Berberine for PCOS: Research, Periods and Hormonal Health

It's Polyendocrine Metabolic Ovarian Syndrome (PMOS) Awareness Month and at Lena, we believe the dissemination of evidence-based and current literature supports women in making the best decisions about their health, so we wanted to share our latest findings, from our medical expert Dr Rachel Denham. PMOS is a complex condition and many practitioners and doctors are searching for novel ways to help their patients. Enter, Berberine, the ancient herb that is making waves in PMOS research. We're diving into how it works and why it is being used for these patients.

What Is Berberine And How Does It Work?

Berberine is a naturally occurring yellow alkaloid compound extracted from plants like barberry and goldenseal, found in many herbal plants like barberry and goldenseal, with widespread use in Traditional Chinese and Ayurvedic medicine for different health conditions. It has primarily been studied for metabolic* conditions and cancers, with new and exciting research discussing its effects in people with PMOS.

Because of its deep yellow colour, it was initially used as a dye for wool and other fabrics. The compound Berberine is found in Berberis plants and there have been many documented accounts of its medicinal use for 1000s of years. In particular, the combination of Berberine and Curcumin (found in turmeric) is discussed frequently in research as an aid to reduce inflammation.

Berberine is a pleiotropic molecule, meaning it has many different effects across the body. Some of the most important effects are:

• Reducing glucose levels. According to one 2023 study, Berberine "alleviates insulin resistance, promotes insulin secretion, promotes glucose uptake, induces glycolysis, and inhibits gluconeogenesis in the liver".
• Improving fertility outcomes in women with PMOS.

*A metabolic condition is one that negatively impacts the body's ability to process and distribute nutrients such as carbohydrates, proteins and fats.

How Can PMOS/PCOS Affect Your Periods?

Polycystic ovary syndrome (PCOS), also referred to as PMOS, can affect more than your hormones. It can also change your menstrual cycle.

If you have PCOS, you might experience irregular periods, longer gaps between periods or missed periods altogether. This is often linked to changes in ovulation, the process in which an ovary releases an egg. When ovulation happens irregularly, your periods can become less predictable too.

Insulin resistance is also common in PCOS. This is when the body's cells respond less effectively to insulin, the hormone that helps regulate blood sugar. Higher insulin levels can contribute to hormonal changes, including increased androgen levels, which may affect ovulation and menstrual regularity.

Hormones influence many aspects of the menstrual cycle, from ovulation to the changes that happen throughout the month. If you want to understand how these processes work together, explore our guide to hormones, what they do and how they work.

What can irregular periods tell you?

An irregular menstrual cycle can have several causes, and it does not automatically mean you have PCOS. However, if your periods are consistently irregular, you regularly miss periods or your usual cycle changes significantly, it is worth speaking with a healthcare professional.

Tracking your period dates, cycle length and any changes in bleeding can help you notice patterns and give your healthcare professional useful information. You can learn more about the power of ovulation and understanding your menstrual cycle to help you become more familiar with your body's patterns.

If you have PCOS and experience infrequent periods, it is particularly important to discuss this with a healthcare professional, as going long periods without a bleed can increase the risk of the uterine lining becoming too thick.

If you're unsure how to raise concerns about your cycle, our guide on how to talk to your doctor about women's health can help you prepare for that conversation.

Understanding your menstrual cycle is one part of understanding your hormonal health. It can also help you recognise when a change deserves further investigation. For a broader introduction to the different phases of your cycle, read our guide to making your menstrual cycle your superpower.

Can Berberine Help Regulate Your Period?

Berberine is a plant-derived compound that has been studied for its potential effects on insulin resistance and metabolic health. Because insulin resistance can play a role in PCOS, researchers have also investigated whether berberine might influence menstrual regularity and ovulation.

Some small studies have reported improvements in menstrual regularity among people with PCOS taking berberine. However, the evidence remains limited, and differences in study design, supplement formulations and study quality make it difficult to draw firm conclusions. Berberine has not been established as a reliable treatment for irregular periods or PCOS.

It is also important to remember that irregular periods can have different causes. Taking a supplement without understanding the reason for a cycle change may delay appropriate assessment or treatment.

What Does The Research Say About Berberine And PMOS?

Women with PMOS have an infertility rate that is "15 times greater and an early pregnancy loss rate three times greater" than women without PMOS. Berberine's ability to reduce glucose levels and reduce insulin resistance in women has a direct impact on a woman's fertility outcomes.

Raised insulin levels in PMOS 

Furthering this, because women with PMOS are predisposed to developing gestational (pregnancy-related) diabetes, Berberine shows promising results in also reducing these rates if the woman does go on to have a pregnancy.

How Do I Get Berberine?

Berberine is sold in the UK as an unregulated supplement, rather than a medicine which your doctor would prescribe. Because it is unregulated, it's important to go with a trusted provider of supplements and herbs, as it won't have any medical approval stamps.

You can order Berberine online from many different stockists, we recommend doing your research beforehand so you find a high quality supplement.

Is berberine safe to take for PCOS?

Berberine can cause side effects, including digestive discomfort, and it can interact with certain medications. It should not be treated as a substitute for medical care. People who are pregnant, breastfeeding or trying to conceive should seek medical advice before considering berberine, as its safety in these situations is a concern.

If you are considering berberine for PCOS, insulin resistance or irregular periods, speak with a qualified healthcare professional first. They can help you understand the potential benefits and risks, discuss the available evidence and consider options suited to your individual circumstances.

Your periods can offer useful clues about your health, but they are only one part of the picture. If your cycle changes or you are concerned about irregular bleeding, getting personalised advice is a better starting point than relying on a supplement alone.

If you're also exploring reusable period care, our Menstrual Cup 101 guide explains how menstrual cups work and offers practical guidance on getting started.

Written and edited by Dr Rachel Denham, a trained medic and Women's Health Practitioner, who has worked across the charity and humanitarian sector and now specialises in women's health. Rachel is the creator of Bloody Nora, a women's health and wellbeing zine that fuses storytelling, art and science.