How To Use Berberine for PCOS Treatment

If you are wondering how to use Berberine for PCOS treatment, we’ve got you covered. Berberine has been shown to have positive health benefits for women with PCOS. In this article, we will discuss what PCOS is and how Berberine can help as a natural support.

What is PCOS or Polycystic Ovary Syndrome?

PCOS stands for Polycystic Ovary Syndrome and is a hormonal condition that affects the menstrual cycles and ovarian function in women. It affects 5-10% of women.

It is characterized by an imbalance of hormones and often metabolism. Specifically we see 2 important characteristics:

high levels of androgens (testosterone/DHT/DHEA) or increased sensitivity to androgens. These high androgen levels can be associated with acne and excess facial and body hair growth. High testosterone can lead to various symptoms such as irregular menstrual cycles, weight gain, and difficulty conceiving.
higher levels of insulin or reduced effectiveness of insulin at balancing blood sugar levels in the blood, and this is known as insulin resistance.

These two important hormonal imbalances in PCOS can lead to an increased risk for other health conditions such as metabolic syndrome, high blood pressure, diabetes and heart disease.

Other symptoms that women with polycystic ovary syndrome experience can include:

irregular periods, often quite long time intervals between periods and often a lack of ovulatory cycles.
difficulty conceiving
high anti-mullerian hormone (AMH) and
multiple follicles visible on ultrasound scan which is known as polycystic ovaian morphology and is where the name of the condition originates from.

What is Berberine?

Berberine is a natural plant alkaloid found in a number of plants such as goldenseal, barberry, Oregon grape, and the rhizomes of Coptis chinensis. People have been using it for a long time as herbal medicine in traditional Chinese medicine and in other countries such as Iran, due to it's many health benefits. It has been used to fight infections, aid digestion, and treat skin conditions (Berberine: Traditional Uses 2018).

Currently scientists are taking a closer look at berberine's potential role in managing polycystic ovary syndrome (PCOS). Berberine has shown promise in addressing some of these symptoms.

Studies have found that berberine may help improve insulin sensitivity, which is crucial for managing PCOS. By enhancing insulin sensitivity, berberine lowers blood glucose (Berberine: A Promising Therapeutic Approach to PCOS 2023). This may help regulate menstrual cycles and reduce the risk of developing type 2 diabetes and other metabolic conditions that are associated with PCOS.

Berberine's ability to modulate hormone levels and support weight management makes it an attractive option for women with PCOS. Hormonal imbalances, particularly elevated levels of testosterone, are common in PCOS and can contribute to symptoms like excess hair growth and acne. Berberine may help restore hormonal balance, leading to improvements in these symptoms.

How Can Berberine Help With PCOS?

Berberine has been studied for its effects on PCOS. It has been shown to have multiple health benefits for women with this condition.

Let's break down the benefits of berberine in women with PCOS:

Balancing Hormones

Berberine has been found to regulate levels of insulin, testosterone, and therefore allowing better cyclical production of estrogen and progesterone. In particular regarding testosterone, berberine appears to:

reduce testosterone and free androgen index (FAI),
increase sex hormone binding globulin (SHBG), and
attenuate the clinical symptoms of androgen excess, including excess facial/body hair (hirsutism) and acne (Berberine in PCOS 2023).

Improving Insulin Sensitivity

Berberine enhances insulin sensitivity and improves glucose metabolism, leading to better blood sugar control. This can help reduce the risk of developing type 2 diabetes and metabolic syndrome (Glucose-lowering effect of berberine on type 2 diabetes 2022).

Improving Ovulation for Fertility

Improved insulin sensitivity supports optimal ovary function. Insulin resistance interferes with ovulation. Insulin sensitivity supports ovulation, making it easier for your ovaries to release an egg each month, which is important if you're trying to get pregnant.

By improving ovulation, it increases your chances of having a baby. Berberine can increase ovulation by 22% in one study which was not as good as letrozole, a fertility medication, but was still a good improvement (RCT: Letrazole and Berberine on fertility in PCOS 2016).

Berberine is also as effective as metformin when used alongside IVF for pregnancy rates, improving metabolism and reducing ovarian hyperstimulation (Berberine, PCOS and IVF).

Improving Ovulation for Overall Health

For women not trying to conceive, having a regular period is important for the health of the uterus, mood, sleep, bone health and cardiovascular health.

In women with PCOS who have have chronic anovulation (no ovulation), berberine has been used and found to be effective in a pilot study to reduce insulin resistance to the restoration of regular periods and ovulation.

Fourteen percent of women regained ovulatory cycles after 4 months of treatment regardless of weight. Overall 25 percent of cycles became ovulatory (Berberine, Menstrual Patterns, Ovulation, Hormones & Metabolism in Anovulatory Women with PCOS 2015).

Reducing Belly Fat

Berberine may have health benefits for helping move fat away from your belly. The medical term is visceral fat as it surrounds your abdominal organs (viscera). A summary of randomized controlled trials showed that berberine use:

promoted weight loss,
reduced BMI
reduced waist circumference, and
reduced c-reactive protein (CRP) a marker of inflammation (Berberine and Obesity 2020).

Even if you don't lose weight overall, berberine can still help make your belly fat go down, which is associated with reduced risk of metabolic diseases (Berberine vs Metformin on Metabolism in PCOS 2012).

Improved Cholesterol Levels

Berberine may also help improve cholesterol levels. It is associated with lower LDL cholesterol and triglycerides and higher HDL cholesterol in women (Berberine For Dyslipidemia 2023).

Supports Gut Health

Berberine may also have antimicrobial and anti-inflammatory properties, making it beneficial for gut health. It appears that berberine itself is poorly absorbed by into the body (Berberine Update 2015).

Gut bacteria metabolise berberine and the metabolites appear to be the substances that have beneficial impacts on gut health.

Reducing Fatty Liver Disease

Fatty liver disease is another metabolic condition associated with PCOS. Berberine has been shown to improve fatty liver disease by reducing inflammation and improving insulin sensitivity (Berberine For Fatty Liver Disease 2016).

Delaying or preventing fatty liver disease is important to reduce the risk of developing more serious liver conditions such as cirrhosis.

The Science Behind Berberine for PCOS

Clinical studies and research have provided evidence of berberine's effectiveness in addressing various aspects of PCOS.

Berberine Improves Glucose Metabolism By Multiple Pathways

It increases the sensitivity of insulin receptors (InsR), which enhances uptake of glucose into cells.
It activates adenosine monophosphate-activated protein kinase (AMPK) in muscle and fat cells. This is a key regulator of cellular energy metabolism, which helps improve insulin sensitivity and glucose uptake in cells.
It up-regulates the expression of GLUT-4 receptor - the receptor that glucose binds to and transports glucose into fat and muscle cells for use.
Berberine reduces glucose absorption in the gut by inhibiting an enzyme (𝛼-Glucosidase) that breaks down sugars.

Berberine Also Influences Lipid Metabolism

It increases fatty acid oxidation or breakdown of fatty acids for utilisation in cells (Berberine and Obesity 2020).

How to Use Berberine for PCOS?

Incorporating berberine into your PCOS management plan can be helpful, but it's important to do it carefully and under the guidance of a healthcare professional.

The recommended dosage of berberine which have been used in research studies for PCOS typically ranges from 500 mg to 1500 mg per day, divided into two to three doses. Here are some tips on how to use berberine safely and effectively:

Start With a Low Dose

It's a good idea to begin with a low dose of berberine, such as 500 milligrams per day. This helps your body get used to the supplement and reduces the risk of side effects.

Gradually Increase the Dosage

After starting with a low dose, you can gradually increase the amount of berberine you take.

You might increase it to 1000 milligrams per day, divided into two doses. Some people may need up to 1500 milligrams per day, but it's essential to increase the dosage slowly to avoid side effects.

Divide the Dose

Taking berberine in divided doses throughout the day can help reduce the risk of stomach upset.

Monitor for Side Effects

While berberine is generally safe for most people, it can cause side effects in some individuals. As berberine is poorly absorbed and is actively metabolised by your gut bacteria, common side effects include stomach discomfort, such as diarrhea, constipation, or nausea.

If you experience any of these side effects, you may need to reduce your dose or stop taking berberine and discuss with your health professional.

Consider Potential Interactions

Berberine can interact with certain medications, including blood thinners, cholesterol-lowering drugs, glucose-lowering medications such as those used for diabetes and medications metabolized by the liver. It's essential to talk to your doctor before starting berberine if you're taking any medications to avoid potential interactions.

Be Patient

It may take some time to see the effects of berberine on your PCOS symptoms. A typical menstrual cycle is 4 weeks so change to hormones and periods takes time. Many studies used for weight change or cholesterol change are at least 90 days long.

By following these tips and working closely with your healthcare provider, you can safely incorporate berberine into your PCOS management plan and potentially experience improvements in your symptoms and overall well-being.

Combine Berberine With Lifestyle Changes

Berberine is a supplement - and as such it should supplement your health habits. Combined berberine with healthy lifestyle changes that will support your body maintain homeostasis or balance. Lifestyle changes that support homeostasis include:

a balanced diet, which for some women with PCOS, may be a low-carb diet to support their insulin and glucose metabolism.
regular exercise or movement, and
mind-body practices to reduce stress,
restful sleep.

These lifestyle modifications can enhance the effectiveness of berberine in managing PCOS symptoms.

Specifically, randomized control trials show that berberine and lifestyle changes improved cholesterol and HBA1C (a measure of diabetes) better than lifestyle changes alone (Meta-analysis: berberine for diabetes, hyperlipemia and hypertension 2015).

Top Supplements for PCOS

Key Points About Berberine and PCOS

Berberine shows promise as a natural supplement for managing PCOS symptoms by:

improving insulin sensitivity,
reducing testosterone,
improving menstrual cycle +hormonal balance and therefore ovulation,
reducing cholesterol and
supporting weight management and healthy body composition changes.

It's essential to approach its use cautiously and under the guidance of a healthcare professional.

By incorporating berberine into a comprehensive PCOS treatment plan that includes lifestyle modifications and medical interventions, women with PCOS can take proactive steps towards better health and well-being. Remeber - change takes time.

Dr Deborah Brunt is a menopause doctor at Rebelle Health and would love to support you through the perimenopause and menopausal stages, supporting all aspects of your health and wellbeing.

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