Natural anti-androgen supplements reduce testosterone or block its effects. In women, androgen blockers can improve the symptom of unwanted facial hair (hirsutism), often associated with PCOS.
Anti-androgen supplements are not a stand-alone treatment for facial hair or acne. You still need to fix the underlying reason for androgen excess or the underlying driver of your type of PCOS. For example, if you’ve been taking a masculinizing type of birth control, then stop taking it. If you have PCOS, then identify your type of PCOS and treat that.
👉 Tip: For acne, read How to prevent and treat post-pill acne (even if you’re not post-pill).
Restoring normal ovulation can go a long way to reducing testosterone because both estrogen and progesterone have beneficial anti-androgen effects.
Natural anti-androgen supplements for hirsutism
Zinc improves ovarian function thereby decreasing androgens and increasing progesterone, which is a natural androgen blocker. Zinc also downregulates the enzyme 5 alpha-reductase and therefore reduces the conversion of testosterone to dihydrotestosterone (DHT).
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. Read Why zinc is my favorite prescription for healthy periods.
Progesterone reduces testosterone in three ways: It downregulates 5-alpha reductase; blocks androgen receptors; and reduces luteinizing hormone (LH), thereby reducing LH stimulation of the ovary to make testosterone. The best way to obtain progesterone is to ovulate and make your own. You can also supplement progesterone as cyclic progesterone therapy.
👉 Tip: There’s no progesterone in hormonal birth control. They’re progestins, some of which are more similar to testosterone than they are to progesterone.
Peony & 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) downregulates the enzyme (CYP17A1) that produces testosterone and contains phytoestrogens that downregulate androgen production and block androgen receptors. Together, the two herbs have the synergistic effect of normalizing pituitary hormones. Peony & licorice combination did well in a 2017 clinical trial for PCOS. Licorice raises blood pressure, so 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. This natural anti-androgen 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 acts as a natural anti-androgen by blocking 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. I recommend 100 mg per day.
Vitex agnus-castus lowers prolactin and so can improve the high-prolactin type of androgen excess, which is quite different from PCOS. When prolactin is high, it can cause androgen excess by 1) increasing the adrenal androgen DHEA, and 2) up-regulating 5-alpha reductase. When prolactin is not high, Vitex can actually worsen the androgen excess PCOS. Read the Dos and don’ts of Vitex.
👉 Tip: You don’t need all of these supplements. Start with the core treatment for your type of PCOS, 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 twelve months to see an improvement.
- Chapter 7 of Period Repair Manual
- 4 Causes of Androgen Excess in Women
- 4 Types of PCOS (a Flowchart)
- Cyclic progesterone therapy for PCOS
What is your experience with natural testosterone blockers?