One of the most difficult side effects of polycystic ovarian syndrome (PCOS) for some women is hair thinning and/or excess facial and body hair growth, known as Hirsutism. Not all women with PCOS experience this, but many do. It can be extremely hard to control and embarrassing, lowering the quality of life for these women.
“Over 95% of women who have all three of the classic signs of obesity, hirsutism and/or irregular menses, have PCOS,” according to Dr. Tori Hudson, N.D. In women with Hirsutism related to PCOS, there is a link pointing to excessive androgenic hormones. These androgenic hormones include testosterone, androstenedione, and DHEA. Women with PCOS tend to have higher levels of the androgen testosterone. Testosterone present in excessive levels, as found in some women with PCOS, is converted to much stronger dihydrotestosterone (DHT) by the enzyme 5 alpha-reductase. DHT is thought to be responsible for male pattern baldness in men, but also thinning hair in women. This may also cause excessive hair growth in unwanted areas in women, especially on the face.
A study performed in 2009 by the Center for Endocrinology, Diabetes & Metabolism, at the University of Birmingham, UK, found that both obese and normal weight women with PCOS had higher levels of 5 alpha-reductase than women with the same BMIs that do not have PCOS. The study shows that women with PCOS have the ability to convert testosterone to DHT more easily than women who do not have PCOS. This creates excessive levels of DHT in women with PCOS. This is why women with PCOS often have Hirsutism.
The berries of Saw Palmetto have been found to inhibit DHT production by reducing 5 alpha-reductase production, which may help prevent Hirsutism in women with PCOS.
What is Saw Palmetto?
Saw Palmetto (Serenoa repens) is a small palm. It is the only plant species classified in the genus Serenoa. It is native to the Atlantic and Gulf coastal plains of the United States. This plant is a 70 million dollar-a-year industry for the state of Florida due to its medicinal actions. Parts of the Saw Palmetto that are used are the berries, heart of the palm, and the fronds. The berry looks much like an olive. The berry has been said to taste like an intense sweet, slight vanilla flavor at first, then like a very strong blue cheese ending in tobacco or pepper juice flavor. This sounds pretty disgusting and may be why this plant is most often taken by capsule or liquid extract.
Coastal Native American Indians ate Saw Palmetto berries regularly to sustain health. They are very high in essential fatty acids and natural sugars. The berries were used to treat debilitating conditions as a general tonic. Older Seminole Indians called the berries the “spring of life”. Today Saw Palmetto is most popular for being used as a natural medicine for improving prostate health in men.
How Does Saw Palmetto Work to Reduce the Incidence of Hirsutism?
It appears Saw Palmetto may aid PCOS Hirsutism in the following ways…
- Increases DHT breakdown
- Inhibits DHT production
- Reduces 5 alpha-reductase activity
- Inhibits DHT binding to androgen receptor sites
Many naturopathic physicians have found that Saw Palmetto greatly helps women grow their thinning head hair back, while also reducing unwanted facial and body hair growth.
Other Ways Saw Palmetto May Help With PCOS
Women with PCOS usually have high levels of estrogen, and low levels of progesterone; known as estrogen dominance. This may cause uterine hypertrophy, also known as endometrial hyperplasia. Excessive levels of estrogen may cause excessive cell proliferation of the endometrium. The endometrium is the inner-most layer of the uterus. Saw Palmetto is strengthening for the body tissues, aiding in proper formation and function of the uterine cells. It has also been found to lower the incidence of acne associated with PCOS.
Suggested Dosage for Saw Palmetto
Saw Palmetto takes time to be effective. It is suggested for use over a 6-week period, taking notes of any improvements over that time. If improvements are noted, it may be continued on for best results.
Suggested Dosage Capsule: 400mg capsule a day
Suggested Dosage Liquid Extract: 1 tsp. liquid extract a day
*Saw Palmetto combines well with Vitex, Licorice Rt. and Nettles Root for reduction of PCOS. Licorice has also been found to reduce serum testosterone levels in women with PCOS.
*Saw Palmetto also combines well with Damiana to support healthy libido at an equal ratio 1:1 for increasing libido.
Because this plant has anti-androgenic effects, manipulating some hormone levels in the body, it is not suggested for combination with any type of medications for fertility that also affect hormone levels. Speak with your doctor prior to using Saw Palmetto if you plan on taking medications for PCOS. Do not use Saw Palmetto prior to getting hormone testing for any fertility issue. Saw Palmetto may affect the test results. Do not use Saw Palmetto during pregnancy or breastfeeding.
Saw Palmetto has been found safe for long-term use in most cases. Talk to your doctor or natural health care practitioner to see if Saw Palmetto is right for you.
- Vassiliadi, D. A., Barber, T. M., Hughes, B. A., Mccarthy, M. I., Wass, J. A., Franks, S., . . . Stewart, P. M. (2009). Increased 5α-Reductase Activity and Adrenocortical Drive in Women with Polycystic Ovary Syndrome. The Journal of Clinical Endocrinology & Metabolism, 94(9), 3558-3566. doi:10.1210/jc.2009-0837 Retrieved from: https://academic.oup.com/jcem/article/94/9/3558/2597400
- Saw Palmetto Extract Could Help PCOS-related Hirsutism (Unwanted Hair Growth). (n.d.). Retrieved from: http://www.ovarian-cysts-pcos.com/saw-palmetto.html
- Deane, G. (n.d.). Saw Palmetto Saga. Retrieved from: http://www.eattheweeds.com/saw-palmetto-saga-3/
- Hudson, T. (2008). Womens encyclopedia of natural medicine: alternative therapies and integrative medicine for total health and wellness. New York: McGraw-Hill.
- Lust, J. B. (1974). The herb book. Toronto: Bantam.
- Romm, A. J. (2010). Botanical medicine for women’s health. St. Louis, MO: Churchill Livingstone/Elsevier.
- Hudson, T., MD ND. (n.d.). Polycystic Ovarian Syndrome (PCOS). Retrieved from: http://drtorihudson.com/general/endocrine-health/pcos/polycystic-ovarian-syndrome-pcos/
- Saw Palmetto – Special Subjects. (n.d.). Retrieved from: https://www.merckmanuals.com/professional/special-subjects/dietary-supplements/saw-palmetto
- Atypical Endometrial Hyperplasia. (n.d.). Retrieved from: https://my.clevelandclinic.org/health/diseases/16569-atypical-endometrial-hyperplasia