Resveratrol Improves PCOS Menstrual Cycles

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Resveratrol improves PCOS menstrual cycles

Effect of resveratrol on menstrual cyclicity, hyperandrogenism and metabolic profile in women with PCOS

doi.org/10.1016/j.clnu.2021.02.004

Background

A recent review of Resveratrol suggested that supplementation could decrease androgen production and improve ovarian function.

In clinical trials, resveratrol reduced levels of total testosterone (TT) and dehydroepiandrosterone sulfate (DHEA-S) n women with PCOS, along with gene expression of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1 (HIF).

However both of these studies were small in sample size and of limited duration.

Aim

To establish the efficacy of 3-month resveratrol treatment on the endocrinological and metabolic status of women with PCOS.

Methodology

Women with PCOS were recruited from 3 hospitals across between August 2017 and July 2018. To minimise confounding factors the exclusion criteria included diabetes, Cushing’s disease, acromegaly and other similar conditions (eg hyperprolactinemia, thyroid disorders), along with pregnancy or breastfeeding.

After calculating an adequate study group size, 78 women who satisfied the inclusion exclusion criteria were randomly assigned to one of the 2 groups (Resveratrol or Placebo). Each patient, according to their group allocation, took either 1000mg of resveratrol or a matching placebo, once daily for a total of 3 months.

Medical and obstetric history along with demographic information and anthropometry was recorded during initial assessment. Blood samples were collected, following a 10-12 hour fast, along with evaluation of clinical features (hirsutism, acne, hair loss, menstrual frequency) and ultrasonography of the ovaries.

Primary study outcome was to identify any changes in testosterone levels after 3 months of treatment. Other indicators of androgen excess such as FAI (Free Androgen Index), SHBG (Sex hormone binding globulin), DHEA (Dehydroepiandrosterone), LH (Luteinizing hormone) and FSH (Follicle stimulating hormone) were also measured.

Results

From an initial 78 participants, 65 completed the study (Resveratrol = 35, Placebo = 30). Mean age was 27.1 years with a mean PCOS duration of 5.2 years. Baseline characteristics of the two groups revealed no significant differences in age, smoking status or disease duration.

At completion of the trial, clinical signs of acne or hirsutism showed no statistically significant improvement however the proportion of normal menstrual cycles significantly improved (76.5 vs. 51.6 %) in the treatment group while hair loss significantly decreased (32.1 vs. 68.0 %).

Interestingly analysis of hormonal and metabolic parameters, showed that levels of testosterone, FSH and ALP significantly changed in the resveratrol group, however final levels were not significantly different to the placebo controlled group (p > 0.05), and therefore no conclusion could be drawn. Analysis of the various other endocrine indicators (DHEA, SHBG, FAI, LH, FSH and LH/FSH) also showed no effect.

Next secondary analysis of metabolic, cardiovascular and anthropometric parameters revealed no change following treatment, with the exception of fat mass, which increased among the resveratrol group (23.55 vs. 21.99 Kg) post trial.

Further statistical analysis of the data, restricted to only those who completed the trail, rather than all patients (Intention-to-treat) did not the findings.

Of note, no adverse side effects was observed in this group of women during treatment, including hepatic indicators and clinical markers of kidney health.

The authors concluded that restoration of menstrual function in women with PCOS is most likely unrelated to the mevalonte pathway, since no markers of cholesterol status changed post treatment.

SUMMARY: EFFECT OF RESVERATROL IN PCOS

Resveratrol, the polyphenol compound found in red wine, significantly improved menstrual cyclicity (76.5% vs. 51.6%) in women with PCOS, following 3 months of 1000mg capsules daily, however lean mass also decreased (44.5 vs. 42.6 kg), and cholesterol levels did not change, requiring further study.

Limitations

  1. Small overall group sizes
  2. Self-reporting of hair loss

Funding

No external funding was declared for this study.

Glossary

Acromegaly
A disorder caused by excess growth hormone levels.

Anthropometric
Proportional measurements of the human body.

Confounding
A variable which distorts an association.

Endocrine
Internal system comprising of glands that produce and secrete hormones.

Granulosa cells
A primary cell type within the ovary that provides the physical support and microenvironment needed for the developing oocyte.

Hepatic
Related to the liver.

Hirsutism
Male pattern hair growth.

P-value
The probability that a result occurred by random chance.

Similar studies

Bahramrezaie M, et al. (2019). Effects of resveratrol on VEGF & HIF1 genes expression in granulosa cells in the angiogenesis pathway and laboratory parameters of polycystic ovary syndrome: a triple-blind randomized clinical trial. https://doi.org/10.1007/s10815-019-01461-6

Ma H and Qiao Z, (2018). Analysis of the efficacy of resveratrol treatment in patients with scarred uterus. https://doi.org/10.3892/etm.2018.6126

Banaszewska B, et al. (2016). Effects of Resveratrol on Polycystic Ovary Syndrome: A Double-blind, Randomized, Placebo-controlled Trial. https://doi.org/10.1210/jc.2016-1858

Benrick A, et al. (2013). Resveratrol Is Not as Effective as Physical Exercise for Improving Reproductive and Metabolic Functions in Rats with Dihydrotestosterone-Induced Polycystic Ovary Syndrome. https://doi.org/10.1155/2013/964070


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