant PCOS. Thorough search through all the clinical studies showed mixed results. Studies with positive results showed improvement in induction of ovulation as compared to negative studies showing contrary results. More randomized clinical trials are still needed to establish its definitive role in CC-resistant PCOS.

Chromium mineral
Chromium may be slightly helpful in improving glucose tolerance.

Effect of chromium supplementation on insulin resistance and ovarian and menstrual cyclicity in women with polycystic ovary syndrome.
Fertility Sterility. 2005. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, Texas
In women with polycystic ovary syndrome, chromium picolinate (200 microg/d) improves glucose tolerance compared with placebo but does not improve ovulatory frequency or hormonal parameters. This pilot study indicates that future studies in the polycystic ovary syndrome population should examine higher dosages or longer durations of treatment.

Fenugreek seed extract
Int J Med Sci. 2015. Efficacy of a Novel Fenugreek Seed Extract (Trigonella foenum, Furocyst) in Polycystic Ovary Syndrome (PCOS). The present study is an open label, one-arm, non-randomized, post-marketing surveillance study in 50 premenopausal women (18-45 years, BMI<42) diagnosed with PCOS using a novel fenugreek seed extract, Furocyst, 2 capsules of 500 mg each day, enriched in approximately 40% furostanolic saponins, over a period of 90 consecutive days. The study was conducted to determine its efficacy on the reduction of ovarian volume and the number of ovarian cysts. Furocyst treatment caused significant reduction in ovary volume. Approximately 46% of study population showed reduction in cyst size, while 36% of subjects showed complete dissolution of cyst. It is important to mention that 71% of subjects reported the return of regular menstrual cycle on completion of the treatment and 12% of subjects subsequently became pregnant. Overall, 94% of patients benefitted from the regimen. Significant increases in luteinizing hormone (LH) and follicular stimulating hormone (FSH) levels were observed compared to the baseline values. Extensive blood chemistry, hematological and biochemical assays demonstrated the broad-spectrum safety. Furocyst caused significant decrease in both ovarian volume and the number of ovarian cysts. Serum ALT, BUN and CK were assessed to demonstrate the broad-spectrum safety of Furocyst. No significant adverse effects were observed. In summary, Furocyst was efficacious in ameliorating the symptoms of PCOS.

Glucomannan and Inositol
Minerva Ginecol. 2014. Combination inositol and glucomannan in PCOS patients. Aim of the study was to evaluate the efficacy of natural substances such as inositol and glucomannan, and their combination in reducing glucose levels and improving insulin sensitivity in PCOS patients. Forty women with clinical and endocrinological signs of PCOS were enrolled in the study and divided into three groups, including ten women each. The three groups were respectively treated with the combination inositol and glucomannan (A group), inositol (B group), glucomannan (C group) for a period of 3 months. Plasma levels of glucose and insulin were evaluated before and after treatment in our laboratory. There was a reduction in blood glucose and insulin levels, with particular significance in the group treated with the combination of inositol-glucomannan. Present results show that the association-inositol glucomannan may represent a good therapeutic strategy in the treatment of PCOS women with insulin resistance.

Hoodia appetite suppressant
I came across your website regarding hoodia supplements while searching to see if there are any reports on results similar to my own. I have been diagnosed seven years ago with PCOS, three other doctors confirmed this diagnosis. My weight continued to elevate from 5'5" 135 pounds to a whopping 220 pounds. I had been taking metformin (for insulin resistance) this entire time with no positive weight loss results, although all docs had told me it was a good possibility. My menstrual cycle had almost ceased completely, with periods intervals of about one every four to five months. About 9 months ago, I ordered a two month supply of hoodia online and started taking four hoodia pills a day with my 500mg metformin 2 times a day. My menstrual cycle returned at a 28 day interval almost immediately. After three months, I had lost almost thirty pounds from my middle, lost all sugar and white flour cravings. I tapered off of the metformin and continued on the hoodia supplements for about a month, and results ceased. I then tried metformin alone for about a month with no results either. Returned to the metformin / hoodia combo (I call it a cocktail) and results started up almost immediately again. I am now down to 155 pounds and counting. It seems apparent to me that this is an effective mix for PCOS patients, yet I do not find ANY studies or evidence online. Other results I have noticed only in combination: Immediate return of libido, No need for antidepressants whatsoever, No more symptoms of lethargy.
   This is very interesting.

Licorice herb or tea use
Licorice can reduce serum testosterone probably due to the block of 17-hydroxysteroid dehydrogenase and 17-20 lyase. Licorice could be considered an adjuvant therapy of hirsutism and polycystic ovary syndrome.

Licorice reduces serum testosterone in healthy women.
Steroids. 2004 Oct-Nov.
Licorice has been considered a medicinal plant for thousands of years. The most common side effect is hypokalemic hypertension, which is secondary to a block of 11beta-hydroxysteroid dehydrogenase type 2 at the level of the kidney, leading to an enhanced mineralocorticoid effect of cortisol. We have investigated the effect of licorice on androgen metabolism in nine healthy women 22-26 years old, in the luteal phase of the cycle. They were given 3.5 g of a commercial preparation of licorice (containing 7.6% W.W. of glycyrrhizic acid) daily for two cycles. CONCLUSIONS: Licorice can reduce serum testosterone probably due to the block of 17-hydroxysteroid dehydrogenase and 17-20 lyase. Licorice could be considered an adjuvant therapy of hirsutism and polycystic ovary syndrome.

Inositol
Myo inositol has been studied. Other names for Myo-Inositol include: Inositol, Inositol Monophosphate, and Inositol Hexaphosphate.

Metabolic and hormonal effects of myo-inositol in women with polycystic ovary syndrome: a double-blind trial.
Eur Rev Med Pharmacol Sci. 2009 Mar-Apr; Costantino D, Minozzi G, Minozzi E, Guaraldi C. Centro Salute della Donna, Azienda USL, Ferrara, Italy.
To investigate the effects of treatment with Myo-inositol (an insulin sensitizing drug), on circulating insulin, glucose tolerance, ovulation and serum androgens concentrations in women with the Polycystic Ovary Syndrome (PCOS). Forty-two women with PCOS were treated in a double-blind trial with Myo-inositol plus folic acid or folic acid alone as placebo. Treatment of PCOS patients with Myo-inositol provided a decreasing of circulating insulin and serum total testosterone as well as an improvement in metabolic factors.

Ginekol Pol. January 2014. The role of inositol deficiency in the etiology of polycystic ovary syndrome disorders. Inositol acts as a second messenger in insulin signaling pathway Literature data suggest inositol deficiency in insulin-resistant women with the polycystic ovary syndrome. Supplementation of myo-inisitol decreases insulin resistance as it works as an insulin sensitizing agent. The positive role of myo-inositol in the treatment of polycystic ovary syndrome has been of increased evidence recently The present review presents the effects of myo-inositol on the ovarian, hormonal and metabolic parameters in women with PCOS.

Maitake mushroom has been evaluated.

Spearmint tea may or may not help
Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. A randomized controlled trial.
Phytother Res. 2010 Feb. Grant P. Department of Diabetes and Endocrinology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK.
Hirsutism in polycystic ovarian syndrome (PCOS), consequent to elevated androgen levels leads to significant cosmetic and psychological problems. Recent research in Turkey has shown that spearmint tea has antiandrogenic properties in females with hirsutism. Forty two volunteers were randomized to take spearmint tea twice a day for a 1 month period and compared with a placebo herbal tea. Free and total testosterone levels were significantly reduced over the 30 day period in the spearmint tea group. LH and FSH also increased. Patient's subjective assessments of their degree of hirsutism scored by the modified DQLI were significantly reduced in the spearmint tea group. There was, however, no significant reduction in the objective Ferriman-Galwey ratings of hirsutism between the two trial groups over the trial duration. There was a clear and significant alteration in the relevant hormone levels. This is associated clinically with a reduction in the self-reported degree of hirsutism but unfortunately not with the objectively rated score. It was demonstrated and confirmed that spearmint has antiandrogen properties, the simple fact that this does not clearly translate into clinical practice is due to the relationship between androgen hormones and follicular hair growth and cell turnover time. Simply put, the study duration was not long enough. The original studies from Turkey were in fact only 5 days long. The time taken for hirsutism to resolve is significant and a much longer future study is proposed as the preliminary findings are encouraging that spearmint has the potential for use as a helpful and natural treatment for hirsutism in PCOS.

Vitamin D
Ginekol Pol. 2014. Associations of vitamin D concentration with metabolic and hormonal indices in women with polycystic ovary syndrome presenting abdominal and gynoidal type of obesity. We demonstrated that women with PCOS are often vitamin D deficient.

Chinese herbal medicine
PLoS One. 2014 Feb 10. Oriental medicine kyung-ok-ko prevents and alleviates dehydroepiandrosterone-induced polycystic ovarian syndrome in rats. Kyung-Ok-Ko (KOK), a traditional herbal prescription composed of Rehmannia glutinosa Liboschitz var. purpurae, Lycium chinense, Aquillaria agallocha, Poria cocos, Panax ginseng, and honey, has been widely used in traditional Oriental medicine as a vitalizing medicine or as the prescription for patients with age-associated disorders such as amnesia and stroke.

Hormone use
Do you think DHEA supplementation would be helpful in polycystic ovary syndrome?
   I think not, it may actually be the wrong hormone to take and could aggravate the condition but I am not sure.

Selenium mineral not helpful
J Trace Elem Med Biol. 2016. Effects of selenium supplementation on glucose homeostasis and free androgen index in women with polycystic ovary syndrome: A randomized, double blinded, placebo controlled clinical trial. This study showed that selenium supplementation in PCOS patients may worsen insulin resistance in them.

Diagnosis of polycystic ovary syndrome and complications
PCOS is a diagnosis of exclusion of other causes of hyperandrogenism. Screening for diabetes is important.

Clin Epidemiol. Dec 18 2013. Epidemiology, diagnosis, and management of polycystic ovary syndrome. PCOS is a common heterogeneous endocrine disorder characterized by irregular menses, hyperandrogenism, and polycystic ovaries. The prevalence of PCOS varies depending on which criteria are used to make the diagnosis, but is as high as 15%-20% when the European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine criteria are used. Clinical manifestations include oligomenorrhea or amenorrhea, hirsutism, and frequently infertility. Risk factors for PCOS in adults includes type 1 diabetes, type 2 diabetes, and gestational diabetes. Insulin resistance affects 50%-70% of women with PCOS leading to a number of comorbidities including metabolic syndrome, hypertension, dyslipidemia, glucose intolerance, and diabetes. Studies show that women with PCOS are more likely to have increased coronary artery calcium scores and increased carotid intima-media thickness. Mental health disorders including depression, anxiety, bipolar disorder and binge eating disorder also occur more frequently in women with PCOS. Weight loss improves menstrual irregularities, symptoms of androgen excess, and infertility.

Women with PCOS have an increased risk of endometrial carcinoma, type 2 diabetes mellitus, and possibly cardiovascular disease. PCOS increases risk for infertility. PCOS and insulin resistance are associated.

Polycystic ovary syndrome symptoms
These include irregular menstruation, which is the most common symptom of PCOS; infertility, hirsutism, thinning hair, skin abnormalities including skin tags and acanthosis nigricans, which darkens and thickens the skin, usually on the neck or in the underarms or groin. This condition results from excess insulin in the blood stream. There may also be depression and anxiety.

Treatment of polycystic ovary syndrome
Weight loss appears to improve egg release in obese women with polycystic ovary syndrome. Treatment is directed at the presenting symptom as the primary cause is unknown. Long-term medical treatment may include the oral contraceptive pill or metformin. Long-term surveillance is recommended for the early detection and treatment of potential metabolic complications.

I have been diagnosed by my endocrinologist with PCOS. I have been placed on metformin (after trying solely natural products first), and I am finally seeming to do better (currently on 1500mg./day, but my doctor wants me to work on up to 2000mg/day). This flu season has been particularly difficult one for my family and me. I've had to take two rounds of Levaquin (again after trying various natural products) to finally get over infections. I was considering taking Dr. Ohirrah's probiotic formula to try to support my immune system and "build back." Would there be any contraindication in taking this or any other probiotic (concerning the lactic acid in the products) and in the rare, but possible, side-effect of lactic acidosis with taking metformin.
   I have not seen any studies regarding the interactions between metformin and probiotics, but generally probiotics do not have much of an interactions with most medications and supplements.

I'm writing about my daughter she has PCOS. I bought her Flax Oil could you tell me if she needs the hulls for the testosterone to bind to? I read where the hulls is were they found the lowered level of testosterone.
   A. I prefer consuming flax seeds rather than the oil.