Polycystic ovarian syndrome (PCOS) is associated with irregular menstrual periods, infertility, obesity, diabetes, excess hair growth, acne, and other hormonal difficulties. Researchers compared the effects of lifestyle changes alone or with placebo to lifestyle combined with metformin. They found that lifestyle modification combined with taking metformin resulted in increased weight loss. As a result, there was a lower body mass index (BMI), and improved menstruation.

In a new study published last week in Reproductive Biology and Endocrinology, researchers investigated the effects of abnormal uterine bleeding, alopecia, quality of life, and acne in women with PCOS.

Pharmaceutical interventions provide some improvements but they do not correct many of the underlying factors and have side effects that may not be tolerated by patients. Many PCOS patients are overweight and have dietary habits that exacerbate the condition.

This randomized clinical trial included sixty-four women with PCOS assigned to take 250 mg of magnesium supplementation per day or placebo over a 10-week period. Abnormal uterine bleeding, alopecia, quality of life, and acne were assessed by the International Federation of Gynecology and Obstetrics criteria, the Sinclair Scale, the Health Survey Quality of Life Questionnaire, and the Global Acne Grading System.

As a result, magnesium supplementation significantly improved the quality of life including physical functioning, energy, fatigue, emotional wellbeing, social functioning, general health, and total quality of life compared to the placebo. No significant effects were observed on acne, alopecia, or abnormal uterine bleeding.

This study demonstrates that magnesium supplementation in women with PCOS has a significant positive effect on improving overall quality of life. Since magnesium is a coenzyme of more than 300 enzymes in the body as well as many chemical reactions require sufficient magnesium level, it is not surprising for optimal health the body depends on adequate intake of magnesium.

Other nutrients to consider to support PCOS:

Studies have shown that an inositol deficiency is common in women with PCOS. There appears to be a reduced ability to process, metabolize, and effectively use inositol from foods which is a distinctive characteristic feature of PCOS. As a result, the nutritional requirements of PCOS patients may not be met by a simple change in the diet and that inositol should be viewed as a conditionally essential nutrient in these women.

Myo-inositol and D-chiro-inositol are both essential for patients with PCOS. The conversion of myo-inositol to D-chiro-inositol is of interest because errors here have been strongly involved in PCOS patients. Strong evidence supports that the body makes D-chiro-inositol from myo-inositol and more evidence suggests that some people are less able to make this conversion than others.  Along this spectrum, people who are completely unable to convert myo-inositol to D-chiro-inositol are only going to benefit from supplementation with D-chiro-inositol. Other people who make the conversion, but with less than optimal efficiency, may benefit from large doses of myo-inositol. And, other individuals in between, might see the best results from a blend of the two. Since this conversion is impaired in individuals with PCOS, it is important to always include D-chiro-inositol with myo-inositol supplementation. D-chiro-inositol is the more potent form of inositol for supporting insulin resistance, however, myo-inositol is need for oocyte quality and maturation. Therefore, supplementing with D-chiro-inositol alone cannot not fulfill myo-inositol’s roles that are specific and different from D-chiro-inositol, since it does not convert to myo-inositol.

Also, essential fatty acids should be consumed in our diets for overall health, but most individuals with insulin resistance are deficient. Fish oils improve insulin sensitivity and reduce inflammation. 

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Jaripur M, Ghasemi-Tehrani H, et al. The effects of magnesium supplementation on abnormal uterine bleeding, alopecia, quality of life, and acne in women with polycystic ovary syndrome: a randomized clinical trial. Reprod Biol Endocrinol. 2022 Aug 2;20(1):110.

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