Polycystic ovary syndrome (PCOS) is the most prevalent hormonal disorder in women of reproductive age, affecting approximately 21% of women across the globe, according to a recent systematic review. It is characterized by the presence of any two of the following: oligo-ovulation or anovulation, clinical or biochemical hyperandrogenism, or polycystic ovaries observed through ultrasound. Furthermore, PCOS is a leading cause of fertility challenges for women.
Insulin resistance is a critical metabolic feature of the pathogenesis of PCOS. Consequently, PCOS is deemed a risk factor for type 2 diabetes. Studies have demonstrated a positive correlation between elevated fasting insulin and androgen levels, where “the severity of hyperinsulinemia correlates with the degree of clinical expression of the syndrome.”
Certain nutrients, such as chromium, may be clinically relevant to women with PCOS by supporting optimal glucose and insulin metabolism. Chromium helps to promote healthy insulin metabolism at the receptor level. In one study, insulin-resistant women with PCOS (n = 132) exhibited significantly lower serum chromium levels compared to controls (n = 42).
Dietary sources of chromium vary, making measurements in food relatively inaccurate. Chromium can be found in whole grains, green beans, broccoli, nuts, and egg yolks, but the exact quantity can vary per batch. Notably, foods high in simple sugars, like sucrose and fructose, lack chromium and may, in fact, promote its excretion. As a result, supplementation may be warranted for certain individuals.
A systematic review and meta-analysis comprising seven randomized controlled trials (n = 351) explored the link between chromium and PCOS. The findings suggest that women with PCOS who were supplemented with chromium picolinate experienced significantly decreased body mass index (BMI), fasting insulin, and free testosterone. Obesity is a recognized risk factor for PCOS and insulin resistance. It has been shown that healthy weight loss may increase normal insulin responses and decrease androgen levels. Clinical trials and reviews have demonstrated that obese individuals who received chromium supplementation displayed decreased body weight and body fat compared to a placebo.
In a randomized controlled trial involving 85 women aged 20 to 35 with PCOS, participants received 1,000 mcg of chromium picolinate per day or a placebo for six months. The subjects were encouraged to maintain similar diets and exercise plans. The chromium group showed significant reductions in BMI (P < 0.001) and fasting serum insulin (P = 0.007), along with a significant rise in fasting glucose insulin ratio (P = 0.045). By the fourth month, ovulation (P = 0.011) and regular menstruation (P = 0.002) became significantly more common in the chromium group compared to the placebo group.
While chromium demonstrates support for healthy glucose and insulin metabolism, the clinical relevance to women with PCOS remains a subject of conflicting results, warranting further research. It is important to note that a whole food diet, exercise, and healthy weight loss can also help to support optimal insulin and glucose metabolism, which may promote healthy hormonal balance in women with PCOS.
By Danielle Moyer Male, MS, CNS, LDN