Nutritional Supplements and Complementary Therapies in Polycystic Ovary Syndrome

Abstract

Polycystic ovary syndrome (PCOS) affects 1 in 5 women of reproductive age, and is characterized by menstrual irregularities, clinical or biochemical hyperandrogenism, and the presence of polycystic ovary morphology. One of the recommended treatment strategies in the international evidence-based guidelines is lifestyle modification, which includes diet and exercise, with the aim of improving a range of health outcomes. The incurable nature of PCOS reinforces the importance of developing novel and innovative symptomatic relief strategies, which are currently the only available approaches for improving quality of life for these women. Women with PCOS tend to be nutrient deficient in many common vitamins and minerals, thought to be associated with the psychological (depression, anxiety, etc.) and physiological (insulin resistance, diabetes, infertility, etc.) sequelae of the condition. Nutrient supplementation and the integration of complementary medicine as adjuncts to traditional lifestyle-based therapies in PCOS could therefore provide additional benefits to these women. In this review, we synthesize the evidence regarding nutrient supplementation and complementary therapies in PCOS, predominantly from randomized controlled trials, systematic reviews, and meta-analyses, to provide an overview of the state of knowledge in this field. The evidence to date suggests that specific vitamins (B-12, inositols, folate, vitamins D, E, and K), vitamin-like nutrients (bioflavonoids and α-lipoic acid), minerals (calcium, zinc, selenium, and chromium picolinate), and other formulations (melatonin, ω-3 fatty acids, probiotics, and cinnamon), as well as some complementary approaches such as acupuncture and yoga may be beneficial in PCOS. However, there remain areas of uncertainty and key limitations in the literature that must be overcome before these therapies can be integrated into routine clinical practice.

Keywords: PCOS; complementary medicine; diet; minerals; nutraceutical; nutrition; polycystic ovary syndrome; review; supplementation; vitamins.

FIGURE 1

Putative effects of various nutritional supplements and complementary therapies on main and secondary health outcomes/risk factors associated with PCOS. Solid arrows indicate an increase or exacerbating effect on the outcome; dashed arrows indicate a decrease or diminishing effect on the outcome. α-LA, α-lipoic acid; CM, complementary medicine; CrP, chromium picolinate; CVD, cardiovascular disease; Hcy, homocysteine; Mg, magnesium; NAC, N-acetyl cysteine; PCOS, polycystic ovary syndrome; selenium, Se; zinc, Zn.