Improving Fertility and Insulin Resistance with Supplements For PCOS

Overview

Polycystic ovarian syndrome (PCOS) is a hormonal disorder that that affects about 6% to 10% of women. PCOS not only causes menstrual and fertility issues, but also mental health issues, obesity, type 2 diabetes, insulin resistance, and metabolic syndrome. (11)

Hormonal medications like birth control pills are often prescribed for PCOS, as well as metformin for insulin resistance.

The supplements listed below help with some of the underlying problems of women suffering from PCOS.

Acknowledgment and Disclaimer

This article cites research compiled by other sources. These include Natural Medicines Database, the Fullscript organization, and others. Product links are chosen based on the best fit with the published research, however, this site is meant for educational purposes only. Individuals are advised to consult a Registered Dietitian Nutritionist or healthcare professional about diet and nutritional supplement intake.

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Omega-3 with Vitamin E 

Omega-3 with Vitamin E 

1000 mg of omega-3 with 400 IU vitamin E (8)

(22)

  • Overweight women with PCOS showed increased total antioxidant capacity levels when given 2 g of omega-3 with 400 IU of vitamin E (23)
  • Lipid profile and oxidative stress improved and women with PCOS . They showed decreased serum triglycerides, LDL, and total/HDL, and increased plasma total antioxidant capacity when supplemented for 12 weeks (22)
  • Systematic review of 9 trials found omega-3 fatty acids may improve insulin resistance in patients with PCOS (26)  

Vitamin D

Vitamin D: 1000 IU to 4000 IU per day for a minimum of 12 weeks  (14)(7)

  • In a systematic review of 11 studies, it was found that continuous supplementation of vitamin D up to 4000 IU per day was associated with improved insulin sensitivity. (16 Łagowska 2018 )
  • A Vitamin D Dose of 4000 IU per day was more effective than 1000 IU in decreasing total testosterone and increasing total antioxidant capacity in insulin-resistant PCOS patients (14 Jamilian 2017)

Berberine

Berberine is extracted from Chinese medicinal herbs and has been used as an insulin sensitizer.

500 mg per day, for a minimum of 3 months (5 )

  • Berberine lead to decreases in the waist circumference, total cholesterol (TC), triglycerides (TG), and LDL cholesterol, as well as increase in HDL cholesterol in women with PCOS.(25)  
  • In a review of 9 randomized controlled trials, berberine was found to be comparable to metformin as demonstrated by no significant differences found between them in alleviating insulin resistance, improving glycolipid metabolism or reproductive endocrine condition (17)
  • Berberine is considered unsafe in pregnancy because it crosses the placenta and causes uterine contractions according to the Natural Medicines Database. Product literature does advise against taking Berberine if you are pregnant or nursing. Nevertheless, infertile women with PCOS undergoing In Vitro Fertilization experienced an increase in live birth rate when given berberine. (1

Chromium Picolinate

Chromium picolinate200 µg, per day, minimum 8 weeks (12 )(13)

  • Women with PCOS who took 200 micrograms of chromium for 8 weeks had lower blood glucose, improved insulin sensitivity, and improved markers for cardio-metabolic risk. (15)
  • A review of 7 randomized trials found chromium supplementation decreased BMI, fasting insulin, and free testosterone concentration in women with PCOS. (10
  • Chromium supplementation improved pregnancy rate by 16.7%, decreased prevalence of acne by 20.0%, improved oxidative stress, increased total antioxidant capacity and decreased hirsutism. (13)

Inositol

Inositol

1-2 g inositol (myo-inositol and d-chiro-inositol), minimum 3 months (6))(19)(21)

  • Myoinositol was found to improve increase estradiol, and alleviate insulin resistance (27 )
  • Women with PCOS given 1200 mg of d-chiro-inositol twice daily had improved insulin sensitivity. (4)
  • Myoinositol and d-chiro-inositol both improved ovarian and metabolic functions in women with PCOS. A study compared 6 months of supplementation with 4g of myo-inositol(MI) or 1g of d-chiro-inositol(DCI). The research found myoinositol was better for metabolic function and di-chiro-inositol was better for decreasing hyperandrogenism. (21)
  • A trial of women taking 2g of inositol twice per day for 3 months found that the ratio 40:1 MI/DCI was ideal for restoring and normalizing ovulation in PCOS patients. (19)
  • Combined myoinositol and d-chiro-inositol was more effective after 3 months of treatment than myoinositol alone. (20)

References

  1. (An 2014) https://pubmed.ncbi.nlm.nih.gov/23869585/ (C)
  2. (Ashoush 2016) https://pubmed.ncbi.nlm.nih.gov/26663540/ (B)
  3. Bozdag, 2016 https://pubmed.ncbi.nlm.nih.gov/27664216/ (A)
  4. (Cheang 2008)https://pubmed.ncbi.nlm.nih.gov/18803944/ (C)
  5. Cicero 2014) https://pubmed.ncbi.nlm.nih.gov/24728953/ (C) 
  6. Colazingari 2013) https://pubmed.ncbi.nlm.nih.gov/23708322/ (C)
  7. Dastorani https://pubmed.ncbi.nlm.nih.gov/30286768/ (C)
  8. Ebrahimi 2017 https://pubmed.ncbi.nlm.nih.gov/28407657/ (B)
  9. Fang 2017 https://pubmed.ncbi.nlm.nih.gov/28107851/ (A)
  10. Fazelian 2017) https://pubmed.ncbi.nlm.nih.gov/28595797/ (A)
  11. Gilbert 2018) https://pubmed.ncbi.nlm.nih.gov/30099747/ (A)
  12. Jamilian 2015. https://pubmed.ncbi.nlm.nih.gov/26279073/ (B)
  13. Jamilian 2016 https://pubmed.ncbi.nlm.nih.gov/26613790/ (B)
  14. Jamilian 2017). https://pubmed.ncbi.nlm.nih.gov/29186759/ (B)
  15. Jamilian 2018 https://pubmed.ncbi.nlm.nih.gov/29307112/ (C)
  16. Łagowska 2018 https://pubmed.ncbi.nlm.nih.gov/30400199/ (A)
  17. Li 2018 https://pubmed.ncbi.nlm.nih.gov/30538756/ (A)
  18. Nasri, 2017 https://pubmed.ncbi.nlm.nih.gov/28235206/ (B)
  19. Nordio 2019 https://pubmed.ncbi.nlm.nih.gov/31298405/ (C)
  20. Nordio 2012 https://pubmed.ncbi.nlm.nih.gov/22774396/ (C)
  21. Pizzo 2014 https://pubmed.ncbi.nlm.nih.gov/24351072/ (C)
  22. Rahmani 2017 https://pubmed.ncbi.nlm.nih.gov/27619403/ (B)
  23. Sadeghi 2020 https://pubmed.ncbi.nlm.nih.gov/30961460/ (C)
  24. Abootorabi 2018 https://pubmed.ncbi.nlm.nih.gov/29271278/ (C) 
  25. Wei 2012) https://pubmed.ncbi.nlm.nih.gov/22019891/ (C)
  26. Yang 2018https://pubmed.ncbi.nlm.nih.gov/29580250/ (A) 
  27. Zeng 2018 https://pubmed.ncbi.nlm.nih.gov/29052180/ (A)

About the Author

Stephanie Figon, MS, RDN, LD

Founder of NutriScape.NET. As a dietitian since 1992, Steph Figon has had experiences in consulting, 15 years in clinical, and has operated a private practice nutrition counseling office for since 2011. The RDNutriScape Instagram