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Are you one of the up to 20% of reproductive-aged women currently suffering from polycystic ovarian syndrome (PCOS)? PCOS is one of the most common hormonal diseases. It is a multifaceted disease with a complex set of metabolic and hormonal abnormalities, including high testosterone, failure to ovulate, and insulin resistance. This leads to wide variety of PCOS symptoms, including irregular menses, acne, abnormal hair growth, increased body mass (with weight gain around the abdomen), difficulty losing weight, and difficulty getting pregnant. In addition to infertility and obesity, the potential long-term problems associated with PCOS include type 2 diabetes, cardiovascular disease, and uterine cancer. Conventional treatment, which is centered on drug treatments including hormonal contraceptives, progestins, and metformin (a drug that increases the body’s sensitivity to insulin), is not particularly effective and is fraught with side effects.[3-5] That’s why many women have turned to PCOS natural treatment.
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PCOS Natural Treatment with NAC
N-acetyl-cysteine (NAC) is a natural variant of the amino acid L-cysteine. When taken as a supplement, NAC acts as a powerful antioxidant, mucolytic (breaks up mucus), and insulin regulator. NAC also stimulates the production of glutathione, the body’s most important detoxification compound.
NAC supplementation improves insulin levels,insulin sensitivity, ovulation, and fertility in women with PCOS[6-10] and it works as well as metformin.[7,8] Both treatments significantly improve insulin resistance and testosterone levels and the results are comparable.[7,8] They also both help to reduce menstrual irregularity, abnormal hair growth, and cholesterol. And in women with PCOS undergoing fertility treatment, NAC significantly improves ovulation and pregnancy rates and works as well as metformin for improving egg and embryo quality.[9,10] NAC is much safer and better tolerated than metformin, however.
The recommended dose of NAC is 600 mg twice a day.
Inositol for PCOS
Inositol, a natural compound belonging to the vitamin B complex, plays an important role in insulin regulation. Inositol also appears to have other actions, not related to insulin, that improve menstrual regularity in women with PCOS.
There are two forms of inositol available as supplements: myo-inositol and d-chiro-inositol. Both are capable of improving menstrual regularity and insulin resistance in PCOS patients.[11-14] D-chiro-inositol appears to be better at reducing testosterone levels, while myo-inositol may be superior for improving metabolic abnormalities such as insulin resistance. Therefore, a combination of the two forms may be better than either alone. One recent study combined relatively low doses of the two forms and found that the low-dose combination significantly improved cholesterol, triglycerides, and insulin resistance in women with PCOS.
The most common recommended dose of myo-inositol is 4 grams (4,000 mg) per day, while that of d-chiro-inositol is 1 gram (1,000 mg) a day, in divided doses. Inositol is typically taken with folic acid (400 mcg per day).
The Combination of NAC and Inositol May Be the Best PCOS Natural Treatment
Given the excellent results obtained with both NAC and inositol supplements, a group of Italian researchers recently decided to study the two in combination. They treated 91 PCOS patients, half of whom had insulin resistance, with NAC (600 mg twice a day), myo-inositol (2000 mg twice a day), and folic acid (200 mcg twice a day) for 12 months. Insulin sensitivity significantly improved in the subgroup of PCOS patients suffering from insulin resistance, while menstrual regularity and ovulation rates significantly improved in all patients, whether they had insulin resistance to begin with or not. This combination of myo-inositol, NAC, and folic acid may be even more effective than either of the two supplements alone, and the addition of 1 gram of d-chiro-inositol may provide even greater benefits.
What Else to Do for PCOS
PCOS is a complex and multifaceted disease that requires a comprehensive approach to treatment. In addition to NAC and inositol, PCOS natural treatment always involves dietary and exercise therapies, as well as other nutritional and herbal supplements. For example, a high protein/low carb diet, or a Mediterranean-style low glycemic load diet is often recommended. Acupuncture and supplementation with fish oil, vitamin D, berberine, green tea, and other herbal extracts have also been shown to treat PCOS.
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Originally published in 2015, this post has been updated.
 Intern Emerg Med. 2014 Dec 13. [Epub ahead of print]
 Acta Diabetol. 2014 Oct 15. [Epub ahead of print]
 Reprod Fertil Dev. 2014 Nov 13. [Epub ahead of print]
 Arch Gynecol Obstet. 2014 Nov 22. [Epub ahead of print]