Polycystic Ovary Syndrome, or PCOS, is a condition which affects many women worldwide and it is a leading cause of female infertility.
PCOS consists of three main features: irregular or no periods, polycystic ovaries and hormonal imbalance. This leads to a range of symptoms which can vary in severity, and each woman experiences her own combination of these. The symptoms include problems conceiving, weight gain, acne and unwanted facial hair growth. Find out more about PCOS here.
Unfortunately there is no cure for PCOS. But the good news is that there are many ways you can manage the symptoms. There are a number of medicines available which you should ask your doctor about. In addition to this, there are numerous combination supplements available on the market.
We know how confusing it can be to choose the right supplement, so we have reviewed six of the most popular PCOS combination products for you.
Top 6 PCOS supplements
The Scoring Method
We have compared six of the most popular combination PCOS supplements available in the UK and EU based on their price, nutrient ingredients and customer service.
We determined which nutrients had good scientific evidence supporting their use in PCOS in the form of peer-reviewed scientific studies. Then we used these nutrients to determine which products were most comprehensive and cost effective.
There is a lot of variation in the quality and price of the products. The most expensive products are not always necessarily the best.
Although there is scientific evidence to support the use of these supplements and their components, results are not guaranteed and can vary from person to person.
The products in this comparison can all be bought at external online shops via so-called affiliate links. These links have no influence on the price and generate a small commission upon completion of the purchase, which makes the free use of this website possible.
Click to view the full scoring table.
You can download the table in high-resolution here.
How we have weighted the nutrients
Inositol is particularly important in PCOS because it can improve a wide range of symptoms from fertility problems to unwanted hair growth. There is strong evidence supporting its use in a large number of clinical studies and meta-analyses. We have therefore made this an important factor in our scoring, and we allocated up to 30 points for products including 2000 mg of myo-inositol and 250 mg of D-chiro-inositol.
The importance of ALA and NAC (N-Acetylcysteine) in PCOS has been shown in more than 10 clinical studies. We have therefore allocated up to 10 points for products including a minimum of 100 mg of ALA and 100 mg of NAC.
Omega-3 fatty acids, folate (folic acid/vitamin B9) and chromium are also important compounds, and there is a moderate amount of evidence supporting their use in PCOS. We have therefore allocated up to 5 points to products including any of these nutrients.
We also allocated 1 point to products for each of the following they contained: choline, betaine, pine bark extract, coenzyme Q10, vitamin B6, vitamin B7, vitamin B12, vitamin C, vitamin E, and vitamin D3. This is because they have been shown to have some effect in improving PCOS symptoms.
Finally, we awarded 20 points depending on the quality of service from each company. We allocated 5 points for each of the following factors: delivery within 2 days, customer service telephone helpline, production within the EU, and good quality of online shop.
Why “multi-nutrient” supplements?
Any woman who has been diagnosed with PCOS should consider taking supplements, after discussing these with her doctor.
Supplements can be very helpful in managing the symptoms of the condition to reduce the effect they have on your daily life.
Nutrient components of combination supplements
Supplements contain a wide range of nutrients. This scientific jargon sometimes feels like a completely different language, and it can be difficult to make an informed decision about which product to choose. Fear not, we’re here to help! We have broken down the jargon and outlined how each nutrient can be helpful in PCOS.
Inositol is a particularly popular compound in PCOS supplements as it has a range of beneficial effects. This compound is present in foods including cereals and fruits. There are two types of inositol: myo-inositol and D-chiro-inositol. The body converts myo-inositol into D-chiro-inositol using an enzyme.
Studies have found that myo-inositol can help to restore ovulation and fertility in women with PCOS when taken alone or in combination with D-chiro-inositol [1. Unfer V, Nestler JE, Kamenov ZA, Prapas N, Facchinetti F. Effects of Inositol(s) in Women with PCOS: A Systematic Review of Randomized Controlled Trials. International Journal of Endocrinology. Internet. 2016. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5097808/]. It regulates menstrual cycles and improves egg quality. It can also improve success rates in IVF treatments with better fertilisation rates [2. Regidor PA, Schindler AW, Lesoine B, Druckman R. Management of women with PCOS using myo-inositol and folic acid. New clinical data and review of the literature. Hormone Molecular Biology and Clinical Investigation. Internet. 2018. 34(2). Available from: https://www.ncbi.nlm.nih.gov/pubmed/29498933].
Furthermore myo-inositol improves blood glucose control. It can also increase the levels of Sex Hormone Binding Globulin (SHBG) when taken for a longer period of time (24 weeks or more) [3. Unfer V, Facchinetti F, Orru B, Giordani B, Nestler J. Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocrinology Connections. Internet. 2017. 6(8):647-658. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655679/] . This hormone reduces the effect of testosterone in the body. Therefore it can help to combat the symptoms associated with excess androgens, including unwanted hair growth. Myo-inositol may also help with weight loss [4. Gerli S, Papaleo E, Ferrari A, Di Renzo GC. Randomized, double blind placebo-controlled trial: effects of myo-inositol on ovarian function and metabolic factors in women with PCOS. European Review for Medical and Pharmacological Sciences. Internet. 2017. 11(5):347-54. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18074942].
D-chiro-inositol is linked to blood glucose control too. Scientists have discovered that women with PCOS have reduced levels of D-chiro-inositol in their bodies, and they lose more of this compound in their urine [5. Baillargeon JP, Iuorno MJ, Apridonidze T, Nestler JE. Uncoupling Between In. and Release of a D-Chiro-Inositol-Containing Inositolphosphoglycan Mediator of In. Action in Obese Women with Polycystic Ovary Syndrome. Metabolic Syndrome and Related Disorders. Internet. 2010. 8(2):127-135. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140116/]. This results in women with PCOS having poorer blood sugar control. Therefore it makes sense that D-chiro-inositol supplements help to improve the body’s mechanisms to control blood glucose levels. This happens by increasing the body’s sensitivity to key hormones which affect blood glucose. D-chiro-inositol also reduces the levels of male hormones in the bloodstream [6. Iuorno MJ, Jakibowicz DJ, Baillargeon JP, Dillon P, Gunn RD, Allan G, Nestler JE. Effects of d-chiro-inositol in lean women with the polycystic ovary syndrome. Endocrine Practice. Internet. 2002. 8(6):417-23. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15251831].
However, it is not advisable to take D-chiro-inositol alone. This is because the ovaries are different to other tissues in the body and scientists think that only myo-inositol has an effect on them, not D-chiro-inositol. There is evidence suggesting that D-chiro-inositol supplementation alone is toxic for ovaries and egg quality [7. Isabella R, Raffone E. Does ovary need D-chiro-inositol? Journal of Ovarian Research. Internet. 2012. 5:14. Available from: https: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3447676/].
Myo-inositol and D-chiro-inositol work best when taken together.
Therefore your best option is a combination supplement including both myo-inositol and D-chiro-inositol to maximise your fertility. Scientists recommend taking supplements which combine myo-inositol and D-chiro-inositol in the ratio 40:1, as this reflects their composition in the human body [8. Bevilacqua A, Bizzarri M. Physiological role and clinical utility of inositols in polycystic ovary syndrome. Best Practice and Research: Clinical Obstetrics and Gynaecology. Internet. 2016. 37:129-139. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27117028].
Alpha-lipoic acid (ALA) is an antioxidant. Scientists have found that it helps to reduce glucose levels in obese PCOS patients [9. Genazzani AS, Shefer K, Della Casa D, Prati A, Napolitano A, Manzo A, Despini G, Simoncini T. Modulatory effects of alpha-lipoic acid (ALA) administration on in. sensitivity in obese PCOS patients. Journal of Endocrinological Investigation. Internet. 2018. 41(5):583-590. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29090431]. It also increases the body’s sensitivity to hormones important for blood glucose control in patients who are not obese [10. Masharani U, Gjerde C, Evans JL, Youngren JF, Goldfine ID. Effects of Controlled-Release Alpha Lipoic Acid in Lean, Nondiabetic Patients with Polycystic Ovary Syndrome. Journal of Diabetes Science and Technology. Internet. 2010. 4(2):359-364. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2864173/].
NAC is an amino acid. Scientists have found that it can improve the body’s sensitivity to hormones important for blood glucose control [11. Fulghesu AM, Ciampelli M, Giuseppe M, Belosi C, Selvaggi L, Ayala GF, Lanzone A. N-acetyl-cysteine treatment improves in. sensitivity in women with polycystic ovary syndrome. Fertility and Sterility. Internet. 2002. 77(6):1128-1135. Available from: https://www.sciencedirect.com/science/article/pii/S0015028202031333]. Some evidence also shows that it can reduce BMI, making it useful in weight loss. As well as this it can reduce excess hair growth and free testosterone levels in the body [12. Oner G, Muderris II. Clinical, endocrine and metabolic effects of metf. vs N-acetyl-cysteine in women with polycystic ovary syndrome. European Journal of Obstetrics, Gynaecology and Reproductive Biology. Internet. 2011. 159(1):127-31. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21831508].
Furthermore, it has positive effects on fertility. NAC supplements can restore ovulation and improve the pregnancy rate in women with PCOS [13. Thakker D, Raval A, Patel I, Walia R. N-Acetylcysteine for Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials. Obstetrics and Gynaecology International. Internet. 2015. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306416/].
Omega-3 fatty acids are found in fish oil, and they are famous as supplements in many conditions ranging from heart disease to arthritis. So it is no surprise that they are also useful in PCOS. Studies have shown that they increase levels of SHBG in the body, and therefore reduce testosterone levels [14. Oner G, Muderris II. Efficacy of omega-3 in the treatment of polycystic ovary syndrome. Journal of Obstetrics and Gynaecology. Internet. 2013. 33(3):289-91. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23550861]. As a result, omega-3 supplements may help against excess hair growth.
Furthermore omega-3 supplements can improve blood glucose control and may also support weight loss. Scientists found a significant reduction in the waist circumference of subjects in a study following omega-3 supplementation[15. Khani B, Mardanian F, Fesharaki SJ. Omega-3 supplementation effects on polycystic ovary syndrome symptoms and metabolic syndrome. Journal of Research in Medical Sciences. Internet. 2017. 22:64. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461594/].
Omega-3 also reduces levels of leptin in the body. Leptin is a hormone which is produced by fat cells, and its purpose is to regulate energy balance and weight. If a person has more fat, they have more leptin in their bloodstream. Leptin levels rise when you gain weight and fall when you lose weight. Normally when leptin levels are high, the brain responds by using more energy in the form of burning more calories.
However in obesity, which is a problem for many PCOS patients, the levels of leptin in the body are very high. This develops into leptin resistance, where the brain no longer responds to the high leptin levels. This means fat cells continue producing even more of this hormone.
The consequence of this is that weight loss becomes very difficult. This is because your body’s metabolism is low and your appetite is raised. Your body is essentially in starvation mode when it should be in fat-burning mode. However scientists have found that omega-3 can reduce leptin levels and leptin resistance [16. Gray B, Steyn F, Davies PSW, Vitetta L. Omega-3 fatty acids: a review of the effects on adiponectin and leptin and potential implications for obesity management. European Journal of Clinical Nutrition. Internet. 2013. 67:1234-1242. Available from: https://www.nature.com/articles/ejcn2013197]. These effects make it easier to burn fat and lose weight, especially when combined with the effects of omega-3 on blood glucose control.
Additionally, omega-3 can improve fertility. Scientists have found that it can help to regulate the menstrual cycle [17. Nadjarzadeh A, Firouzabadi RD, Vaziri N, Daneshbodi H, Lotfi MH, Mozaffari-Khosravi H. The effect of omega-3 supplementation on androgen profile and menstrual status in women with polycystic ovary syndrome: A randomized clinical trial. Iranian Journal of Reproductive Medicine. Internet. 2013. 11(8):665-672. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941370/]. It can also reduce inflammation in the body, which helps with hormonal balance.
Folate, or folic acid, is particularly useful for fertility. Scientists found that a combination of folate and myo-inositol restored ovulation and improved pregnancy rates [18. Regidor PA, Schindler AE. Myoinositol as a Safe and Alternative Approach in the Treatment of Infertile PCOS Women: A German Observational Study. International Journal of Endocrinology. Internet. 2016. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5011528/]. Folate may also help to reduce inflammation and therefore improve hormonal balance [19. Bahmani F, Karamali M, Shakeri H, Asemi Z. The effects of folate supplementation on inflammatory factors and biomarkers of oxidative stress in overweight and obese women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled clinical trial. Clinical Endocrinology. Internet. 2014. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/cen.12451].
Chromium is a mineral which enhances the activity of hormones involved in blood glucose control. In the presence of the biologically active form of chromium, a lower level of these hormones is needed to have an effect in the body. Scientists have also found that chromium supplements improve the body’s sensitivity to these hormones [20. Amooee S, Parsanezhad ME, Shirazi MR, Alborzi S, Samsami A. Metf. versus chromium picolinate in citrate-resistant patients with PCOS: A double-blind, randomized clinical trial. Iranian Journal of Reproductive Medicine. Internet. 2013. 11(8):611-618. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941367/], [21. Lucidi RS, Thyer AC, Easton CA, Holden AEC, Schenken RS, Brzyski RG. Effect of chromium supplementation on IR and ovarian and menstrual cyclicity in women with polycystic ovary syndrome. Fertility and Sterility. Internet. 2005. 84(6):1755-1757. Available from: https://www.sciencedirect.com/science/article/pii/S0015028205029444]. Additionally, it is useful in weight loss [22. Fazelian S, Rouhani MH, Bank SS, Amani R. Chromium supplementation and polycystic ovary syndrome: A systematic review and meta-analysis. Journal of Trace Elements in Medicine and Biology. Internet. 2017. 42:92-96. Available from: https://www.sciencedirect.com/science/article/pii/S0946672X17300755].
Choline is a compound which regulates the amount of homocysteine in the body. Scientists have found that there is an association between homocysteine levels and heart disease, as well as other conditions. This is why doctors class high homocysteine levels as a risk factor for developing cardiovascular disease.
Choline is important in transporting fats from the liver and lowering cholesterol [23. Rajabi AA, Castro GSF, Da Silva RP, Nelson R, Thiesen A, Vannucchi H, Vine DF, Proctor SD, Field CJ, Curtis JM, Jacobs RL. Choline Supplementation Protects against Liver Damage by Normalizing Cholesterol Metabolism in Pemt/Ldlr Knockout Mice Fed a High-Fat Diet. The Journal of Nutrition. Internet. 2013. 144(3):252-257. Available from: https://academic.oup.com/jn/article/144/3/252/4571666]. Therefore it may help in the metabolic problems which arise in PCOS. This is because women with PCOS are more likely to have high levels of ‘bad’ cholesterol and therefore a higher risk of developing cardiovascular disease.
High levels of homocysteine in the blood, or hyperhomocysteinaemia, is a problem among women with PCOS [24. Maleedhu P, Vijayabhaskar M, Sharma SSB, Kodumuri PK, Vasundhara DD. Status of Homocysteine in Polycystic Ovary Syndrome. Journal of Clinical and Diagnostic Research. Internet. 2014. 8(2):31-33. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972590/]. However research suggests that betaine can be useful in lowering homocysteine levels in the blood [25. Olthof MR, Verhoef P. Effects of betaine intake on plasma homocysteine concentrations and consequences for health. Current Drug Metabolism. Internet. 2005. 6(1):15-22. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15720203].
The body uses coenzyme Q10 to break down carbohydrates in the body instead of storing them as fat. Scientists have found that it is useful in reducing glucose and cholesterol levels [26. Samimi M, Mehrizi MZ, Foroozanfard F, Akbari H, Jamilian M, Ahmadi S, Asemi Z. The effects of coenzyme Q10 supplementation on glucose metabolism and lipid profiles in women with polycystic ovary syndrome a randomized, double-blind, placebo-controlled trial. Clinical Endocrinology. Internet. 2016. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/cen.13288].
Vitamin C may be useful in cardiovascular disease and lowering cholesterol [27. McRae MP. Vitamin C supplementation lowers serum low-density lipoprotein cholesterol and triglycerides: a meta-analysis of 13 randomized controlled trials. Journal of Chiropractic Medicine. Internet. 2008. 7(2):48-58. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2682928/].
Scientists have found that vitamin D is important in PCOS. Lower vitamin D levels are associated with obesity in women with PCOS [28. Hahn S, Haselhorst U, Tan S, Quadbeck B, Schmidt M, Roesler S, Kimmig R, Mann K, Janssen OE. Low Serum 25-Hydroxyvitamin D Concentrations are Associated with IR and Obesity in Women with Polycystic Ovary Syndrome. Experimental and Clinical Endocrinology and Diabetes. Internet. 2006. 114(1):577-583. Available from: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-2006-948308]. Therefore it makes sense that vitamin D supplements would be helpful.
Studies have already shown that vitamin D can improve blood glucose control [29. Parildar H, Cigerli O, Unal DA, Gulmez O, Demirag NG. The impact of vitamin D replacement on glucose metabolism. Pakistan Journal of Medical Sciences. Internet. 2013. 29(6):1311-1314. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905396/]. Furthermore, scientists have found that taking a combination of calcium and vitamin D can have positive effects on fertility. These effects include an improvement in egg development and menstrual regularity [30. Firouzabadi RD, Aflatoonian A, Modarresi S, Sekhavat L, Taheri SM. Therapeutic effects of calcium and vitamin D supplementation in women with PCOS. Complementary Therapies in Clinical Practice. Internet. 2012. 18(2):85-88. Available from: https://www.sciencedirect.com/science/article/pii/S1744388112000060]. In the same study, vitamin D supplements also helped with weight loss.
Studies have shown that vitamin E together with coenzyme Q10 can improve blood glucose control and reduce testosterone levels [31. Ebrahimi FA, Samimi M, Foroozanfard F, Jamilian M, Akbari H, Rahmani E, Ahmadi S, Taghizadeh M, Memarzadeh MR, Asemi Z. The effects of omega-3 fatty acids and vitamin E co-supplementation on indices of IR and hormonal parameters in patients with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Experimental and Clinical Endocrinology and Diabetes. Internet. 2017. 125(6):353-359. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28407657]. There is also evidence that this combination can improve mental health in PCOS [32. Jamilian M, Shojaei A, Samimi M, Ebrahimi FA, Aghadavod E, Karamali M, Taghizadeh M, Jamilian H, Alaeinasab S, Jafarnejad S, Asemi Z. The effects of omega-3 and vitamin E co-supplementation on parameters of mental health and gene expression related to in. and inflammation in subjects with polycystic ovary syndrome. Journal of Affective Disorders. Internet. 2018. 229:41-47. Available from: https://www.sciencedirect.com/science/article/pii/S0165032717320967].
Scientists have discovered an association between low levels of vitamin B12, obesity, and higher homocysteine levels [33. Kaya C, Cengiz SD, Satiroglu H. Obesity and IR associated with lower plasma vitamin B12 in PCOS. Reproductive Biomedicine Online. Internet. 2009. 19(5):721-6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20021721]. Therefore supplements may help to counter these effects.
There has been some progress in proving this theory. A study investigated the effects of supplements containing vitamin B1, B6 and B12. The results showed that these vitamins were effective in reducing homocysteine levels [34. Kilicdag EB, Bagis T, Tarim E, Aslan E, Erkanli S, Simsek E, Haydardedeoglu B, Kuscu E. Administration of B-group vitamins reduces circulating homocysteine in polycystic ovarian syndrome patients treated with metf.: a randomized trial. Human Reproduction. Internet. 2005. 20(6):1521-1528. Available from: https://academic.oup.com/humrep/article/20/6/1521/748818].
Vitamin B12 is also important in PCOS in relation to metf.. Metf. is a medication that many PCOS patients use to improve their sensitivity to hormones which control blood glucose levels. As a result, this medicine is effective in improving weight loss, fertility and reducing testosterone levels.
However long-term use of metf. at high doses can result in a deficiency in vitamin B12 [35. Liu Q, Li S, Quan H, Li J. Vitamin B12 status in metf. treated patients: systematic review. PLOS One. Internet. 2014. 9(6). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4069007/]. This happens because metf. alters a reaction involving calcium which is responsible for the body absorbing vitamin B12. Therefore to combat vitamin B12 deficiency, it is a good idea to take calcium supplements [36. Bauman WA, Shaw S, Jayatilleke E, Spungen AM, Herbert V. Increased intake of calcium reverses vitamin B12 malabsorption induced by metf.. Diabetes Care. Internet. 2000. 23(9):1227-31. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10977010]. However, it is important to discuss this with your doctor first.
Scientists have found that vitamin B6, or pyridoxine, is useful in reducing homocysteine levels . It is also important in maintaining hormonal balance in the body.
Vitamin B7, or biotin, is important for gluconeogenesis in the body. This process involves building glucose from lactate and amino acids.
Pine bark extract is used in diabetes and related health issues, as well as cardiovascular disease. These applications may be relevant for PCOS patients.
Fertilovit PCOS has the biggest range of nutrients. However, Ovarifert PCOS offers five times more D-Chiro Inositol for less then half the cost!
Overall PCOS is a complex condition and each woman experiences a different combination of symptoms. Supplements can be very helpful in managing these symptoms. However certain supplements are best for specific symptoms. It is important to research which product is best for you.
We hope that our article has been useful in explaining the benefits of specific nutrients, and our analysis of six popular supplements has helped you to make an informed decision. For more advice, it is best to discuss these products with your doctor or pharmacist.