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Nigella in the management of adolescent polycystic ovary syndrome (PCOS): results of a randomised controlled trial

A clinical trial published in July this year found that short-term supplementation with nigella (Nigella sativa) may be effective in improving hormonal balance, menstrual irregularities and reducing ovarian volume in adolescents with PCOS. PCOS is a common endocrine disorder in women of a reproductive age and is the most common cause of infertility due to anovulation. It is associated with irregular menstrual cycles, excess facial and body hair, acne, heavier weight, ovarian cysts and increased risk of diabetes. Early diagnosis and treatment of this condition can prevent long-term health, reproductive and emotional consequences associated with this syndrome. Nigella has antioxidant, anti-inflammatory and insulin resistance-lowering properties which may have therapeutic benefits in PCOS.

The 16-week trial was conducted on 103 adolescents (mean age 17) with PCOS who had been referred to private or government obstetrics and gynaecology clinics in Iran. Participants were randomly allocated to either the intervention group (1000mg capsule per day of nigella) or control group (10mg tablet per day of the hormone medroxyprogesterone from the 14th day of the cycle for 10 nights). The mean difference in hirsutism score changes, right and left ovarian volume (by ultrasound), serum luteinising hormone (LH) and testosterone were significantly higher in the intervention group compared to the control group. The occurrence of infrequent periods, heavy irregular menstrual bleeding and absence of menstruation were significantly reduced after the study in the intervention group compared to the control group.

The researchers concluded that nigella’s effect on hirsutism might be related to male sex hormone-reducing effects. They said the reduced serum LH levels could be attributed to the effects of nigella on insulin resistance. Previous evidence has shown that increased insulin levels and insulin resistance intensify the production of sex steroids stimulated by ovarian gonadotropins and cause abnormal LH secretion. Nigella’s effect on menstrual disorders could be due to phytoestrogen compounds. Phytoestrogens are weak oestrogenic compounds that bind to oestrogen receptors. The authors also postulated that another mechanism of action might be related to nigella’s unsaturated fatty acid content, including linoleic acid and oleic acid. The oestrogenic effects of these unsaturated fatty acids have been reported in previous studies. Further research and long-term studies are warranted to validate the potential therapeutic effects of nigella in adolescents with PCOS.

References

Mahmoudian A, Ashouri A, Bilandi RR, Mohammadzadeh F, Dashti S, Bahri N. The possible short-term of Nigella sativa - L in the management of adolescent polycystic ovarian syndrome: results of a randomized controlled trial. J Ovarian Res. 2024 Jul 12;17(1):144. doi: 10.1186/s13048-024-01460-x. PMID: 38997723; PMCID: PMC11242022.