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Berberine For PCOS: We Compare Berberine VS Metformin And Discuss The Link Between Insulin Resistance And Infertility

Polycystic Ovarian Syndrome (PCOS) occurs in 1 out of 10 women between the ages of 15-44 and results in irregular periods, acne, and an increased risk of obesity. Most PCOS cases are diagnosed in women who are in their 20s and 30s who are actively trying to become pregnant. 

PCOS mainly results from the presence of oxidative stress which is an imbalance between damaging oxidizing agents and protective antioxidants. Consequently, other more serious conditions can occur in women with PCOS including infertility and insulin resistance.

Clinicians normally treat insulin resistance with metforminーa drug that lowers blood glucose concentrations without risking hypoglycemia. However, there’s promise that berberine, a natural plant-based alkaloid, may reverse insulin resistance as effectively and at a lower cost.

Insulin Resistance And Infertility

Patients with severe cases of PCOS experience higher levels of oxidative stress and scientists have linked this to an increased prevalence of infertility and insulin resistance

Women with PCOS and central obesity are more likely to be infertile. A higher amount of adipose tissue increases the presence of free fatty acids that desensitize tissues to insulin. Consequently, insulin resistance develops which raises testosterone production and results in infertility.

There are different types of PCOS that are categorized depending on the symptoms women experience. For example, type I PCOS may lead to high levels of testosterone, infertility, and polycystic ovaries, whereas women with type IV PCOS are only infertile and have polycystic ovaries. A study found that the PCOS type dictated the severity of insulin resistance and that type I had the highest levels of insulin in the blood.

In men, infertility is also associated with insulin resistance. A review observed a clear link between insulin resistance and reduced production of sex hormones in diabetic men. Studies have found that treating insulin resistance with metformin is effective in restoring male fertility.

How To Treat Insulin Resistance Naturally

Natural therapy for insulin resistance includes better sleep, eating a diet that’s rich in fiber and low in saturated fats, and exercising on a regular basis. The overall aim of this therapy is to focus on visceral fat reduction, altering insulin metabolism, and limiting oxidative stress. Other nutrients you may want to include in your diet are turmeric, cinnamon, fenugreek, ginger, and garlic which all appear to increase insulin sensitivity.

Improving insulin sensitivity and reducing oxidative stress are the main objectives for supplemental remedies. Studies have discovered that the following supplements have potential for the natural management of insulin resistance and PCOS:

  • Omega-3 fatty acids reduce oxidative stress in mitochondria.
  • Magnesium supplementation aids in reducing insulin resistance in those with diabetes and overweight non-diabetics.
  • Chromium picolinate increases insulin receptor sensitivity and enhances insulin activity.
  • Trans-resveratrol may reverse insulin resistance but the evidence remains weak so far.
  • Live probiotics improved insulin resistance in type 2 diabetic patients.
  • Berberine is a popular choice for women with PCOSーit is as effective as metformin for reversing insulin resistance.

For PCOS, clinicians often prescribe N-acetyl cysteine (NAC) which produces the powerful antioxidant glutathione. By reducing oxidative stress, NAC helps prevent infertility and other harmful PCOS-associated conditions.

Berberine For PCOS

Women suffering from PCOS often experience insulin resistance, high levels of testosterone, and infertility. Let’s look at berberine’s effect on each of these side effects.

Insulin resistance is especially prevalent in obese patients with PCOS. A review concluded that berberine restores normal glycolipid metabolism partly due to its effect on AMP-activated Protein Kinaseーa regulatory metabolic enzyme. This regulatory action subsequently enhances insulin sensitivity and berberine achieves this by boosting insulin receptor expression and altering visceral fat distribution.

The main reason insulin is produced is to facilitate cellular glucose uptake. A review reported that berberine promotes glucose uptake in peripheral tissues, reducing the need for insulin release initially.

Abnormally high levels of testosterone in women often result in hirsutismーthe overgrowth of thick, dark hair all over the body and acne, causing psychological distress and low self-esteem. A study found that berberine (in combination with cyproterone acetate) reduces testosterone levels, preventing hair growth and acne. 

For infertility, many studies show that berberine increases ovulation and birth rates in PCOS patients. Scientists believe berberine improves fertility by modulating the hypothalamic-pituitary-adrenal (or brain-hormone) axis.

Berberine VS Metformin

Berberine Pros

  • Reduces insulin resistance
  • Fewer side effects
  • Safe in pregnant women and women planning on becoming pregnant
  • Cheaper than metformin

Berberine Cons

  • Lower bioavailability
  • GI-related side effects may occur after long-term use

Metformin Pros

  • Reduces insulin resistance
  • Recommended by FDA for effectively treating Type 2 diabetes

Metformin Cons

  • Higher incidence of side effects
  • Long-term use of metformin can affect vitamin B12 absorption
  • GI-related side effects are common in Metformin

If considering taking both, you should limit the dose of berberine due to potential drug interactions.

How Long Does It Take To Reverse Insulin Resistance?

It takes roughly 48 hours to 4-5 days to notice a significant reduction in blood sugar levels with Metformin. For berberine, many studies notice results after 3 months

Treating insulin resistance also involves altering diet and improving exercise habits, so results are very dependent on these changes.

Berberine PCOS Success Stories

For PCOS, one user found that once they started taking berberine their ovulation cycles normalized and they started having periods again. Similarly, another user with PCOS exclaimed “Holy Berberine!” in reaction to their acne disappearing and their diminished urge for binge eating.

Another PCOS sufferer who has struggled to lose weight lost 3 pounds suddenly after taking berberine for 2 weeks. They took 1,000mg in the morning and 500mg in the evening. They also found that berberine stimulated bowel movements more often, which may explain this weight loss.

However, some have found that berberine can make them feel more nauseous compared to taking metformin. Similarly, others experienced palpitations and anxiety with berberine.

On the whole, it appears that those who are taking berberine for managing PCOS symptoms notice its beneficial effects. Berberine’s side effects and possible drug interactions appear to be the only reasons why some have stopped taking it.

Take-Home Message

Berberine effectively manages PCOS symptoms and prevents the development of PCOS-associated conditions like infertility. Consequently, berberine improves the wellbeing of those that live with PCOS. Unlike metformin, it will take much longer to notice berberine working its magic on insulin resistance. However, as berberine has fewer side effects and is cheaper than metformin, it is certainly an appealing supplement to take for restoring normality to those suffering from PCOS.

Looking To Buy Berberine? Read Our Review Of The Best Berberine Supplements.

Studies And Research You Can Read About Berberine For PCOS And Insulin Resistance

Editor’s note: we are regularly updating this review. If you see any problems, weird interpretations of the data, or just want to say hi, please reach out to

Photo by Zohre Nemati on Unsplash

About the author

Lucy is a UK-based freelance writer focusing on biological content, whether it may involve animal biology or health and well being. Having achieved a First Class Zoology degree at the University of Bristol, Lucy has a diverse knowledge base and enjoys writing for others. Lucy is also a medical student in London who enjoys, in her free time, weight lifting at the gym or hiking along precarious routes in the great outdoors.

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