PCOS

Polycystic ovary syndrome, covered against the 2023 international guideline: what the diagnosis actually involves, which supplements and medications have evidence, and where the evidence is much weaker than the marketing.

Every claim below carries an evidence grade. What do these grades mean?

Lara BridenNaturopathic DoctorAuthor, Period Repair Manual Lara Briden

PCOS

PCOS by Type: Treat the Root Cause

1Rule out other causes of androgen excess before accepting a PCOS diagnosis (n/a)
2Test triglycerides, ALT or fasting insulin, not just blood glucose or HbA1c (If insulin is high, this is likely driving the androgen excess; roughly 70% of PCOS diagnoses fit this type)
3Note whether symptoms started 3 to 6 months after stopping a drospirenone or cyproterone birth control pill (If your LH is elevated, Briden's herbal choice is peony and licorice; if prolactin is high-normal instead, she uses vitex (chasteberry), never both, and never vitex if LH is elevated)

What to buy

Myo-Inositol Powder ~$16

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Lara BridenNaturopathic DoctorAuthor, Period Repair Manual Lara Briden

PCOS

Myo-Inositol for PCOS: The Dose, and the Honest Grade

1Get PCOS confirmed by a clinician before you treat it (PCOS is a diagnosis of exclusion. Thyroid disease, high prolactin, non-classic congenital adrenal hyperplasia and androgen-secreting tumours can all look like it, and the assessment involves cycle history, androgens, thyroid and prolactin. This page is not a diagnosis and cannot be used as one.)
2Take 2 g of myo-inositol twice a day, 4 g in total (4 g a day is the dose most myo-inositol PCOS trials used, taken as 2 g twice daily in water. Trials ran myo-inositol alone at 1 to 4 g a day, most at 4 g, and myo-inositol plus folic acid at 2 to 4 g with 200 to 400 mcg of folic acid. This is the dose Lara Briden gives in her own write-up as well.)
3Do not take D-chiro-inositol on its own (If you buy a blend, the ratio to look for is 40 parts myo-inositol to 1 part D-chiro-inositol. Understand that this specific ratio rests on very low certainty evidence: it comes from physiological reasoning and mouse models, plus two small human trials comparing ratios. Plain myo-inositol on its own is the better-supported choice.)

What to buy

Myo-Inositol Powder ~$16

GO DEEPER →

More protocols on this topic are added here as they clear research and compliance review. We would rather show a short list we stand behind than pad it out.

Lara Briden

Naturopathic Doctor (ND), Author · Author, Period Repair Manual; Christchurch, New Zealand

Experts behind PCOS protocols

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Lara Briden

Naturopathic Doctor (ND), Author

2 protocols