Vitamin D supplementation has no effect on insulin resistance assessment in women with polycystic ovary syndrome and vitamin D deficiency. Omega-3 fatty acid supplementation decreases liver fat content in polycystic ovary syndrome: a randomized controlled trial employing proton magnetic resonance spectroscopy. High-dose vitamin D supplementation and measures of insulin sensitivity in polycystic ovary syndrome: a randomized, controlled pilot trial. Effects of d-chiro-inositol in lean women with the polycystic ovary syndrome. Women with polycystic ovary syndrome have intrinsic insulin resistance on euglycaemic-hyperinsulaemic clamp. Effects of Chinese Green Tea on Weight, and Hormonal and Biochemical Profiles in Obese Patients With Polycystic Ovary Syndrome—A Randomized Placebo-Controlled Trial Administration of B-group vitamins reduces circulating homocysteine in polycystic ovarian syndrome patients treated with metformin: a randomized trial. Adding the phytoestrogen Cimicifugae Racemosae to clomiphene induction cycles with timed intercourse in polycystic ovary syndrome improves cycle outcomes and pregnancy rates – a randomized trial The potential implications of a PCOS diagnosis on a woman's long-term health using data linkage. Implications of Polycystic Ovary Syndrome for Pregnancy and for the Health of Offspring Selenium Supplementation and the Effects on Reproductive Outcomes, Biomarkers of Inflammation, and Oxidative Stress in Women with Polycystic Ovary Syndrome. Effects of selenium supplementation on glucose homeostasis and free androgen index in women with polycystic ovary syndrome: A randomized, double blinded, placebo controlled clinical trial. The effects of calcium-vitamin D and metformin on polycystic ovary syndrome: a pilot study. The effect of cinnamon extract on insulin resistance parameters in polycystic ovary syndrome: a pilot study. The effect of calcium and vitamin D supplementation on menstrual cycle, body mass index and hyperandrogenism state of women with poly cystic ovarian syndrome Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome. Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. A randomized controlled trial.
Insulin resistance is one of the most common features of polycystic ovary syndrome ( PCOS ) . Some studies suggest that vitamin D deficiency may have a role in insulin resistance ; thus , the aim of the current study was to determine the effect of vitamin D supplementation on insulin resistance in women with PCOS and a vitamin D deficiency . We hypothesized that vitamin D supplementation would lower the glucose level and insulin resistance in women with PCOS and a vitamin D deficiency . The current study was a r and omized , placebo-controlled , double-blinded trial with 50 women with PCOS and a vitamin D deficiency , 20 to 40 years old , assigned to receive 3 oral treatments consisting of 50,000 IU of vitamin D₃ or a placebo ( 1 every 20 days ) for 2 months ( vitamin D , n = 24 ; placebo , n = 26 ) . The fasting blood glucose , insulin , 25-hydroxyvitamin D , and parathyroid hormone levels , as well as the homeostasis model assessment of insulin resistance and quantitative insulin sensitivity check index were measured at baseline and after treatment . In the vitamin D group , the serum level of 25-hydroxyvitamin D increased ( 6.9 ± 2.8 to 23.4 ± 6.1 ng/mL , P < .0001 ) , and the parathyroid hormone level decreased ( 70.02 ± 43.04 to 50.33 ± 21.99 μ IU/mL , P = .02 ) . There were no significant changes in the placebo group . There was a significant increase in insulin secretion in the vitamin D group ( P = .01 ) , but this was not significant compared with the placebo group . The fasting serum insulin and glucose levels and the insulin sensitivity and homeostasis model assessment of insulin resistance did not change significantly by the end of the study . We were not able to demonstrate the effect of vitamin D supplementation on insulin sensitivity and insulin resistance in women with PCOS and vitamin D deficiency CONTEXT There is an association between nonalcoholic fatty liver disease ( NAFLD ) and the polycystic ovary syndrome ( PCOS ) . Marine-derived omega-3 fatty acids have favorable effects on cardiovascular risk and could reduce liver fat in NAFLD . OBJECTIVE The primary aim of this study was to examine the effects of omega-3 fatty acids on liver fat in PCOS . The secondary aim was to assess their effects on traditional cardiovascular risk factors . DESIGN AND SETTING We conducted a r and omized , crossover study at a tertiary cardiovascular research center . SUBJECTS Twenty-five women with PCOS ( mean age , 32.7 yr ; mean body mass index , 34.8 kg/m(2 ) ) participated in the study . INTERVENTION We compared 4g/d of omega-3 fatty acids with placebo over 8 wk . MAIN OUTCOME MEASURES The primary outcome measure was hepatic fat content quantified using proton magnetic resonance spectroscopy . Secondary outcome measures included fasting lipids and blood pressure . RESULTS Omega-3 fatty acids significantly decreased liver fat content compared with placebo [ 10.2 ( 1.1 ) vs. 8.4 (0.9)% ; P = 0.022 ] . There was also a reduction in triglycerides [ 1.19 ( 1.03 - 1.47 ) vs. 1.02 ( 0.93 - 1.18 ) mmol/liter ; P = 0.002 ] , systolic blood pressure [ 124.1 ( 12.1 ) vs. 122.3 ( 14.5 ) mm Hg ; P = 0.018 ] , and diastolic blood pressure [ 73.2 ( 8.4 ) vs. 69.7 ( 8.3 ) mm Hg ; P = 0.005 ] with omega-3 fatty acids compared with placebo . Omega-3 fatty acids particularly decreased hepatic fat in women with hepatic steatosis , defined as liver fat percentage greater than 5 % [ 18.2 ( 11.1 ) vs. 14.8 (9.3)% ; P = 0.03 ] . CONCLUSIONS Omega-3 fatty acid supplementation has a beneficial effect on liver fat content and other cardiovascular risk factors in women with PCOS , including those with hepatic steatosis . Whether this translates into a reduction in cardiometabolic events warrants further study OBJECTIVE To determine the effects of high-dose vitamin D on insulin sensitivity in polycystic ovary syndrome ( PCOS ) . DESIGN R and omized , placebo-controlled trial . SETTING Academic medical center . PATIENT(S ) Twenty-eight women with PCOS . INTERVENTION(S ) Vitamin D3 , 12,000 IU , or placebo daily for 12 weeks . MAIN OUTCOME MEASURE(S ) The primary outcome was quantitative insulin sensitivity check index . Secondary outcomes included glucose and insulin levels during a 75-g oral glucose tolerance test and blood pressure . RESULT ( S ) Twenty-two women completed the study . Compared with placebo , vitamin D significantly increased 25-hydroxyvitamin D ( mean [ 95 % confidence interval ] in vitamin D group 20.1 [ 15.7 to 24.5 ] ng/mL at baseline and 65.7 [ 52.3 to 79.2 ] ng/mL at 12 weeks ; placebo 22.5 [ 18.1 to 26.8 ] ng/mL at baseline and 23.8 [ 10.4 to 37.2 ] ng/mL at 12 weeks ) . There were no significant differences in quantitative insulin sensitivity check index and other measures of insulin sensitivity ; however , we observed trends toward lower 2-hour insulin and lower 2-hour glucose . We also observed a protective effect of vitamin D on blood pressure . CONCLUSION ( S ) In women with PCOS , insulin sensitivity was unchanged with high-dose vitamin D , but there was a trend toward decreased 2-hour insulin and a protective effect on blood pressure . CLINICAL TRIAL REGISTRATION NUMBER NCT00907153 OBJECTIVE To determine whether the administration of D-chiro-inositol , a putative insulin-sensitizing drug , would affect the concentration of circulating insulin , the levels of serum and rogens , and the frequency of ovulation in lean women with the polycystic ovary syndrome . METHODS In 20 lean women ( body mass index , 20.0 to 24.4 kg/m 2 ) who had the polycystic ovary syndrome , treatment was initiated with either 600 mg of D-chiro-inositol or placebo orally once daily for 6 to 8 weeks . We performed oral glucose tolerance tests and measured serum sex steroids before and after therapy . To monitor for ovulation , we determined serum progesterone concentrations weekly . RESULTS In the 10 women given D-chiro-inositol , the mean ( + /- st and ard error ) area under the plasma insulin curve after oral administration of glucose decreased significantly from 8,343 + /- 1,149 mU/mL per min to 5,335 + /- 1,792 mU/mL per min in comparison with no significant change in the placebo group ( P = 0.03 for difference between groups ) . Concomitantly , the serum free testosterone concentration decreased by 73 % from 0.83 + /- 0.11 ng/dL to 0.22 + /- 0.03 ng/dL , a significant change in comparison with essentially no change in the placebo group ( P = 0.01 ) . Six of the 10 women ( 60 % ) in the D-chiro-inositol group ovulated in comparison with 2 of the 10 women ( 20 % ) in the placebo group ( P = 0.17 ) . Systolic ( P = 0.002 ) and diastolic ( P = 0.001 ) blood pressures , as well as plasma triglyceride concentrations ( P = 0.001 ) , decreased significantly in the D-chiro-inositol group in comparison with the placebo group , in which these variables either increased ( blood pressure ) or decreased minimally ( triglycerides ) . CONCLUSION We conclude that , in lean women with the polycystic ovary syndrome , D-chiro-inositol reduces circulating insulin , decreases serum and rogens , and ameliorates some of the metabolic abnormalities ( increased blood pressure and hypertriglyceridemia ) of syndrome STUDY QUESTION What is the prevalence of insulin resistance ( IR ) and the contributions of intrinsic and extrinsic IR in women diagnosed with polycystic ovary syndrome ( PCOS ) according to the Rotterdam criteria ? SUMMARY ANSWER We report novel clamp data in Rotterdam diagnosed PCOS women , using World Health Organization criteria for IR showing that women with PCOS have a high prevalence of IR , strengthening the evidence for an aetiological role of IR in both National Institutes of Health ( NIH ) and Rotterdam diagnosed PCOS in lean and overweight women . WHAT IS KNOWN ALREADY PCOS is a complex endocrine condition with a significant increased risk of gestational diabetes and type 2 diabetes . STUDY DESIGN , SIZE , DURATION Using a cross-sectional study design , 20 overweight and 20 lean PCOS ( Rotterdam criteria ) , 14 overweight and 19 lean body mass index ( BMI ) -matched control non-PCOS women underwent clinical measures of IR after a 3-month withdrawal of insulin sensitizers and the oral contraceptive pill . MATERIAL S , SETTING , METHODS In an academic clinic setting ,  glucose infusion rate ( GIR )  on euglycaemic-hyperinsulinaemic clamp was investigated as a marker of insulin sensitivity . MAIN RESULTS AND THE ROLE OF CHANCE PCOS women were more IR than BMI -matched controls ( main effect for BMI and PCOS ; P < 0.001 ) . IR was present in 75 % of lean PCOS , 62 % of overweight controls and 95 % of overweight PCOS . Lean controls ( mean ± SD ; GIR 339 ± 76 mg min⁻¹ m⁻² ) were less IR than lean PCOS ( 270 ± 66 mg min⁻¹ m⁻² ) , overweight controls ( 264 ± 66 mg min⁻¹ m⁻² ) and overweight PCOS ( 175 ± 96 mg min⁻¹ m⁻² ) . The negative relationship between BMI and IR reflected by GIR was more marked in PCOS ( y = 445.1 - 7.7x , R² = 0.42 ( P < 0.0001 ) than controls ( y = 435.5 - 4.6x , R² = 0.04 ( P < 0.01 ) ) . LIMITATIONS , REASONS FOR CAUTION The study did not use glucose tracer techniques to completely characterize the IR , as well as the lack of matching for body composition and age . WIDER IMPLICATION S OF THE FINDINGS IR is exacerbated by increased BMI , supporting intrinsic IR in PCOS . BMI impact on IR is greater in PCOS , than in controls , irrespective of visceral fat , prioritizing lifestyle intervention and the need for effective therapeutic interventions to address intrinsic IR and prevent diabetes in this high-risk population . STUDY FUNDING /COMPETING INTEREST(S ) This investigator-initiated trial was supported by grants from the National Health & Medical Research Council ( NHMRC ) Grant number 606553 ( H.J.T. , N.K.S. and S.K.H. ) as well as Monash University and The Jean Hailes Foundation . H.J.T. is an NHMRC Research Fellow . N.K.S. is supported through the Australian Government 's Collaborative Research Networks ( CRN ) programme . A.E.J. is a Jean Hailes and NHMRC scholarship holder . The authors declare that there is no conflict of interest associated with this manuscript Objectives : To study the effects of green tea on body weight , and biochemical and hormonal profiles in obese Chinese women with polycystic ovary syndrome ( PCOS ) . Methods : Thirty-four obese Chinese women with PCOS were r and omized into either treatment with green tea capsules or placebo for 3 months . The anthropomentric measurements , and biochemical and hormonal profiles before and after treatment in each group were compared . Results : The body weight of the green tea group decreased by a nonsignificant 2.4 % after treatment ; whereas the body weight , body mass index ( BMI ) , and body fat content of the control group were significantly higher after 3 months . There were no differences in any of the hormone levels measured in either group . The biochemical profiles of the two groups were also similar except that there was a small but significant rise in the triglyceride level in the green tea group . Fewer patients in the green tea group remained amenorrhoeic , but this was not significantly different from the control group . Conclusions : Green tea supplementation did not significantly reduce body weight in obese women with PCOS , nor did it alter the glucose or lipid metabolism BACKGROUND The aim of the current study was to assess the effects of B-group vitamins and folic acid administration on serum levels of homocysteine ( Hcy ) in patients with polycystic ovarian syndrome ( PCOS ) on short-term metformin treatment . METHODS Patients were r and omly assigned to one of three treatment groups . Group 1 patients ( n = 20 ) received metformin ( 850 mg twice daily ) ; group 2 patients ( n = 20 ) received metformin ( 850 mg twice daily ) and B-group vitamins ( vitamin B1 , 250 mg ; vitamin B6 , 250 mg ; vitamin B12 , 1000 microg twice daily ) ; and group 3 patients ( n = 20 ) received metformin ( 850 mg twice daily ) and folic acid ( 174 microg twice daily ) . In all groups , lipid profiles and plasma total Hcy , vitamin B12 , folic acid and glucose levels were recorded at baseline and at 3 months . RESULTS A 26.5 % increase in Hcy levels was seen after 12 weeks of metformin therapy , while 21.17 and 8.33 % decreases in Hcy levels were detected when B-group vitamins or folic acid plus metformin were given respectively . There were no statistically significant differences recorded in insulin sensitivity using homeostasis model assessment in the three groups . CONCLUSION These findings suggest that B-group vitamins and folic acid administration counteract the Hcy-increasing effect seen with metformin therapy Abstract Background : Owing to their potential to act as estrogen receptor modulators and interfere with aromatase enzyme in animal studies , phytoestrogens ( PE ) may be useful as part of ovulation induction for polycystic ovary syndrome ( PCOS ) . Patients and methods : Patients < 35 years , presenting with infertility and PCOS , were included and r and omly allocated to either group I ( clomiphene citrate ; CC ) or group II ( CC plus Cimicifugae racemosae ; CR ) . Primary outcome was pregnancy rate . Secondary outcomes included ovulation , midcycle serum estradiol and luteinizing hormone ( LH ) as well as mid-luteal serum progesterone . Results : Analysis included 98 patients in group I versus 96 patients in group II . Both groups were matched regarding demographics and basic data . Significant differences were elicited when comparing days until HCG injection ( 15.0 ± 1.7 versus 12.0 ± 1.9 , p = 0.91 ) , endometrial thickness ( mm ) ( 8.5 ± 1.9 versus 12.5 ± 1.9 , p < 0.001 ) , serum levels of mid-luteal and midcycle estradiol ( p < 0.001 ; Figure 2 ) , LH ( IU/ml ) ( p < 0.001 ) as well as mid-luteal progesterone ( p < 0.001 ) . PE plus CC group had significantly higher clinical pregnancies per cycle ( 33/192 ( 17.2 % ) versus 71/204 ( 34.8 % ) , p < 0.01 ) , compared to the CC only group . Conclusions : Adding CR to clomiphene-induction cycles with timed intercourse in polycystic ovarian syndrome improves cycle outcomes and pregnancy rates CONTEXT The polycystic ovary syndrome ( PCOS ) is the commonest endocrine abnormality in women of reproductive age . OBJECTIVE To determine the rate of hospital admissions for women with PCOS in Western Australian population in comparison to women without PCOS . DESIGN A population -based retrospective cohort study using data linkage in a statewide hospital morbidity data base system . SETTING All hospitals within Western Australia . PARTICIPANTS A total of 2566 women with PCOS hospitalized from 1997 - 2011 and 25 660 r and omly selected age-matched women without a PCOS diagnosis derived from the electoral roll . MAIN OUTCOME MEASURES Hospitalizations by ICD-10-M diagnoses from 15 years were compared . RESULTS Hospitalizations were followed until a median age of 35.8 years ( interquartile range , 31.0 - 39.9 ) . PCOS was associated with more nonobstetric and non-injury-related hospital admissions ( median , 5 vs 2 ; P < .001 ) , a diagnosis of adult-onset diabetes ( 12.5 vs 3.8 % ) , obesity ( 16.0 vs 3.7 % ) , hypertensive disorder ( 3.8 vs 0.7 % ) , ischemic heart disease ( 0.8 vs 0.2 % ) , cerebrovascular disease ( 0.6 vs 0.2 % ) , arterial and venous disease ( 0.5 vs 0.2 % and 10.4 vs 5.6 % , respectively ) , asthma ( 10.6 vs 4.5 % ) , stress/anxiety ( 14.0 vs 5.9 % ) , depression ( 9.8 vs 4.3 % ) , licit/illicit drug-related admissions ( 8.8 vs 4.5 % ) , self-harm ( 7.2 vs 2.9 % ) , l and transport accidents ( 5.2 vs 3.8 % ) , and mortality ( 0.7 vs 0.4 % ) ( all P < .001 ) . Women with PCOS had a higher rate of admissions for menorrhagia ( 14.1 vs 3.6 % ) , treatment of infertility ( 40.9 vs 4.6 % ) , and miscarriage ( 11.1 vs 6.1 % ) and were more likely to require in vitro fertilization ( 17.2 vs 2.0 % ) . CONCLUSION PCOS has profound medical implication s for the health of women , and health care re sources should be directed accordingly OBJECTIVE : To study the influence of polycystic ovary syndrome ( PCOS ) on obstetric and perinatal outcomes and on offspring in childhood . METHODS : Using statewide data linkage systems within Western Australia , 2,566 hospitalized women with a PCOS diagnosis and at least one pregnancy at 20 weeks of gestation or greater , between 1997 and 2011 , were compared with 25,660 r and omly selected age-matched women not hospitalized with a PCOS diagnosis with regard to perinatal outcomes , congenital anomalies , and general health of offspring . Hospitalizations were categorized by International Classification of Diseases , 10th Revision diagnoses and rates by 10 years by Kaplan-Meier estimates . Polycystic ovary syndrome effects were summarized using adjusted odds ratios ( ORs ) and hazard ratios ( HRs ) with 95 % confidence intervals ( CIs ) after controlling for maternal and perinatal characteristics , including maternal diabetes and obesity . RESULTS : Of women with PCOS ( n=1,789 ) , 69.7 % and 62.9 % ( n=16,139 ) of women without PCOS had one or more births . Hospitalizations up to 31 years were examined for 38,361 offspring . Offspring of women with PCOS were at higher risk of preterm birth ( 15.5 % compared with 7.6 % OR 1.74 , 95 % CI 1.53–1.98 ) , perinatal mortality ( 2.3 % compared with 0.7 % , OR 1.49 , 95 % CI 1.02–2.18 ) , more postnatal hospitalizations ( 14.1 % compared with 7.9 % , OR 1.21 , 95 % CI 1.05–1.40 ) , more congenital anomalies ( 6.3 % compared with 4.9 % , OR 1.20 , 95 % CI 1.03–1.40 ) , cardiovascular ( 1.5 % compared with 1.0 % , OR 1.37 , 95 % CI 1.01–1.87 ) , and urogenital defects ( 2.0 % compared with 1.4 % OR 1.36 , 95 % CI 1.03–1.81 ) . Maternal PCOS was associated with increased hospitalizations for their offspring , including metabolic disorder ( 7.9 % compared with 5.3 % , HR 1.43 , 95 % CI 1.26–1.65 ) , disease of the nervous system ( 9.4 % compared with 6.9 % , HR 1.17 , 95 % CI 1.03–1.33 ) , and asthma ( 6.9 % compared with 4.9 % , HR 1.32 , 95 % CI 1.13–1.54 ) . CONCLUSION : Controlling for increased perinatal risk , maternal PCOS was associated with a predisposition to adverse health outcomes for their offspring . LEVEL OF EVIDENCE : Selenium supplementation could be effective on reproductive outcomes , biomarkers of inflammation , and oxidative stress among women with polycystic ovary syndrome ( PCOS ) . The aim of the study was to determine the effects of selenium supplementation on reproductive outcomes , biomarkers of inflammation , and oxidative stress in PCOS patients . The present r and omized double-blind , placebo-controlled trial was conducted on 64 women aged 18 - 40 years old with PCOS at the clinic affiliated to Ardabil University of Medical Sciences , Ardabil , Iran . The participants were r and omly assigned to 2 groups receiving either 200 μg selenium daily ( n=32 ) or placebo ( n=32 ) for 8 weeks . Hormonal profiles , biomarkers of inflammation , and oxidative stress were measured and compared both before and after the treatment . After 8 weeks of intervention , pregnancy rate in the selenium group was higher than in the placebo group : 18.8 ( 6/32 ) vs. 3.1 % ( 1/32 ) , p=0.04 . In addition , alopecia ( 40.6 vs. 9.4 % , p=0.004 ) and acne ( 46.9 vs. 12.5 % , p=0.003 ) decreased following the consumption of selenium supplements compared with placebo . Additionally , patients who received selenium supplements had significantly decreased serum dehydroepi and rosterone ( DHEA ) levels ( p=0.02 ) , hirsutism ( modified Ferriman-Gallwey scores ) ( p<0.001 ) , serum high sensitivity C-reactive protein ( hs-CRP ) ( p=0.02 ) , and plasma malondialdehyde ( MDA ) levels ( p=0.01 ) compared with placebo . We did not observe any significant effects of taking selenium supplements on other hormonal profiles , nitric oxide ( NO ) , and other biomarkers of oxidative stress . Taken together , selenium supplementation for 8 weeks among PCOS women had beneficial effects on reproductive outcomes , DHEA , hs-CRP , and MDA levels . Supporting Information for this article is available online at http://www.thieme-connect.de/products BACKGROUND / OBJECTIVES Insulin resistance ( IR ) is a main pathophysiologic feature in polycystic ovary syndrome ( PCOS ) patients which is triggered by elevated oxidative stress in these patients . Selenium , an essential micronutrient , is a major constituent of antioxidant enzymes such as glutathione peroxidase . Recently , decreased plasma selenium concentrations were reported in PCOS patients . So , the present study was carried out in order to assess whether selenium consumption can improve the metabolic response to insulin and reduce the insulin resistance in these women . SUBJECTS/ METHODS A total of 53 PCOS patients ( diagnosed by Rotterdam criteria ) , 18 - 42 years old , participated in this r and omized , double-blind and placebo controlled trial for 12 weeks ( selenium , n=26 ; placebo , n=27 ) . The effects of daily administration of 200 μg selenium or placebo on serum glucose , total testosterone ( tT ) , sex hormone binding globulin ( SHBG ) and free and rogen index ( FAI ) in fasting state were evaluated . RESULTS At the end of the study , insulin resistance was significantly increased in selenium recipients when compared with the placebo group ( 2.05 ± 0.39 when compared with 1.81 ± 0.25 , p=0.017 ) . Also , selenium supplementation result ed in marginally significant increase ( p=0.056 ) in insulin level when compared with the placebo group . There were no statistically significant changes in other study endpoints , when comparing the two groups . CONCLUSION This study showed that selenium supplementation in PCOS patients may worsen insulin resistance in them . Until the results of larger studies become available , indiscriminate consumption of selenium supplements in PCOS patients will warrant caution OBJECTIVE The aim of this study was to evaluate the effects of calcium-vitamin D and metformin on the menstrual cycle and ovulation in patients with polycystic ovary syndrome ( PCOS ) . MATERIAL S AND METHODS In this pilot study , 60 infertile PCOS patients were enrolled in a r and omized clinical trial and divided into three equal groups . Group 1 received 1,000 mg of calcium and 400 IU of vitamin D per day , orally . Group 2 received the same as Group 1 , plus 1,500 mg/day of metformin . Group 3 received 1,500 mg/day of metformin . The patients were treated for 3 months and followed up for a further 3 months . Regularity of menses , number of large follicles ( > or = 14 mm ) and pregnancy rates were compared among the three groups . RESULTS Generalized estimating equation tests showed that the number of dominant follicles ( > or = 14 mm ) during the 2 - 3 months of follow-up was higher in the calcium-vitamin D plus metformin group than in either of the other two groups ( p = 0.03 ) . CONCLUSION The effects of metformin and calcium-vitamin D in regulating the menstrual cycle suggest that they could also be effective for the treatment of anovulation and oligomenorrhea , with possible consequences for pregnancy rates in PCOS patients Cinnamon extract has been shown to reduce insulin resistance in in vitro and in vivo studies by increasing phosphatidylinositol 3-kinase activity in the insulin signaling pathway and thus potentiating insulin action . Fifteen women with polycystic ovary syndrome ( PCOS ) were r and omized to daily oral cinnamon and placebo for 8 weeks . Comparisons of post-treatment to baseline insulin sensitivity indices using fasting and 2-hour oral glucose tolerance tests showed significant reductions in insulin resistance in the cinnamon group but not in the placebo group . A larger trial is needed to confirm the findings of this pilot study and to evaluate the effect of cinnamon extract on menstrual cyclicity Background : Poly cystic ovary syndrome ( PCOS ) is considered one of the most common endocrine disorders of women in reproductive age . The aim of this study was evaluating the efficacy of calcium and Vitamin D supplementation on the regularity of menstrual cycles , body mass index ( BMI ) and hyper and rogenism state of women with PCOS . Material s and Methods : In this clinical trial , 80 women with PCOS were evaluated . They r and omly located in four groups receiving metformin ( group 1 ) , metformin plus calcium and Vitamin D ( group 2 ) , calcium and Vitamin D ( group 3 ) and placebo ( group 4 ) for 4 months . BMI , regularity of menstrual cycles , hyper and rogenism ( hirsutism and acne ) and serum calcium and Vitamin D levels were compared in four study ing groups at baseline and 4 months after the trial . Results : All studied subjects were similar at baseline ( P > 0.05 ) . After trial , the frequency of hirsutism and acne were not different among groups . Frequency regular menstrual cycle and dominant follicle were significantly higher in group 1 and 2 than others ( P < 0.05 ) . After trial , there was no significant difference with respect to BMI among groups . Conclusion : Vitamin D and calcium supplementation in addition to metformin therapy in women with PCOS could result in a better outcome in a variety of PCOS symptoms including menstrual regularity , and ovulation BACKGROUND The polycystic ovary syndrome is a common cause of infertility . Clomiphene and insulin sensitizers are used alone and in combination to induce ovulation , but it is unknown whether one approach is superior . METHODS We r and omly assigned 626 infertile women with the polycystic ovary syndrome to receive clomiphene citrate plus placebo , extended-release metformin plus placebo , or a combination of metformin and clomiphene for up to 6 months . Medication was discontinued when pregnancy was confirmed , and subjects were followed until delivery . RESULTS The live-birth rate was 22.5 % ( 47 of 209 subjects ) in the clomiphene group , 7.2 % ( 15 of 208 ) in the metformin group , and 26.8 % ( 56 of 209 ) in the combination-therapy group ( P<0.001 for metformin vs. both clomiphene and combination therapy ; P=0.31 for clomiphene vs. combination therapy ) . Among pregnancies , the rate of multiple pregnancy was 6.0 % in the clomiphene group , 0 % in the metformin group , and 3.1 % in the combination-therapy group . The rates of first-trimester pregnancy loss did not differ significantly among the groups . However , the conception rate among subjects who ovulated was significantly lower in the metformin group ( 21.7 % ) than in either the clomiphene group ( 39.5 % , P=0.002 ) or the combination-therapy group ( 46.0 % , P<0.001 ) . With the exception of pregnancy complications , adverse-event rates were similar in all groups , though gastrointestinal side effects were more frequent , and vasomotor and ovulatory symptoms less frequent , in the metformin group than in the clomiphene group . CONCLUSIONS Clomiphene is superior to metformin in achieving live birth in infertile women with the polycystic ovary syndrome , although multiple birth is a complication . ( Clinical Trials.gov number , NCT00068861 [ Clinical Trials.gov ] . ) Hirsutism in polycystic ovarian syndrome ( PCOS ) , consequent to elevated and rogen levels leads to significant cosmetic and psychological problems . Recent research in Turkey has shown that spearmint tea has anti and rogenic properties in females with hirsutism . No research has yet been undertaken to assess whether a reduction in and rogen levels brought about by spearmint tea , translates to a clinical improvement in the degree of hirsutism . This study was a two centre , 30 day r and omized controlled trial . Forty two volunteers were r and omized to take spearmint tea twice a day for a 1 month period and compared with a placebo herbal tea . At 0 , 15 and 30 days of the study serum and rogen hormone levels and gonadotrophins were checked , the degree of hirsutism was clinical ly rated using the Ferriman-Galwey score and a question naire ( the modified DQLI = Dermatology Quality of Life Index ) was used to assess improvements in the level of self-reported hirsutism .  Forty one of 42 patients completed the study .  Free and total testosterone levels were significantly reduced over the 30 day period in the spearmint tea group ( p < 0.05 ) . LH and FSH also increased ( p < 0.05 ) . Patient 's subjective assessment s of their degree of hirsutism scored by the modified DQLI were significantly reduced in the spearmint tea group ( p < 0.05 ) . There was , however , no significant reduction in the objective Ferriman-Galwey ratings of hirsutism between the two trial groups over the trial duration ( p = 0.12 ) . There was a clear and significant alteration in the relevant hormone levels . This is associated clinical ly with a reduction in the self-reported degree of hirsutism but unfortunately not with the objective ly rated score . It was demonstrated and confirmed that spearmint has anti and rogen properties , the simple fact that this does not clearly translate into clinical practice is due to the relationship between and rogen hormones and follicular hair growth and cell turnover time . Simply put , the study duration was not long enough . The original studies from Turkey were in fact only 5 days long . The time taken for hirsutism to resolve is significant and a much longer future study is proposed as the preliminary findings are encouraging that spearmint has the potential for use as a helpful and natural treatment for hirsutism in PCOS
Background Polycystic ovary syndrome ( PCOS ) is a common , reproductive endocrinopathy associated with serious short and long term health risks .
Many women with PCOS use ingestible complementary medicines .
This systematic review examined the effect on menstrual regulation and adverse effects from r and omised controlled trials .