Best Supplements for PCOS

Share this article

Listen to this article on Spotify, or watch it on YouTube.

Dealing with PCOS can be challenging due to its various complications. The choice of supplements depends on the specific problems you’re facing. In this article, we’ll explore the effectiveness of supplements for five common PCOS issues: insulin difficulties, lipid or cholesterol issues, excessive facial and body hair, fertility problems, and weight gain.

Research summary

To provide you with reliable information, I delved into extensive research papers that examined the impact of these supplements on real people. I focused solely on studies conducted on humans, excluding theories or experiments conducted only on animals or in laboratories. The goal is to present supplements backed by clear evidence of benefits in human cases.

The rankings are based on the solid evidence available for treating specific symptoms. A higher ranking doesn’t automatically mean greater effectiveness; it simply indicates more substantial proof supporting its practical use.

best-supplements-for-PCOS — Supplements with most evidence for treating PCOS.

Strong potential

Let’s discuss the supplements that show significant promise in addressing PCOS issues.

Berberine

Berberine, a compound found in various plants, holds significant promise in addressing PCOS concerns. Clinical research suggests that a daily intake of 500 mg of berberine over 3 to 6 months can positively impact multiple PCOS-related health markers. This includes improvements in blood sugar levels, insulin resistance, cholesterol levels, testosterone levels, and waist-to-hip ratio.

Remarkably, berberine exhibits similarities to metformin, a well-known diabetes medication. However, its impact on pregnancy and birth rates in women with PCOS remains uncertain. While one study indicates potential increases in clinical pregnancies and live births, another study combining berberine with letrozole shows no significant improvement in live birth rates compared to using letrozole alone.

Inositol

Inositol, a sugar alcohol found in foods like cereals and legumes, emerges as a beneficial supplement for PCOS. Myo-inositol and D-chiro-inositol, two of its forms, are commonly used together, with myo-inositol demonstrating more positive effects on various PCOS aspects.

Research highlights inositol’s ability to control blood sugar, improve fat levels, and reduce fasting insulin, testosterone, and waist-to-hip ratio when combined with folic acid. Combining inositol with metformin can enhance these outcomes. Both inositol forms also contribute to improved ovulation rates, egg quality, and pregnancy results, particularly in women under 35.

L-Carnitine

L-carnitine, a naturally occurring amino acid derivative in our bodies, plays a noticeable role in addressing PCOS challenges. Studies suggest its impact on body weight, body mass index, waist, and hip size. Additionally, L-carnitine may improve blood sugar control and insulin sensitivity.

However, its effects on fat levels, heart risk, and liver fat remain uncertain. In the realm of fertility, L-carnitine supplements may enhance ovulation and pregnancy chances, particularly for women with poor responses to conventional treatments.

Moderate potential

Let’s delve into some supplements that could be beneficial for PCOS, though they might not be as potent as the ones we discussed earlier.

CoQ10

Coenzyme Q10 (CoQ10) is a fat-soluble compound akin to vitamin K. Taking it as a supplement might aid those with PCOS by enhancing blood sugar levels, insulin sensitivity, and certain hormone levels.

Most studies used doses of 100 to 200 mg daily for 8 to 10 weeks. In a small study, it showed potential positive effects on issues like hair loss, acne, depression, anxiety, and excess hair growth.

N-acetyl cysteine

Derived from the amino acid L-cysteine, N-acetyl cysteine appears particularly useful for improving fertility in women with PCOS. Research suggests it could boost ovulation frequency, especially in those not responding well to clomiphene citrate. It may also enhance the chances of getting pregnant and having a successful birth.

However, compared to metformin, it may not be as effective for blood sugar control and insulin sensitivity.

Flaxseed & Flaxseed Oil

Flaxseed and its oils contain alpha-linolenic acid (ALA), an essential omega-3 fat. Adding them to your diet could be beneficial for individuals with PCOS experiencing issues with cholesterol and triglyceride levels.

Some research also indicates that incorporating flaxseed might support weight loss, improve insulin resistance, and enhance hormonal levels related to PCOS.

Weak potential

There are a few more options worth considering, albeit with varying levels of potential impact. These supplements can complement the effectiveness of those discussed earlier, working synergistically for better outcomes.

Chromium

Chromium, a vital trace mineral for metabolism, may offer support to women managing PCOS, especially when coupled with dietary and exercise efforts.

While it could potentially enhance ovulation frequency and menstrual regularity, its role in addressing insulin resistance remains a topic of debate in research. Some studies suggest improved insulin response, while others do not report significant changes.

Additionally, chromium’s contribution to weight loss, though present, is likely subtle.

Turmeric

Derived from turmeric, curcumin, an active antioxidant, exhibits potential benefits for individuals with PCOS. Despite its inherent potency, curcumin faces absorption challenges in the stomach. Combining it with substances like black pepper or piperine extracts can enhance its efficacy.

Research indicates positive impacts on sugar levels and insulin response. However, findings on its influence on blood fat levels vary among studies. While there is a notion of turmeric aiding weight loss, the effect is not notably pronounced.

Quercetin

Found in foods like onions, apples, berries, teas, and red wine, quercetin, a flavonoid, shows promise in supporting PCOS well-being. Limited studies suggest potential improvements in pregnancy chances, egg quality, and even support for in vitro fertilization (IVF) treatments. However, its effects on insulin response exhibit inconsistency, warranting further exploration.

Selenium

Crucial for antioxidant production, selenium plays a role in enhancing PCOS outcomes. A study involving individuals with PCOS demonstrated positive outcomes, including increased pregnancy rates, reduced excessive hair growth and acne, improved insulin sensitivity, and lower fasting blood glucose levels during IVF treatments with a daily intake of 200 mcg of selenium for 8 weeks.

Which supplements can help with PCOS?

So, you might be thinking, “How do I make sense of all this information?” Well, taking all these supplements at once might not be the most practical approach. On the flip side, picking just one may not deliver the best results. It’s essential to understand that these ratings aren’t a measure of how each supplement benefits you individually; they’re based on research supporting their use.

Here’s a straightforward suggestion: go for 2 or 3 supplements that target your specific PCOS symptoms. For example, if you’re aiming for weight loss, consider berberine and l-carnitine. If excess body hair is a concern, adding N-acetyl cysteine could be a smart move.

Now, let’s say fertility is your top priority, especially during IVF. Inositol might be your go-to supplement. If you’re open to more, throw in some folic acid to support inositol or address another concern that matters to you.

But hold on, supplements aren’t the only answer for PCOS and its symptoms. Your diet and exercise habits play a significant role and are likely to be more effective, especially for weight loss. Opting for a low-carb diet and stepping up your exercise routine can make a real difference in managing many PCOS symptoms.

In a nutshell, while supplements can help, they’re not the sole solution. This review is here to give you a solid, evidence-based foundation for choosing supplements that have proven effectiveness for PCOS. So, whether it’s weight loss, fertility, or other concerns, make informed choices based on your specific goals and needs.

Top supplement choices

Berberine (dihydro) – 2 to 4 caps / day
Berberine (generic) – 2 to 3 caps w/ meals
Berberine (Thorne) – 1 to 2 caps w/ meals
Chromium nicotinate (GTF) – 1 to 5 caps / day
Chromium picolinate – 1 to 5 caps / day
CoQ10 – 1 to 2 caps / day
CoQ10 (ubiquinol) – 1 to 2 caps / day
Flaxseed (ground) – 1 to 3 tsp w/ meals
Flaxseed (whole) – 1 to 3 tsp w/ meals
Folic acid – 1 cap / day
Folic acid (methyl) – 1 cap / day
Inositol (caps) – 2 to 4 caps / day
Inositol (powder) – 1 to 2 scoops / day
L-Carnitine (caps) – 2 to 4 caps / day
L-Carnitine (powder) – 2 to 4 scoops / day
N-acetyl cysteine – 2 to 3 caps / day
Quercetin – 1 to 2 caps / day
Turmeric (generic) – 2 to 4 caps / day
Turmeric (Meriva) – 2 to 3 caps / day

Learn more about

Citations

An Y, Sun Z, Zhang Y, Liu B, Guan Y, Lu M. The use of berberine for women with polycystic ovary syndrome undergoing IVF treatment. Clin Endocrinol (Oxf). 2014;80(3):425-431. doi:10.1111/cen.12294

Arentz S, Smith CA, Abbott J, Bensoussan A. Nutritional supplements and herbal medicines for women with polycystic ovary syndrome; a systematic review and meta-analysis. BMC Complement Altern Med. 2017;17(1):500. Published 2017 Nov 25. doi:10.1186/s12906-017-2011-x

Asemi Z, Karamali M, Esmaillzadeh A. Metabolic response to folate supplementation in overweight women with polycystic ovary syndrome: a randomized double-blind placebo-controlled clinical trial. Mol Nutr Food Res. 2014;58(7):1465-1473. doi:10.1002/mnfr.201400033

Asbaghi O, Naeini F, Ashtary-Larky D, et al. Effects of chromium supplementation on blood pressure, body mass index, liver function enzymes and malondialdehyde in patients with type 2 diabetes: A systematic review and dose-response meta-analysis of randomized controlled trials. Complement Ther Med. 2021;60:102755. doi:10.1016/j.ctim.2021.102755

Ashoush S, Abou-Gamrah A, Bayoumy H, Othman N. Chromium picolinate reduces insulin resistance in polycystic ovary syndrome: Randomized controlled trial. J Obstet Gynaecol Res. 2016;42(3):279-285. doi:10.1111/jog.12907

Badawy A, State O, Abdelgawad S. N-Acetyl cysteine and clomiphene citrate for induction of ovulation in polycystic ovary syndrome: a cross-over trial [published correction appears in Acta Obstet Gynecol Scand. 2021 Jun 23;:]. Acta Obstet Gynecol Scand. 2007;86(2):218-222. doi:10.1080/00016340601090337

Bahadur A, Arora H, Ravi AK, et al. Comparison of Clinical, Metabolic and Hormonal Effects of Metformin Versus Combined Therapy of Metformin With Myoinositol Plus D-Chiro-Inositol in Women With Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial. Cureus. 2021;13(6):e15510. Published 2021 Jun 7. doi:10.7759/cureus.15510

Chatree S, Thongmaen N, Tantivejkul K, Sitticharoon C, Vucenik I. Role of Inositols and Inositol Phosphates in Energy Metabolism. Molecules. 2020 Nov 1;25(21):5079. doi: 10.3390/molecules25215079. PMID: 33139672; PMCID: PMC7663797.

Chien YJ, Chang CY, Wu MY, Chen CH, Horng YS, Wu HC. Effects of Curcumin on Glycemic Control and Lipid Profile in Polycystic Ovary Syndrome: Systematic Review with Meta-Analysis and Trial Sequential Analysis. Nutrients. 2021;13(2):684. Published 2021 Feb 21. doi:10.3390/nu13020684

Devi N, Boya C, Chhabra M, Bansal D. N-acetyl-cysteine as adjuvant therapy in female infertility: a systematic review and meta-analysis. J Basic Clin Physiol Pharmacol. 2020;32(5):899-910. Published 2020 Nov 19. doi:10.1515/jbcpp-2020-0107

El Sharkwy I, Sharaf El-Din M. l-Carnitine plus metformin in clomiphene-resistant obese PCOS women, reproductive and metabolic effects: a randomized clinical trial. Gynecol Endocrinol. 2019;35(8):701-705. doi:10.1080/09513590.2019.1576622

Elnashar A, Fahmy M, Mansour A, Ibrahim K. N-acetyl cysteine vs. metformin in treatment of clomiphene citrate-resistant polycystic ovary syndrome: a prospective randomized controlled study. Fertil Steril. 2007;88(2):406-409. doi:10.1016/j.fertnstert.2006.11.173

Facchinetti F, Orrù B, Grandi G, Unfer V. Short-term effects of metformin and myo-inositol in women with polycystic ovarian syndrome (PCOS): a meta-analysis of randomized clinical trials. Gynecol Endocrinol. 2019;35(3):198-206. doi:10.1080/09513590.2018.1540578

Fruzzetti F, Perini D, Russo M, Bucci F, Gadducci A. Comparison of two insulin sensitizers, metformin and myo-inositol, in women with polycystic ovary syndrome (PCOS). Gynecol Endocrinol. 2017;33(1):39-42. doi:10.1080/09513590.2016.1236078

Fulghesu AM, Ciampelli M, Muzj G, et al. N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome. Fertil Steril. 2002;77(6):1128-1135. doi:10.1016/s0015-0282(02)03133-3

Gorabi AM, Abbasifard M, Imani D, et al. Effect of curcumin on C-reactive protein as a biomarker of systemic inflammation: An updated meta-analysis of randomized controlled trials. Phytother Res. 2022;36(1):85-97. doi:10.1002/ptr.7284

Heshmati J, Moini A, Sepidarkish M, et al. Effects of curcumin supplementation on blood glucose, insulin resistance and androgens in patients with polycystic ovary syndrome: A randomized double-blind placebo-controlled clinical trial. Phytomedicine. 2021;80:153395. doi:10.1016/j.phymed.2020.153395

Ismail AM, Hamed AH, Saso S, Thabet HH. Adding L-carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate. A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol. 2014;180:148-152. doi:10.1016/j.ejogrb.2014.06.008

Jamilian M, Asemi Z. Chromium Supplementation and the Effects on Metabolic Status in Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial. Ann Nutr Metab. 2015;67(1):42-48. doi:10.1159/000438465

Jamilian M, Mansury S, Bahmani F, Heidar Z, Amirani E, Asemi Z. The effects of probiotic and selenium co-supplementation on parameters of mental health, hormonal profiles, and biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome. J Ovarian Res. 2018;11(1):80. Published 2018 Sep 14. doi:10.1186/s13048-018-0457-1

Jamilian M, Zadeh Modarres S, Amiri Siavashani M, et al. The Influences of Chromium Supplementation on Glycemic Control, Markers of Cardio-Metabolic Risk, and Oxidative Stress in Infertile Polycystic ovary Syndrome Women Candidate for In vitro Fertilization: a Randomized, Double-Blind, Placebo-Controlled Trial. Biol Trace Elem Res. 2018;185(1):48-55. doi:10.1007/s12011-017-1236-3

Kamenov Z, Kolarov G, Gateva A, Carlomagno G, Genazzani AD. Ovulation induction with myo-inositol alone and in combination with clomiphene citrate in polycystic ovarian syndrome patients with insulin resistance. Gynecol Endocrinol. 2015;31(2):131-135. doi:10.3109/09513590.2014.964640

Karamali M, Gholizadeh M. The effects of coenzyme Q10 supplementation on metabolic profiles and parameters of mental health in women with polycystic ovary syndrome. Gynecol Endocrinol. 2022;38(1):45-49. doi:10.1080/09513590.2021.1991910

Karandish M, Mozaffari-Khosravi H, Mohammadi SM, Cheraghian B, Azhdari M. The effect of curcumin and zinc co-supplementation on glycemic parameters in overweight or obese prediabetic subjects: A phase 2 randomized, placebo-controlled trial with a multi-arm, parallel-group design. Phytother Res. 2021;35(8):4377-4387. doi:10.1002/ptr.7136

Khorshidi M, Moini A, Alipoor E, et al. The effects of quercetin supplementation on metabolic and hormonal parameters as well as plasma concentration and gene expression of resistin in overweight or obese women with polycystic ovary syndrome. Phytother Res. 2018;32(11):2282-2289. doi:10.1002/ptr.6166

Lucidi RS, Thyer AC, Easton CA, Holden AE, Schenken RS, Brzyski RG. Effect of chromium supplementation on insulin resistance and ovarian and menstrual cyclicity in women with polycystic ovary syndrome. Fertil Steril. 2005;84(6):1755-1757. doi:10.1016/j.fertnstert.2005.06.028

Mendoza N, Diaz-Ropero MP, Aragon M, et al. Comparison of the effect of two combinations of myo-inositol and D-chiro-inositol in women with polycystic ovary syndrome undergoing ICSI: a randomized controlled trial. Gynecol Endocrinol. 2019;35(8):695-700. doi:10.1080/09513590.2019.1576620

Mirmasoumi G, Fazilati M, Foroozanfard F, et al. The Effects of Flaxseed Oil Omega-3 Fatty Acids Supplementation on Metabolic Status of Patients with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial. Exp Clin Endocrinol Diabetes. 2018;126(4):222-228. doi:10.1055/s-0043-119751

Mousavi SM, Milajerdi A, Varkaneh HK, Gorjipour MM, Esmaillzadeh A. The effects of curcumin supplementation on body weight, body mass index and waist circumference: a systematic review and dose-response meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr. 2020;60(1):171-180. doi:10.1080/10408398.2018.1517724

Mostafa MF, Osman EA, Elkasem MMA, Seddik MI, Herdan R. The Antioxidant Effect of Selenium on Succinylcholine-related Myalgia After Adult Sinuscopies: Randomized Controlled Double-Blind Trial. Pain Physician. 2021;24(6):E743-E751.

Nordio M, Proietti E. The combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone. Eur Rev Med Pharmacol Sci. 2012;16(5):575-581.

Onakpoya I, Posadzki P, Ernst E. Chromium supplementation in overweight and obesity: a systematic review and meta-analysis of randomized clinical trials. Obes Rev. 2013;14(6):496-507. doi:10.1111/obr.12026

Oner G, Muderris II. Clinical, endocrine and metabolic effects of metformin vs N-acetyl-cysteine in women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2011;159(1):127-131. doi:10.1016/j.ejogrb.2011.07.005

Palomba S, Falbo A, Giallauria F, et al. Effects of metformin with or without supplementation with folate on homocysteine levels and vascular endothelium of women with polycystic ovary syndrome. Diabetes Care. 2010;33(2):246-251. doi:10.2337/dc09-1516

Pizzo A, Laganà AS, Barbaro L. Comparison between effects of myo-inositol and D-chiro-inositol on ovarian function and metabolic factors in women with PCOS. Gynecol Endocrinol. 2014;30(3):205-208. doi:10.3109/09513590.2013.860120

Razavi M, Jamilian M, Kashan ZF, et al. Selenium Supplementation and the Effects on Reproductive Outcomes, Biomarkers of Inflammation, and Oxidative Stress in Women with Polycystic Ovary Syndrome. Horm Metab Res. 2016;48(3):185-190. doi:10.1055/s-0035-1559604

Rezvan N, Moini A, Janani L, et al. Effects of Quercetin on Adiponectin-Mediated Insulin Sensitivity in Polycystic Ovary Syndrome: A Randomized Placebo-Controlled Double-Blind Clinical Trial. Horm Metab Res. 2017;49(2):115-121. doi:10.1055/s-0042-118705

Sacchinelli A, Venturella R, Lico D, et al. The Efficacy of Inositol and N-Acetyl Cysteine Administration (Ovaric HP) in Improving the Ovarian Function in Infertile Women with PCOS with or without Insulin Resistance [published correction appears in Obstet Gynecol Int. 2016;2016:2026056]. Obstet Gynecol Int. 2014;2014:141020. doi:10.1155/2014/141020

Samimi M, Jamilian M, Ebrahimi FA, Rahimi M, Tajbakhsh B, Asemi Z. Oral carnitine supplementation reduces body weight and insulin resistance in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Clin Endocrinol (Oxf). 2016;84(6):851-857. doi:10.1111/cen.13003

Samimi M, Zarezade Mehrizi M, Foroozanfard F, et al. The effects of coenzyme Q10 supplementation on glucose metabolism and lipid profiles in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Clin Endocrinol (Oxf). 2017;86(4):560-566. doi:10.1111/cen.13288

Sangouni AA, Pakravanfar F, Ghadiri-Anari A, Nadjarzadeh A, Fallahzadeh H, Hosseinzadeh M. The effect of L-carnitine supplementation on insulin resistance, sex hormone-binding globulin and lipid profile in overweight/obese women with polycystic ovary syndrome: a randomized clinical trial. Eur J Nutr. 2022;61(3):1199-1207. doi:10.1007/s00394-021-02659-0

Sangouni AA, Sasanfar B, Ghadiri-Anari A, Hosseinzadeh M. Effect of l-carnitine supplementation on liver fat content and cardiometabolic indices in overweight/obese women with polycystic ovary syndrome: A randomized controlled trial. Clin Nutr ESPEN. 2021;46:54-59. doi:10.1016/j.clnesp.2021.08.005

Sheida A, Davar R, Tabibnejad N, Eftekhar M. The effect of adding L-Carnitine to the GnRH-antagonist protocol on assisted reproductive technology outcome in women with polycystic ovarian syndrome: a randomized clinical trial. Gynecol Endocrinol. 2023;39(1):1878135. doi:10.1080/09513590.2021.1878135

Shen W, Qu Y, Jiang H, et al. Therapeutic effect and safety of curcumin in women with PCOS: A systematic review and meta-analysis. Front Endocrinol (Lausanne). 2022;13:1051111. Published 2022 Oct 27. doi:10.3389/fendo.2022.1051111

Tagliaferri V, Romualdi D, Immediata V, et al. Metformin vs myoinositol: which is better in obese polycystic ovary syndrome patients? A randomized controlled crossover study. Clin Endocrinol (Oxf). 2017;86(5):725-730. doi:10.1111/cen.13304

Tian H, Guo X, Wang X, et al. Chromium picolinate supplementation for overweight or obese adults. Cochrane Database Syst Rev. 2013;2013(11):CD010063. Published 2013 Nov 29. doi:10.1002/14651858.CD010063.pub2

Vaez S, Parivr K, Amidi F, Rudbari NH, Moini A, Amini N. Quercetin and polycystic ovary syndrome; inflammation, hormonal parameters and pregnancy outcome: A randomized clinical trial. Am J Reprod Immunol. 2023;89(3):e13644. doi:10.1111/aji.13644

Vargas ML, Almario RU, Buchan W, Kim K, Karakas SE. Metabolic and endocrine effects of long-chain versus essential omega-3 polyunsaturated fatty acids in polycystic ovary syndrome. Metabolism. 2011;60(12):1711-1718. doi:10.1016/j.metabol.2011.04.007

Wei W, Zhao H, Wang A, et al. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. Eur J Endocrinol. 2012;166(1):99-105. doi:10.1530/EJE-11-0616

Wu XK, Wang YY, Liu JP, et al. Randomized controlled trial of letrozole, berberine, or a combination for infertility in the polycystic ovary syndrome. Fertil Steril. 2016;106(3):757-765.e1. doi:10.1016/j.fertnstert.2016.05.022

Zadeh Modarres S, Asemi Z, Heidar Z. The effects of selenium supplementation on glycemic control, serum lipoproteins and biomarkers of oxidative stress in infertile women diagnosed with polycystic ovary syndrome undergoing in vitro fertilization: A randomized, double-blind, placebo-controlled trial. Clin Nutr ESPEN. 2022;51:92-96. doi:10.1016/j.clnesp.2022.07.017

Zhang T, He Q, Xiu H, et al. Efficacy and Safety of Coenzyme Q10 Supplementation in the Treatment of Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis. Reprod Sci. 2023;30(4):1033-1048. doi:10.1007/s43032-022-01038-2