Polycystic Ovarian Syndrome (PCOS) affects 10 percent of the female population, according to Samantha Bullock, author of the article “Phytotherapy for Polycystic Ovarian Syndrome.” The androgen testosterone is found at higher levels in women with PCOS than those without. Ruth Trickey, author of the book, “Women, Hormones, and the Menstrual Cycle,” communicates that testosterone levels are directly correlated to the abnormally high insulin levels in these women. Consequently, complications of the disease can cause diabetes, increases the rates of cardiovascular disease and endometrial cancer, and impair fertility in affected women.
Goat’s rue, known more formally as Galega officinalis is the original source of the substance guanidine. Guanidine is the active ingredient in anti-diabetic drug class known as biguanides. Metformin, a drug belonging to the biguanide medication group, is commonly prescribed to women with PCOS. By controlling chronically high blood sugar levels, balancing insulin levels, and encouraging fat loss, Metformin consequently affects the levels of testosterone in women. The article, “Metformin,” published by Clifford Bailey, Ph.D., in the New England Journal of Medicine, details that goat’s rue was used to synthesize drugs like Metformin in the 1920’s, but Trickey notes that it is still used by traditional herbalists today.
Ruth Trickey, in her chapter on herbs, tells of the many roles the Chinese herb, Peonia lactiflora plays in the treatment of gynecological conditions. Although frequently used and studied in China and Japan as an ingredient in complex traditional Chinese formulas, much of the herbs biological influence has been attributed to the constituent, paeoniflorin. Paeoniflorin is able to reduce levels of androgens, in a dose dependent manner, explains Trickey. By reversing the body’s inhibition aromotase activity, in fat cells, the ovaries and hair follicles, peony can reduce the visible and systemic effects of excess testosterone. The aromatase enzyme is responsible for converting androgens into estrogens. It is widely distributed around the body, so by stimulating the activity of this enzyme, androgen levels are reduced and estrogen levels are increased. This can prove helpful in women with PCOS, as they are known to have lower than normal levels of estrogens as well.
Licorice belongs to a group of herbs known as adaptogens. They are herbs used during times of increased stress or convalescence to help the body cope with extreme changes, confers Trickey. The effects of licorice in the body are diverse and include: antibacterial, anti-viral, demulcent or soothing qualities, antioxidant, and cholesterol and blood pressure-lowering. Glycerrhiza glabra, its more formal name, also mimics the action of cortisol in the body. Licorice has been combined with peony in a clinically studied formula that demonstrated testosterone-lowering and ovulation-inducing effects in women with PCOS. The study was published in the March/April 1994 issue of the International Journal of Fertility and Menopausal Studies, K. Takahashi. Both Trickey and Bullock discuss this formula in their resources. It is important to note that long-term use of licorice may result in elevation of blood pressure, fluid retention, and potassium depletion. Trickey cautions its use in people with high blood pressure.
Ruth Trickey discusses the uses of saw palmentto in the treatment of a few different androgen-dominant conditions. The conditions include androgenic alopecia, benign prostatic hypertrophy (BPH) in men, and hirsuitism in females. Hirsuitism is a common symptom of PCOS. Facial hair growth is a normal secondary sexual characteristic in males, but in a woman, it results from having abnormally high testosterone levels. Saw palmetto blocks the conversion of testosterone into its more intensely stimulating byproduct, dihydrotestosterone (DHT). Additionally, Serenoa inhibits the action of the requisite enzyme in the conversion of testosterone from its precursor hormone, androstenedione.