Polycystic ovarian syndrome (PCOS) is associated with irregular menstrual periods, infertility, obesity, diabetes, excess hair growth, acne, and other hormonal difficulties.

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

In a new review published last month in Medicine, researchers investigated the efficacy of omeg-3 polyunsaturated fatty acids in patients with polycystic ovarian syndrome (PCOS).

This meta-analysis consisted of 7 controlled studies including 574 participants. These studies were published between 2016 and 2020 with each study containing between 20 and 100 patients. The study duration was between 8 to 24 weeks. The research team evaluated the efficacy of omega-3 polyunsaturated fatty acids on several biomarkers in patients with PCOS.

As a result, there was a significant reduction in total cholesterol and triglyceride levels as well as a decrease in insulin resistance as measured by the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). In addition, testosterone levels were also lowered in the study group post-treatment. On the other hand, there were no notable effects seen on body mass index (BMI), fasting blood glucose, LDL cholesterol, HDL cholesterol, or Ferriman-Gallwey (mFG) scores. This study demonstrates that omega-3 polyunsaturated fatty acids can be beneficial in supporting specific metabolic markers in PCOS as they can enhance reproductive endocrine, glucose, and lipid levels.

Most individuals in general have an omega-3 fatty acid deficiency or insufficiency. These individuals will often need approximately 2 to 3 grams of EPA/DHA to have an optimal Omega-3 index.

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: Huang Y, Zhang X. Meta-analysis of the efficacy of ω-3 polyunsaturated fatty acids when treating patients with polycystic ovary syndrome. Medicine (Baltimore). 2023 Sep 29;102(39):e35403.

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