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Herbs for PCOS: Biphasic Support for the Menstrual Cycle

Herbs for PCOS: Biphasic Support for the Menstrual Cycle

Women with PCOS often struggle with irregular menstrual cycles. Taking herbs following a biphasic cycle, which mimics a normal menstrual cycle, may help the body to recognize and create a regular menstrual cycle over time.

In women with PCOS, the menstrual cycle begins with irregular production and release of hormones. The hypothalamus releases GnRH in a higher than normal pulsatile frequency in women with PCOS. This allows for increased LH and decreased FSH; this in turn leads to excessive production of the androgens androstenedione and testosterone. This causes the follicle to only mature some, but not enough to achieve full maturity. This also allows for continued increase of estrogen, primarily estrone. The higher levels of androgens and estrogen create a chronic state of low to very low progesterone. Classic polycystic ovaries are a result of chronic anovulation. Endocrine function is imbalanced from the very beginning of the cycle causing mild to severe hormonal imbalance, depending on the individual.

Fortunately, there are specific herbs that can help women with PCOS to achieve hormonal balance, promote proper insulin levels, reduce side effects due to hormonal balance and promote a regular menstrual cycle. The following combination of herbs is intended to harmonize the body systems in women with PCOS, with the intention of achieving healthy fertility.

Biphasic Use of Herbs for PCOS

One blend of specific herbs can be taken during the first half of the menstrual cycle and then another during the second half. Taking herbs in a biphasic cycle may help the body recognize and “remember” how to create a regular menstrual cycle, as it normally should.

The first half of the menstrual cycle is known as the follicular phase. The second half is known as the luteal phase. The average menstrual cycle is about 28-30 days long. Specific herbs can be taken together in a specialized blend during either the follicular or luteal phase, to help promote a regular menstrual cycle. You may notice some of the herbs are part of both biphasic blends; these herbs have supportive actions for the entire menstrual cycle.

Key benefits of biphasic herbal blends for PCOS:

  • Promote proper estrogen metabolism
  • Reduce pelvic congestion
  • Reduce cravings for sweets
  • Aid the body in balanced insulin levels
  • Promote hormonal balance overall
  • Reduce elevated levels of androgens
  • Promote regular ovulation
  • Support the body in increasing progesterone
  • Support proper function of the uterus
  • Support proper endocrine system function

Follicular Phase 1

First half of the menstrual cycle, approximately day 1-14 in the cycle (up to ovulation).
The herbs in this phase are specific to supporting release of the hormones responsible for promoting ovulation, reduction of androgens, and proper formation of the uterine lining in preparation for ovulation.

    Tribulus (Tribulus terrestris)
    This herb promotes regular ovulation. It supports hormonal balance overall. This herb has been found to be wonderful in aiding women with menstrual irregularities; improving timing of the entire menstrual cycle. Tribulus has also been found to be a nourishing tonic for the female reproductive system as a whole, especially concerning the ovaries. Studies have shown that it may reduce ovarian cysts and stimulate ovulation in women who are not ovulating.

    Vitex also known as Chaste tree berry (Vitex agnus-castus)
    Vitex works to balance the hormonal feedback loop, promote ovulation and regular cycles. Vitex has a regulating effect upon the pituitary gland, which supports regular function of the entire menstrual cycle. During the follicular phase, it supports proper timing and release of LH in preparation for ovulation, and FSH for stimulating ovulation.

    Saw Palmetto berry (Serenoa repens)
    Saw Palmetto has been found to inhibit DHT production by reducing 5 alpha-reductase production, which may help prevent hirsutism in women with PCOS. This herb also helps to reduce endometrial hyperplasia and hormonal acne symptoms. It is extremely nutritive and supports proper immune and stress response in the body.

    White Peony Root (Paeonia officinalis)
    White Peony promotes circulation to the reproductive organs which helps to reduce uterine stagnation, ovarian cysts, and painful menstruation. Studies have shown that when White peony is combined with Licorice Rt. (Glycyrrhiza glabra), it performs better, especially for relaxing muscles, reducing painful menstruation, as well as lowering serum and free testosterone levels in women with PCOS.

    Dong Quai root (Angelica sinensis)
    Dong Quai works by promoting blood flow to the pelvis where it will stimulate an absent or scanty period. It also nourishes the blood because it is rich in iron. One of the best uses is helping women who are not menstruating to invite their menstruation back. The increased circulation also helps to strengthen and balance the uterus. Working to strengthen the uterus is vital for women with PCOS, since irregular cycles are common, which may cause the uterine muscles to become weak.

    Gymnema (Gymnema sylvestre)
    Gymnema has been used for hundreds of years to reduce high blood sugar. This herb has a “sugar blocking” action on taste buds and the small intestine. Gymnema blocks the typical paths that sugar molecules take during digestion, delaying the absorption of sugar. It works by stimulating the regeneration of pancreatic cells that produce insulin, which aids in more insulin production, in turn, stimulating production of enzymes that help with the uptake of glucose into cells. It then prevents stimulation of the liver to produce more glucose. Resistance to insulin increases the body’s insulin levels, which affects normal ovulation by preventing the body from ovulating or limiting the maturation process of the released egg. Gymnema also appears to have a lipid-lowering effect.

    Licorice Root (Glycyrrhiza glabra)
    Helps to maintain proper hormone production and release through support of the endocrine system. It works to help balance estrogen levels in the body. It also supports healthy insulin levels and liver health for hormonal balance support. Licorice is excellent for proper immune, inflammation, and stress response as well. Women with PCOS have been shown to benefit from reducing inflammation.

Click here to purchase a formula containing these herbs…

Luteal Phase 2

Second half of the menstrual cycle, after ovulation (about day 14), up to about day 28 or until the menstruation begins.

The herbs for the luteal phase are deeply nourishing for the endocrine system, supporting proper function of the glands that produce and release hormones. Some of the herbs here are the same as the follicular phase herbs, for prolonged, continued, balanced support of the hormones, insulin levels, and reproductive organ health. The goal in this phase is to support the body in increasing and sustaining proper progesterone levels to help reduce estrogen dominance and prepare the uterus for implantation of the fertilized ovum.

    American Ginseng Rt. (Panax quinquefolius)
    American ginseng has been found to provide excellent immune support and strengthens the HPA (hypothalamus-pituitary-adrenal) axis. The HPA axis is vital to proper hormonal balance, stress management, and immune system strength. Supports proper digestion and absorption of nutrients from foods. This plant has also been shown to be helpful in supporting proper glucose levels, which is very important for women with PCOS.

    Vitex also known as Chaste tree berry (Vitex agnus-castus)
    In the second half of the cycle, vitex supports the body in sustaining and increasing progesterone levels in anticipation for implantation of the fertilized egg. Many women with PCOS have low levels of progesterone due to unopposed estrogen; vitex helps the body to balance estrogen and progesterone, for a healthy, regular menstrual cycle.

    Saw Palmetto Berry (Serenoa repens)
    In addition to the benefits already discussed, Saw Palmetto is strengthening for the body tissues, aiding in proper formation and function of the uterine cells. This is vital to preventing endometrial hyperplasia and preventing prolonged bleeding due to this common condition in women with PCOS.

    White Peony Rt.(Paeonia officinalis)
    Continued hormonal balance and reproductive function support for the luteal phase.

    Gymnema (Gymnema sylvestre)
    Continued support for balanced insulin levels throughout the cycle. Maintaining proper insulin levels throughout the cycle is vital to preventing miscarriage. Women who are insulin resistant are 4-5 times more likely to have a miscarriage. Imbalanced insulin levels due to PCOS make it difficult for the embryo to attach properly to the uterus. Reducing insulin resistance helps prevent type 2 diabetes.

    Dong Quai Rt. (Angelica sinensis)
    Continued hormonal balance support. Nourishing to the uterus, promoting healthy circulation to the uterus in preparation for implantation.

    Schisandra Berry (Schisandra chinensis)
    Supportive and protective of liver health, which is vital to hormonal balance. Shown to support immunity, endocrine and nervous system function. Aids stress-related infertility.

    Maca Root (Lepidium meyenii)
    Maca supports healthy progesterone levels in the body. Maca is an adaptogen and an incredible fertility superfood. It helps to balance the hormones, but does not contain any hormones itself. It is able to do this by nourishing and balancing the endocrine system.

Click here to purchase a formula containing these herbs…

Biphasic Herbal Blend for PCOS Q&A

Q: When do I begin taking these herbs if I don’t have a regular menstrual cycle?

A: If you have a somewhat regular cycle, or you know you may start your period sometime in the near future, begin taking them at the beginning of your next cycle (day 1). If you do not know when you are going to begin your period, choose your own day 1 to begin. Count out the days for the follicular phase as if you have a regular cycle, continuing the blend until about day 12-14 in the cycle, then begin the luteal phase herbal blend and continue until you begin your period, or until about day 28-30 in the cycle. Keep utilizing the herbal blends like this; creating a biphasic cycle.

Q: Is it okay to take maca with these herbal blends?

A: Yes, maca is fine to continue. Be sure not to exceed dosage of 3000mg a day.

Q: Can I continue natural progesterone cream with these herbal blends?

A: If you are already using natural progesterone cream (NPC), then yes, it is fine to combine these herbs with NPC use. If you have not yet tried NPC, consider trying a biphasic herbal program for PCOS first. See how your body does over a 3-6-month period. If your progesterone levels are still not adequate, then consider adding the NPC. Note: It is always best to work with an herbalist, ND or a doctor skilled in the use of herbs when choosing to combine NPC and herbal preparations.

Q: Is it okay to use vitex with these biphasic herbal blends for PCOS?

A: No, we don’t recommend using vitex with these biphasic herbal blends, as they both already contain vitex.

Q: What should I do if I find out I am pregnant while taking these herbal formulas? Should I stop taking them and when?

A: Should you find yourself pregnant while taking these herbal formulas, it would be best to discontinue them once you have determined you are pregnant through testing. The herbs in these blends are not recommended for use in pregnancy.

Dr. Christine Traxler M.D., OB/GYN
Dr. Christine Traxler M.D., OB/GYN

Dr. Traxler is a University-trained obstetrician/gynecologist, working with patients in Minnesota for over 20 years. She is a professional medical writer; having authored multiple books on pregnancy and childbirth; textbooks and coursework for medical students and other healthcare providers; and has written over 1000 articles on medical, health, and wellness topics.  Dr. Traxler attended the University of Minnesota College of Biological Sciences and University of Minnesota Medical School,  earning a degree in biochemistry with summa cum laude honors in 1981,  and receiving her Medical Doctorate degree (MD) in 1986.

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  1. Avatar

    Is the Harmonize Formula for both phases?

    • Dear Corrine,

      Some time ago now we reformulated Harmonize Phase 1 & 2 slightly to be one formula, Harmonize. Yes, Harmonize is used during both phases of the cycle.

    • Avatar

      Thank you Elizabeth!

      Do you offer the formula without alcohol? Is the alcohol used gluten free?
      Thanks again!

    • Dear Corrine,

      FertilicaTM Harmonize Formula is only made with grain alcohol and is gluten free.

  2. Avatar

    Hi! I’ve been diagnosed with PCOS but I also have a big cyst in my left ovary (5 cm). Would this herbal regime help me reduce and disappear the big cyst? I was told it would be necessary to remove the ovary surgically and I obviously think there must be other ways. Thank you very much.

  3. Avatar

    I m 25years old, I m suffering from PCOS since 4 years. I tried metaformin capsules and flaxseeds , fish oil supplements and some Ayurvedic medicines . I m diagonise with ovarian cyst. i get perids 3-4 times a years. If i keep forcing my periods to come. I keep on putting on weight , acne, hair loss, facial hair. It does not effect. if i follow proper diet and workout. I m confused with this above list of medicine , which one will suitable for me.. could you please suggest me.

    • Dear Nandini,

      I’m sorry to hear you have to deal with this nuisance of a fertility health issue (well, they all are really, right?). PCOS is a complex endocrine system disorder in which the coordination of the production of and delivery of hormones to where they need to go within the body isn’t happening properly. Ovarian cysts, weight gain, male-patterned hair loss or hair growth, acne and issues with insulin levels and cravings for sweets, all to varying degrees, often come hand-in-hand with PCOS because of the hormonal imbalance.

      Consider learning important information in this article titled How to Reduce the Damaging Effects of PCOS on Fertility Through Diet and Herbs.

      It is important to support your body in re-learning balance by promoting healthy hormonal balance, a healthy uterine lining, regular ovulation, improved estrogen metabolism, reduced cravings for sweets and improved digestion all of which you will learn how to do in the article above.

      It’s important to stick to the program you choose as well! Allowing a natural fertility program to address PCOS time to be effective in key!

      If it would be most helpful to work one on one with a fertility herbalist, consider a Fertility Consultation. This is a great way to be guided on a program designed specifically for you.

      I hope this is helpful!

  4. Avatar

    How long would you need to take all these herbs before you started seeing a regular cycle or ovulation? I have tried acupuncture along with Dong Qui and other herbs and it didn’t work. I didn’t have a period for 3 months so I am leery of trying herbs again to conceive. Thank you!

    • Dear Leah,

      The goal of our programs is to support the body in re-learning balance and/or supporting balance when fertility issues are present. This takes time! The great part about herbs, supplements and natural therapies is that they often work wonders in doing this given commitment to dietary and lifestyle change is made as well.

      Our programs are reliant on the individual to take their health into their own hands and commit to using the products consistently over time. It is because of all of these factors, that I am not able to know how quickly this program will show you it’s working. Shifts in the cycle, cervical mucous, energy levels, weight, mood, etc. may all be experienced within 1-3 cycles of use of our program, but hormonal shifts take a different amount of time for each woman.

      So, along with biphasic menstrual cycle support, consider learning about eating a PCOS Fertility Diet.

  5. Avatar

    thank you for this information. I am just confused about tribulus… I have PCOS and high androgens that prevent me from ovulating and tribulus is mentioned here to be used in the phase prior to ovulation when reducing androgens is essential. When I look online to read up on the herb all I see is how it’s used for men to build muscles and stimulate testosterone. I even found a video of a woman undergoing a sex change and was using tribulus to stimulate beard growth. So I am truly confused and hesitant to try this herb. I do have one more question about goji berries for women with PCOS. I’ve found it listed as one of the top 10 superfoods for PCOS then I also read that it raises testosterone.

    • Dear Jenger,

      Tribulus is an herb known to support male and female fertility health differently. We share the details in our article Tribulus Terrestris: Fertility Herb for Both Men and Women… that I think will explain this well. It has been our experience that the general suggested use of Tribulus that we share or the amount we have in our products would increase androgen levels in women.

      Goji berries are a superfood, they are extremely nutritious and high in antioxidants which protect cell health. One study showed that goji can also help the body have a healthy insulin response. Water (decoction) and alcohol extracts of the Goji berries exerted a stronger antioxidant effect than the fruits alone in the study. We think this is promising news for women who suffer from insulin-resistant PCOS or couples struggling with infertility related to diabetes. Goji does not contain hormones or have an impact directly in hormone levels. To my knowledge it’s effects are in the liver due to that antioxidants, cell protecting and regenerating action, that Goji support hormonal balance. The liver is instrumental in hormonal balance. Learn how here…

      All that said, with PCOS, diet and lifestyle are key! Learn about a PCOS Fertility Diet here…

      I hope this is helpful!

  6. Avatar

    Thank you, but I also forgot to add I have PCOS. So do you think my herbal cocktail and choice of adaptogen (ashwagandha) is a good blend?

  7. Avatar

    I am a 44 year old woman, my cycles are 28 days which is considered normal. But I have terrible cramps and my period are very heavy with small clots. I stopped having problems with acne but have chin hair and slight balding in the top of my head. I know I have low progesterone, high testosterone and is estrogen dominant. I am currently taking saw palmetto, ashwagandha, bovine ovary, vitex and DIM. I am not trying to conceive, just want my hormones balanced. My question is when is the right time to take these herbs to balance my hormones. Should I take them all, all month long?

    • Hello Kyesha!

      Saw Palmetto, Ashwagandha, Vitex and DIM can be taken all cycle long without taking a break. It would be best to reach out to the maker of the bovine ovary supplement you purchased. I am not the best to answer questions about its use.

      I hope your program proves helpful to you soon!

  8. Avatar

    for 2 years now every month I get the cystic acne on my right side of the jawline. It always happens during the ovulation time. It takes months to be cured…
    I had my hormones checked and everything seems to be ok.
    Is it rather an androgenic acne or the acne caused by estrogens dominance/ low progesterone?
    Thank you for your help!

  9. Avatar

    My 22 year old daughter has been on pills to regulate her menstrual cycle. Without them she can not have a period. If she stops taking birth control pills and begins the biphasic program about how long can she expect her periods to begin and she can tell if this program works for her?

    • Dear Diana,

      I am sorry to hear of what your daughter is going through! This is a challenging question to answer.

      Our programs are reliant on the individual to take their health into their own hands. We know that lifestyle choices and dietary habits are equally as important as any herb or supplement taken (and that when diet and lifestyle are optimal herbs and supplements are often more effective). Other health conditions, commitment to using the products consistently over time, etc. are also factors we have no control over. It is because of all of these factors, that I am not able to know how long it will take for you to see results.

      In general, if on one of our health programs, one should begin to see changes within 1-3 months. These changes could be increased energy, improved cervical mucous, ovulation, correction in cycle length, etc… That said, changes do differ so from woman to woman and depend on the underlying cause of the absent period.

  10. Avatar

    Iaso tea not only got my cycle regular again, but it eliminated my cramps, headaches and bloating away. I’m not pledging that it will work for everyone, I just know what it has done for my life. This was a big deal for me because my irregular bleeding has tormented me for 19 years of my life.

  11. Avatar

    I have PCOS and have not had menses for 4 yrs now. My question is can all these herb be taken together? Thanks

    • Dear Kdj,

      Yes, many of the herbs discussed here can be taken together and have been combined to offer biphasic support for the menstrual cycle. Revisit the link at the bottom of this article, Click here to purchase a formula containing these herbs…, to learn more.

      Consider also taking time to learn about eating a PCOS Diet which has been found to be key in helping the body relearn balance.

  12. Avatar

    I have recently been diagnosed with PCOS. My doctor has prescribed Metformin, but I have been taking Viex, Tribulus, Saw Palmetto and Maca for a while on my own. Should I discontinue my herbal products or can I take them with the Metformin?

    • Dear Ivy,

      It will be best to speak with your doctor or a natural healthcare provider near you about combing the herbs you are taking with Metformin.

      It has been my experience that doctors (medical and natural) will coach their patients on combining them, so I hope you are able to speak with him soon.

      It will also be helpful to consider learning about eating a PCOS Diet – a way of eating that supports the body in relearning balance with this endocrine system issue. In fact, dietary changes are known to be key with PCOS.

      Take care!

  13. Avatar

    Which herbs would you recommend I use? My cycles are regular now (after years of being irregular) but I have bad cramps and would like to control my hormone levels and also maintain my symptoms. I am not on any medication but have started taking evening primrose oil. I also take iron tablets as well as Vit D, C and Zinc. Also could you suggest any other vitamins I should take? Many thanks.

    • Dear Salma,

      How wonderful that the changes you have made have supported the body in having a regular menstrual cycle! It is however difficult for me to answer your questions based on just a small piece of the bigger picture of your health.

      You may want to book a Fertility Consultation. Once you book the consultation, you will be able give our fertility herbalist a clear holistic perspective on your situation to analyze and assess properly. This will help her see what it will take to properly support the body in maintaining balance.

  14. Avatar

    I’ve had PCOS for as long a I can remember and without birth control I don’t have my menstrual cycle. I’d like to start the herbs, but where can I get these herbs from?

  15. Avatar

    i have a client with PCOS. We are refining her nutrition along with looking into herbs. Her GYN placed her on birth control pills. Can your formulas be taken and effective while she is still on the pill? Thanks.

    • Dear Bonnie,

      If currently already on fertility medication, herbs should not combine with the medication. Herbs that act on the hormonal system could affect how the medication is working. It is best to only use herbs in preparation beforehand and not mix the two.

  16. Avatar

    Should I take Vitex if I have completely normal cycles??

    • Elizabeth Willett, MA, CH

      Hello RainbowRays!

      With “completely normal cycles”, Vitex may not be necessary. I am curious why you are asking if you have a normal cycle. Can you share more about your fertility health? Why are you researching and asking about Vitex? What fertility health support do you need?

      Knowing a bit more will help me better guide you! I hope to hear back from you!

  17. Avatar

    Could soy isoflavones fit in to this regimen?

    • Elizabeth Willett, MA, CH

      Dear Jessica,

      While soy isoflavones could theoretically fit into this regimen, we are not supporters of consuming soy or soy isoflavones. Our senior herbalist best summed up why in the following article, Herbs and Supplements with Estrogen Action Q&A. I hope you can find time to read this Q&A. I think it will be helpful!