Zinc improves ovarian function, decreases androgens, and increases progesterone, a natural androgen blocker. In a recent clinical trial, zinc supplementation significantly improved hirsutism in only 8 weeks. The recommended dose is 30 to 50 mg immediately after dinner. Do not drink zinc on an empty stomach. Otherwise you will feel ill. See zinc rescue hormone 7 types.
A combination of peony and licorice. Peony (Paeonia lactiflora) inhibits the production of testosterone and promotes the activity of enzyme aromatase which converts testosterone to estrogen. Glycyrrhiza glabra contains phytoestrogens that decrease female serum testosterone and block the androgen receptor. Together, the two herbs have a synergistic effect to normalize pituitary hormones. It has just finished a new clinical trial in 2017. Because liquorice increases blood pressure, please consult clinician about safe use.
Reishi mushrooms (Ganoderma lucidum) inhibit 5 alpha reductase, an enzyme that converts testosterone to a more potent DHT hormone. Reishi has many other health benefits, including immunopotentiating and HPA (adrenal) axis stabilization.
DIM (diindolyl methane) is a phytonutrient derived from vegetables such as broccoli, Brussels sprouts, cabbage, kale. Block the androgen receptor. Since DIM inhibits the aromatase enzyme, it may have the undesirable effect of lowering estrogen, but clinically it has been found to be very effective against both acne and hirsutism . I recommend 100 mg per day.
Saw palmetto (Serenoa repens) inhibits 5-α reductase. In combination with green tea, vitamin D, melatonin, soybean, it worked well in a recent clinical trial of androgenic alopecia. As with DIM, saw palmetto may have an undesirable effect of reducing estrogen. I do not prescribe mainly because I like other treatments like zinc, peony, licorice.
👉 Hint: Melatonin has great potential of PCOS. A recent clinical trial succeeded.
Vitex agnus-castus reduces prolactin and therefore improves prolactin-induced androgen excess and hirsutism. High prolactin can induce androgen excess in two ways: 1) increase adrenal androgen DHEA, 2) upregulate 5 alpha reductase. As high prolactin is not in common with PCOS, I usually do not prescribe Vitex for PCOS. Please look at the Vitex interaction.