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N-Acetyl-Cysteine as a (adjuvant) treatment of Polycystic Ovary Syndrome (PCOS)

Posted Feb 02 2012 4:43pm

Polycystic ovarian syndrome (PCOS) is a complex female medical condition defined as having hyperandrogenism, polycystic ovaries on ultrasound, and/or oligo- or anovulation, affecting about 7-10% of reproductive aged women. PCOS is a condition of unknown etiology, but has been linked to genetic factors as well as endocrine dysfunctions, such as insulin resistance, increased leutinizing hormone surge, decreased sex hormone binding globulin, or abnormal cortisol metabolism (Meletis & Zabriskie, 2006).

Conventional treatment of PCOS includes Metformin, a biguanide, is highly prescribed to Type II Diabetic patients, as well as cardiovascular disease patients, to improve glucose tolerance, through mechanisms of reducing glucose release from the liver, reducing total and free testosterone levels, and increases sex hormone binding globulin level. Clomiphene cirtrate (CC), a selectrive estrogen receptor modulator (SERM), is considered to be the first line therapy for ovulation in PCOS women by inducing ovulation through follicle stimulation and development. One of the major problems with CC therapy is the high incidence of resistance after receiving 150 mg/day, occurring with 15-40% of PCOS patients (Hashim, 2010). Rizk indicates that increased insulin resistance can lead to increase in CC therapy resistance (2005).

N-acetyl cysteine (NAC) is an alternative and complimentary treatment, which can be used for most conditions, ranging from toxicity to diabetes treatments. NAC is a derivative of the amino acid L-cysteine, and is used as a precursor to glutathione, a potent antioxidant. NAC has anti-oxidant, mucolytic, immunomodulating, and anti-inflammatory properties (Meletis & Zabriskie, 2006). The aim of this review was to assess the effect of N-acetyl-cysteine treatment for signs and symptoms of PCOS.

References:
Hashim, Hatem, MRCOG, Kamal Anwar, and Rafat El-Fatah. (2010). N-Acetyl Cysteine Plus Clomiphene Citrate Versus Metformin and Clomiphene Citrate in Treatment of Clomiphene-Resistant Polycystic Ovary Syndrome: A Randomized Controlled Trial. Journal of Women’s Health . 19.11 2043- 2048. Print.

Kilic-Okman, T, and M Kuck. (2004). N-acetyl-cysteine treatment for polycystic ovary syndrome. International Journal of Gynecology and Obsetrics . 85. 296-297. Print.

Meletis, C., & Zabriskie, N. (2006). Natural approaches for treating polycystic ovary syndrome. Alternative & Complementary Therapies, August, 157-163.

Nasr, A. (2010) Effect of N-acetyl-cysteine after ovarian drilling in clomiphene citrate-resistant PCOS women: a pilot study. Reproductive BioMedicine Online. 20. 403-409. Print.

Oner, Gokalp, and Iptisam Ipek Muderris. (2011). Clinical, endocrine and metabolic effects of metformin vs. N-acetyl-cysteine in women with polycystic ovary syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology. 7409. Print.

Rizk, Ahmed, Mohamed Bedaiwy, and Hesham Al-Inany. (2005). N-acetyl-cysteine is a novel adjuvant to clomiphene citrate in clomiphene citrate-resistant patients with polycystic ovary syndrome. Fertility and Sterility. 83.2. 367- 370. Print.

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