Natural anti-androgen treatments reduce testosterone or block its effects. In women, androgen blockers can improve the symptom of unwanted facial hair (hirsutism), usually associated with PCOS.
Anti-androgen supplements are not a stand-alone treatment for PCOS. You still need to fix the underlying driver of your type of PCOS. For example, if you have insulin-resistant PCOS, you need to quit sugar and take magnesium. By fixing the underlying driver of PCOS, you will restore normal ovulation which will naturally result in less testosterone and more estrogen and progesterone—all of which helps hirsutism or facial hair.
⚠️ Tip: Both estrogen and progesterone have strong anti-androgen effects.
⚠️ Tip: Anti-androgen treatments can also help acne, but they’re not as effective as the dietary changes and supplements discussed in my latest acne post.
Natural anti-androgen treatments for hirsutism
Zinc improves ovarian function thereby decreasing androgens and increasing progesterone, which is a natural androgen blocker. In a recent clinical trial, zinc supplementation significantly improved hirsutism in just eight weeks. The recommended dose is 30-50 mg taken directly after dinner. Don’t take zinc on an empty stomach, or it could make you feel sick. See the 7 Ways Zinc Rescues Hormones.
Peony and Licorice combination. Peony (Paeonia lactiflora) inhibits the production of testosterone and promotes the activity of the enzyme aromatase, which converts testosterone to estrogen. Licorice (Glycyrrhiza glabra) reduces serum testosterone in women and contains phytoestrogens that block androgen receptors. Together, the two herbs have the synergistic effect of normalizing the pituitary hormones. Licorice raises blood pressure, so please consult a clinician about safe use.
Reishi mushroom (Ganoderma lucidum) inhibits 5-alpha reductase which is the enzyme that converts testosterone to the more potent DHT hormone. Reishi has many other health benefits including immune enhancement and stabilization of the HPA (adrenal) axis.
DIM (diindolylmethane) is a phytonutrient derived from vegetables such as broccoli, Brussels sprouts, cabbage, and kale. It blocks androgen receptors. Because DIM inhibits the aromatase enzyme, it could have the unwanted effect of decreasing estrogen, but clinically, I’ve found it to be quite effective for both acne and hirsutism. The recommended dose is 100 mg per day.
Saw palmetto (Serenoa repens) inhibits 5-alpha reductase. It did well in a recent clinical trial for androgenetic alopecia when it was combined with green tea, vitamin D, melatonin, and soy. Like DIM, saw palmetto can have the unwanted effect of decreasing estrogen. I don’t prescribe it mainly because I prefer other treatments like zinc, peony, and licorice.
Vitex agnus-castus lowers prolactin and so improves prolactin-induced androgen excess and hirsutism. High prolactin can induce androgen excess in two ways: 1) It increases the adrenal androgen DHEA, and 2) it up-regulates 5-alpha reductase. High prolactin is not common with PCOS which is one reason I usually don’t prescribe Vitex for PCOS. See the Do’s and Don’ts of Vitex.
Progesterone inhibits 5-alpha reductase and blocks androgen receptors. The best way to obtain progesterone is to ovulate and make your own. You can also supplement it. See the 7 Superpowers of Progesterone.
⚠️ Tip: There’s no progesterone in hormonal birth control.
⚠️ Tip: You don’t need all of these supplements. Start with your core PCOS treatment such as quitting sugar and taking magnesium, and then choose one additional anti-androgen treatment such as zinc.
Hirsutism takes a long time to improve
Facial hair or hirsutism is one of the most frustrating symptoms of PCOS and the slowest to improve. Even once you have all the right treatment in place, you may still have to wait six to twelve months to see an improvement.
What is your experience with natural testosterone blockers for PCOS? Please comment.
Yours in health,