Preliminary study indicates that Resveratrol is effective in correcting PCOS Abnormalities.

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Clinical pearls:

• Resveratrol in a dose of 1500 mg/day reduced the levels of Testosterone and DHES by 23.1% and 22.1% in a small pilot study of patients with PCOS.
• It also improved the insulin resistance and decreased serum insulin levels significantly.

Resveratrol found in grapes and red wine can help to reverse the hormonal imbalance found in women with PCOS says the results of small pilot study published online October 18,2016 in  The Journal of Clinical Endocrinology& Metabolism.

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder and affects 1 in 15 women worldwide with less than  50% of women diagnosed. [1] It is responsible for 70 percent of infertility issues in women who have difficulty ovulating, per the PCOS Foundation.[2] It has been recognized and diagnosed for 75 years. Genetic and environmental factors play a part in its causation, but the exact etiology remains unknown.

It has a multifactorial etiology that involves genetic, environmental and hormonal imbalance. Androgen excess is clearly the culprit but insulin resistance also plays a major role in its causation. 

Although large number of women with obesity have PCOS, not all obese women have PCOS. Apart from infertility, PCOS is responsible for many chronic conditions. As per NIH, women with PCOS constitute the largest group at risk for developing CVD and Type 2 DM. More than half will be diagnosed with prediabetic or diabetic before the age of 40 years. [3]

Treatment is currently directed at symptoms rather than treating the pathophysiology which remains largely unknown. Lifestyle modification, weight loss and metformin have all shown to decrease androgen, improve insulin sensitivity and bring about ovulation.

Resveratrol is an antioxidant compound found in many foods like dark chocolate, blueberries, raspberries, including peanuts and pistachio beside grapes and red wine.  It is known to have anti-inflammatory and anti-proliferative property well known to cause apoptosis in cancer cells. In 2010 a study by researchers at University of California School of Medicine, Department of Gynecology and Obstetrics, showed that in-vitro animal studies resveratrol could counteract the negative effect of insulin on ovarian cells and preventing excess proliferation of the theca interstitial ovarian cells.

The recent study is a randomized, double-blind, placebo-controlled trial that evaluated the effects of resveratrol over a period of 3 months at Department of Reproductive Medicine, University of California, San Diego, La Jolla, CA.

The study included 34 patients diagnosed with PCOS as per the Rotterdam criteria,[4] each having at least 2 of the following three clinical or chemical hyperandrogenism; oligo- or amenorrhea; and/or polycystic ovaries as viewed by transvaginal ultrasound.

All study participants were evaluated at baseline and after 3 months for BMI, hirsutism, acne score, Insulin levels, OGTT and other metabolic and endocrine abnormalities.

Participants were then randomly assigned to receive either placebo or 1500 mg/day of oral micronized transresveratrol. Over the course of the studies 3 women were lost to follow-up and one became pregnant, so the final analysis includes 15 women in each arm.

The primary endpoint of the study was changes in testosterone levels (T).

It was seen that resveratrol was significantly effective in bringing down the serum testosterone levels in the study group. Women on resveratrol experienced an average of 23.1% decline of total T levels (.53 ng/mL at baseline to 0.41 ng/ml) which was significantly more than what was observed by use of OC pills and metformin (19%)  over a 12-month period.[5] For women in placebo group no change in T levels was seen. Similarly, serum DHES levels decreased by 22.1% for women taking resveratrol (8.05 μmol/L at baseline to 6.26 μmol/L after 3 months).

Resveratrol also decreased the serum fasting insulin levels and exert a positive increase in Insulin Sensitivity Index of by 66%.

“It is apparent that resveratrol significantly reduces serum levels of T and DHEAS, suggesting an effect on ovarian as well as adrenal androgen production” the authors quoted.

In a press releases accompanying the article, the study’s senior author Dr.  Antoni J. Duleba said “Our study is the first clinical trial to find resveratrol significantly lowers PCOS patients’ levels of testosterone as well as dehydroepiandrosterone sulfate (DHEAS), another hormone that the body can convert into testosterone. This nutritional supplement can help moderate the hormone imbalance that is one of the central features of PCOS.”

He also stated the need for more studies before a recommendation can be made for its use in clinical practice.

The authors reported having no relevant conflicts of interest.

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[1] http://www.pcosfoundation.org/what-is-pcos

[2] http://www.pcosfoundation.org/about-pcos

[3] https://prevention.nih.gov/docs/programs/pcos/FinalReport.pdf

[4] Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19:41– 47

[5] Glintborg D, Altinok ML, Mumm H, Hermann AP, Ravn P, Andersen M. Body composition is improved during 12 months’ treatment with metformin alone or combined with oral contraceptives compared with treatment with oral contraceptives in polycystic ovary syndrome. J Clin Endocrinol Metab. 2014;99:2584 –2591