Dietary supplementation could reduce consequences of complex ovarian syndrome

Polycystic ovary syndrome (PCOS) is one of the most common endocrine (hormone system-related) diseases. Altered sex hormone levels and dysfunction of the ovaries are characteristic of PCOS. The altered hormonal status can mean that the ovaries are unable to release functional and mature follicles (follicles with egg cells maturing inside). As a result, infertility is common in PCOS patients.

Previous clinical studies of N-acetylcysteine ​​(NAC) supplementation and its effects on ovulation and sex hormone profile in women with PCOS have yielded conflicting results and have been controversial. Therefore, scientists have now carried out a systematic review with meta-analysis on possible NAC effects in PCOS.

What is the use of N-acetylcysteine ​​(NAC) in polycystic ovary syndrome?

The systematic research and meta-analysis focused on the influence of NAC supplementation on ovulation and the sex hormone profile in women with PCOS. The authors identified relevant studies from the medical science databases PubMed, Scopus, Embase, Web of Science and Cochrane Central library. Publications up to September 2021 were considered for the analysis.

The search yielded 18 studies with a total of 2185 patients. NAC supplementation significantly reduced total testosterone levels:

• Standardized Mean Difference (SMD): -0.25 ng/mL; 95% confidence interval, CI: -0.39 – -0.10; p<0.001; I2 = 53.9%; p=0.034

In addition, an increase in follicle-stimulating hormone (FSH) could be determined with the supplementation:

• SMD: 0,39 mg/ml; 95 % KI: 0,07 – 0,71; p = 0,01; I2 = 70,9 %; p = 0,002

After correcting for a publication bias, estrogen levels also increased. However, the number of follicles, endometrial thickness, progesterone levels, and levels of serum luteinizing hormone and sex hormone-binding globulins were not affected by the supplementation.

Dietary supplementation with NAC improves some aspects of PCOS

The results of this meta-analysis thus show that dietary supplementation with NAC can influence part of the disease processes in PCOS. Thus, testosterone levels were lowered and FSH levels increased. Supplementation could therefore make an additional contribution to the reproductive system in PCOS.

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Those: Shahveghar Asl Z, Parastouei K, Eskandari E. The effects of N-acetylcysteine on ovulation and sex hormones profile in women with polycystic ovary syndrome: a systematic review and meta-analysis. Br J Nutr. 2023 Jan 4:1-9. doi: 10.1017/S0007114522003270. Epub ahead of print. PMID: 36597797.

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