NMU 135 – NAC, PCOS and Fertility

Nutrition / Natural Medicine Update No 135 (July 10, 2019)

with Dr. James Meschino

Topic: Natural Supplement Improves Management of Polycystic Ovarian Syndrome and Related Infertility and Type 2 Diabetes Problems

Source: Cell Journal (April 2017)

Polycystic Ovarian Syndrome (PCOS) affects 5-10% of reproductive-age women and is considered the most common cause of anovulatory infertility problems. This means that women who are afflicted in this way do not ovulate and thus, are unable to get pregnant. This, of course, can be quite emotionally devastating for women who wish to conceive. To make things worse, PCOS is also associated with pregnancy complications such as recurrent pregnancy loss (RPL), which means having two or more miscarriages. And PCOS can also be very painful if the cysts in the ovaries burst and hemorrhage. Studies show that women with PCOS tend to have a high prevalence of metabolic syndrome, which includes various combinations of obesity, high blood pressure, glucose intolerance (high blood sugar), high triglycerides and decreased blood levels of the good cholesterol, known as the HDL-cholesterol (high-density lipoprotein cholesterol). Other studies show a strong link to type 2 diabetes and increased risk of blood clots due to a high prevalence of protein C deficiency (a genetic problem that increases the risk of blood clots). These factors also contribute to infertility, as they affect a woman’s hormonal function, as well as blood viscosity or blood stickiness.

To help women with PCOS overcome infertility problems a drug called clomiphene citrate (CC) can be used to help induce ovulation. This drug stimulates the pituitary gland to secrete higher amounts of hormones (FSH and LH) that induce ovulation. However, the drug is ineffective in up to 40% of women who use it. But, studies beginning in 2010, have shown that taking the natural supplement N-Acetyl Cysteine (NAC), along with the drug CC increases both ovulation and pregnancy rates in women with PCOS, in cases where the drug CC was previously ineffective.

How Does NAC Supplementation Help in PCOS?

Regarding fertility, NAC helps to break-up the mucus layer on the cervix, which can very much impede conception. One of the negative effects of the drug CC is that it thickens the mucous layer on the cervix preventing the penetration of the sperm to get through this barrier. The mucolytic action of NAC helps to break up this mucus, enabling sperm cells to find their way to the uterus and the fallopian tubes so that fertilization of the egg can occur. As well, NAC has a sensitizing effect on insulin receptors, which helps to lower blood glucose (sugar), and thus lowers insulin secretion. These factors also help to improve hormone function, ovulation and fertility and they reverse metabolic syndrome, lowering blood glucose (sugar) levels and improving the management of type 2 diabetes if it is present. NAC supplementation also enhances a woman’s antioxidant status, which suppresses free radical damage to the body (also known as oxidative stress). Excessive free radical damage has also been implicated in infertility problems in women with PCOS.

As these studies have only been around for a short period of time it’s possible that some doctors and specialists have not seen these published clinical trials. Many doctors follow the latest drug research but are not always exposed to research involving the use of natural supplements such as NAC. By the way, the daily dosage of NAC used in these studies was 1,200 mg, taken once per day, along with the drug CC. If you suffer from PCOS or know someone who does, and NAC supplementation is not part of the treatment plan, then I suggest you bring this research to the attention of your doctor and/or pass the info along to someone you know who suffers from PCOS and might benefit from it.

I have included the key published studies on this subject in the text below as a reference for you.

References:

1. Mokhtari V, et al. A review of various uses of N-Acetyl Cysteine. Cell J. 19(1) April 2017 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/

2.  Sekhon LH, Gupta S, Kim Y, Agarwal A. Female infertility and antioxidants. Curr Women’s Health Rev. 2010;6:84-95. https://scholar.google.com/scholar_lookup?

3. Nasr A. Effect of N-acetyl cysteine after ovarian drilling in clomiphene citrate-resistant PCOS women: a pilot study. Reprod Biomed Online. 2010;20(3):403–409. https://www.ncbi.nlm.nih.gov/pubmed/20089454

Eat Smart, Live Well, Look Great,

Dr. Meschino