Fall is in full swing and winter is fast approaching: consequently, most of our houses have an alluring aroma of nutmeg, clove, and cinnamon. This blend of spices is like a drug to Americans. Cinnamon rolls, apple pie, apple cider, pumpkin pie, pumpkin spice lattes – all of these favorites feature the bold flavors, we seemingly can’t get enough. For those who suffer from polycystic ovary syndrome (PCOS), this obsession may be to your benefit!
Polycystic ovary syndrome (PCOS) is a common cause of infertility, affecting 5-10% of reproductive-age women, and has both hormonal and metabolic components.1 Many women suffer irregular periods or lack thereof, overabundance of male hormones (hyperandrogenism), acne, insulin resistance, diabetes, maybe even some very much-unwanted facial hair (hirsutism), and that’s just to name a few of the long list of possible external and internal symptoms. Of all the symptoms, insulin resistance and hyperinsulinemia (excessive amounts of insulin in the blood compared to glucose) are the predominant defects.
Let’s pretend it’s Christmas already for a minute. You’re sitting around the dinner table surrounded by friends and family with a veritable surfeit of food in front of you, possibly even that pumpkin pie I mentioned before (in my family it’s typically rhubarb and mincemeat, but to each his own). After you have thoroughly savored every morsel, your digestive system begins to breakdown the food into its molecular components, one of which is glucose (from your carbohydrates) which then moves to your bloodstream and causes your blood sugar to spike. Glucose is pivotal to your body – it’s how many of your body cells make their energy. When your blood sugar increases, it triggers your pancreas to start making the hormone insulin. Insulin is like a parent instructing a child; it goes to your cells and tells them to start taking up glucose out of the bloodstream and start converting it to energy. As the cells start importing the glucose, your blood sugar levels begin to decrease and eventually return to normal.
This interaction exists in a balance. If you have insulin resistance, your cells are like unruly teenagers who don’t listen and won’t listen no matter what you say to them. The cells respond poorly to the insulin and consequently significantly less glucose in transferred from the bloodstream to the cells, resulting in continued high blood sugar. In an effort to compensate, the pancreas produces more and more insulin resulting in an excessive amount of insulin in the bloodstream compared to the level of resident glucose; this kind of imbalance is called “hyperinsulinemia” – ‘hyper’ meaning too much, ‘insulin’ obviously means insulin, and ‘-nemia’ is a suffix meaning blood.
In the ovaries, there are also insulin receptors, but rather than telling your ovarian cells to simply let more glucose in, these cells (stroma cells) are stimulated to produce male hormones (androgens).1 So if the body has an excessive amount of insulin, it is easy to see how that could also produce an excessive amount of androgens, eventually resulting in the characteristic hyperandrogenism seen in PCOS patients. That hyperandrogenism is what causes the intermittent or absent periods, increased amount of hair, acne, hypertension, etc.
In an attempt to try to rectify this type II diabetes insulin/hyperinsulinemia/hyperandrogenism debacle, women with PCOS may be prescribed “insulin sensitizing agents” such as metformin and thiazolidinedione (TZD).3 While they work to decrease insulin resistance, improve ovulatory functions, and make your periods less irregular, they come with a handful side effects. On one hand, metformin may result in your heading to the bathroom more often with complaints of nausea (61%), vomiting (30%), and/or diarrhea (65%). On the other hand, TZD’s list of side effects include liver complications, edema, heart failure, and increased risk of bone fracture.
Makes you really want another option doesn’t it?
For a while we have heard cinnamon helps regulate your blood sugar, which it does by improving insulin sensitivity and even mimicking insulin so that even more glucose is moved into your cells and out of the bloodstream.
With this in mind, it seems reasonable to surmise that cinnamon may be able to help fight hyperinsulinemia by making the body more sensitive to it, thereby negating the necessity of the pancreas to make too much of this vital hormone.
Back in 2013 and 2014, a couple of small clinical trials out of Columbia University found cinnamon increases the number of menstrual cycles in women with PCOS.2 In a randomized double-blinded study, women with PCOS were given either cinnamon pills or a placebos daily for 6 months while their diet and activity levels were monitored. Unfortunately, of the initial 45 patients, only 16 completed the entire 6 months: 11 who were given the daily dose of cinnamon, 5 who had the placebo. Initially both these groups had about two periods every 6 months; following the supplementation of cinnamon, those in the experimental group had nearly two more periods than those who had the placebo in that 6-month timeframe. (Yes, I know “nearly two periods” sounds weird, because how can you have less than a period? Remember these are statistics and not everyone had the same number of periods in that 6-month time, so the numbers won’t come out evenly when averaged).
This was a small sampling, so this group put together another experiment, this time taking more measurements. Again the study was plagued by a small sampling as a result of people dropping out of the study or becoming ineligible to continue before the end date; of the original 45, only 17 completed. While they didn’t find a significant improvement in androgen levels and other similar markers, they did see a statistically increased number of menstrual cycles in the group that had cinnamon.
The group holds that a high dropout rate is typical, so this should be considered a pilot study to support future studies. Indeed later studies seem to corroborate this, though their study parameters are slightly varied.
Just a couple months ago, in October, a lab out of China did a mouse model study looking at the effects at the hormone level.1 When cinnamon was included in the daily regimen, they found it decreased the amount of testosterone and insulin in the mice with PCOS. They also measured IGF-1 (insulin-like growth factor 1) and IGFBR-1 (IGF Binding Protein 1) which are involved in androgen production; IGF-1 works with luteinizing hormone (LH) – that hormone everyone with their Ovulation Predictor Kits are obsessing over – to produce androgens, while IGFBP-1 stops this from happening. In a normal state there is much more IGFBR-1 than IGF-1; however, the reverse is seen in the PCOS mice. When cinnamon was added, this reversed condition was ameliorated; it wasn’t exactly back to “normal levels,” but it was better. In the end they found the majority of PCOS mice dosed with cinnamon had more estrus cycles (the name for menstrual cycles in mice) than those that didn’t.
So it seems that cinnamon may be able to help decrease some of your PCOS symptoms. In the studies they use 1.5 grams per day of cassia cinnamon – that amounts to about a ½ teaspoon.
Add it to your morning oatmeal, tea, yogurt, or atop your snack of apple slices and enjoy! Hopefully your body will enjoy it, too.
1Dou, L., Zheng, Y., Li, L., Gui, X., Chen, Y., Yu, M., & Guo, Y. (2018). The effect of cinnamon on polycystic ovary syndrome in a mouse model. Reproductive Biology and Endocrinology,16(1). doi:10.1186/s12958-018-0418-y
2Kort, D., Sullivan, C., Kostolias, A., Depinho, J., & Lobo, R. (2013). Cinnamon supplementation improves menstrual cyclicity in women with polycystic ovary syndrome. Fertility and Sterility,100(3). doi:10.1016/j.fertnstert.2013.07.814
3Kort, D. H., & Lobo, R. A. (2015). Preliminary Evidence that Cinnamon Improves Menstrual Cyclicity in Women With Polycystic Ovary Syndrome. Obstetrical & Gynecological Survey,70(2), 94-95. doi:10.1097/01.ogx.0000461902.16853.84