Multimedialna platforma wiedzy medycznej Internetowa Księgarnia Medyczna Kalendarium Konferencji
Ginekologia Polska
MENU
Shortcuts Submit an article Author Guidelines Ahead Of Print Reviewers 2023

open access

Vol 95, No 4 (2024)
Review paper
Published online: 2023-12-18
View PDF Download PDF file
Get Citation

The role of berberine in polycystic ovary syndrome — a summary of knowledge

Jan Jurgiel1, Adrianna Graniak1, Piotr Opyd1, Tomasz Zawodny1, Michal Lis12
DOI: 10.5603/gpl.95138
·
Pubmed: 38108460
·
Ginekol Pol 2024;95(4):276-284.
Affiliations
  1. Internal Medicine Department with Endocrinology and Diabetology Subdepartment and Nephrology Sub-department with Dialysis Station, Warsaw, Poland
  2. Faculty of Medicine, Lazarski University, Warsaw, Poland

open access

Vol 95, No 4 (2024)
REVIEW PAPERS Gynecology
Published online: 2023-12-18

Abstract

Polycystic ovary syndrome (PCOS) is a widely prevalent condition that affects approximately 5–10% of women of reproductive age. Although first described in the 18th century, a detailed account of the disease was not provided until Stein and Leventhal's 1935 report. Due to the varied symptomatology of PCOS, treatment must be tailored and often involves using multiple drugs for optimal pharmacotherapy. Berberine, an alkaloid with a longstanding history of use, has gained popularity as a potential treatment option for PCOS. Previous studies have demonstrated that berberine can improve hormonal imbalances by reducing testosterone and FAI, increasing SHBG, and mitigating the clinical symptoms of androgen excess, including hirsutism and acne. Moreover, berberine enhances the therapeutic effects of other drugs commonly used in PCOS, such as metformin and oral contraceptive pills. It is generally well-tolerated with a favourable safety profile. However, further research is warranted to establish conclusive evidence regarding berberine's mechanistic underpinnings, therapeutic potential, and long-term safety as a PCOS treatment modality.

Abstract

Polycystic ovary syndrome (PCOS) is a widely prevalent condition that affects approximately 5–10% of women of reproductive age. Although first described in the 18th century, a detailed account of the disease was not provided until Stein and Leventhal's 1935 report. Due to the varied symptomatology of PCOS, treatment must be tailored and often involves using multiple drugs for optimal pharmacotherapy. Berberine, an alkaloid with a longstanding history of use, has gained popularity as a potential treatment option for PCOS. Previous studies have demonstrated that berberine can improve hormonal imbalances by reducing testosterone and FAI, increasing SHBG, and mitigating the clinical symptoms of androgen excess, including hirsutism and acne. Moreover, berberine enhances the therapeutic effects of other drugs commonly used in PCOS, such as metformin and oral contraceptive pills. It is generally well-tolerated with a favourable safety profile. However, further research is warranted to establish conclusive evidence regarding berberine's mechanistic underpinnings, therapeutic potential, and long-term safety as a PCOS treatment modality.

Full Text:

View PDF Download PDF file
Get Citation

Keywords

berberine; polycystic ovary syndrome; pcos; hyperandrogenism; androgens; pcos treatment

About this article
Title

The role of berberine in polycystic ovary syndrome — a summary of knowledge

Journal

Ginekologia Polska

Issue

Vol 95, No 4 (2024)

Article type

Review paper

Pages

276-284

Published online

2023-12-18

Page views

586

Article views/downloads

536

DOI

10.5603/gpl.95138

Pubmed

38108460

Bibliographic record

Ginekol Pol 2024;95(4):276-284.

Keywords

berberine
polycystic ovary syndrome
pcos
hyperandrogenism
androgens
pcos treatment

Authors

Jan Jurgiel
Adrianna Graniak
Piotr Opyd
Tomasz Zawodny
Michal Lis

References (54)
  1. Rondanelli M, Riva A, Petrangolini G, et al. Berberine Phospholipid Is an Effective Insulin Sensitizer and Improves Metabolic and Hormonal Disorders in Women with Polycystic Ovary Syndrome: A One-Group Pretest-Post-Test Explanatory Study. Nutrients. 2021; 13(10).
    CrossRefPubMed
  2. Battaglia C. The role of ultrasound and Doppler analysis in the diagnosis of polycystic ovary syndrome. Ultrasound Obstet Gynecol. 2003; 22(3): 225–232.
    CrossRefPubMed
  3. Speca S, Napolitano C, Tagliaferri G. The pathogenetic enigma of polycystic ovary syndrome. J Ultrasound. 2007; 10(4): 153–160.
    CrossRefPubMed
  4. Stein I, Leventhal M. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol. 1935; 29(2): 181–191.
    CrossRef
  5. Zawadski JK, Dunaif A. Diagnostic Criteria for Polycystic Ovary Syndrome: Towards a Rational Approach. Blackwell Scientific. 1992: 377–384.
  6. Teede HJ, Tay CT, Laven J, et al. International PCOS Network, International PCOS Network, International PCOS Network, International PCOS Network. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod. 2018; 33(9): 1602–1618.
    CrossRefPubMed
  7. Rosenfield RL, Ehrmann DA. The Pathogenesis of Polycystic Ovary Syndrome (PCOS): The Hypothesis of PCOS as Functional Ovarian Hyperandrogenism Revisited. Endocr Rev. 2016; 37(5): 467–520.
    CrossRefPubMed
  8. Azziz R, Carmina E, Dewailly D, et al. Task Force on the Phenotype of the Polycystic Ovary Syndrome of The Androgen Excess and PCOS Society. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril. 2009; 91(2): 456–488.
    CrossRefPubMed
  9. Yang R, Yang S, Li R, et al. Effects of hyperandrogenism on metabolic abnormalities in patients with polycystic ovary syndrome: a meta-analysis. Reprod Biol Endocrinol. 2016; 14(1): 67.
    CrossRefPubMed
  10. Moran LJ, Norman RJ, Teede HJ. Metabolic risk in PCOS: phenotype and adiposity impact. Trends Endocrinol Metab. 2015; 26(3): 136–143.
    CrossRefPubMed
  11. Moghetti P, Tosi F, Bonin C, et al. Divergences in insulin resistance between the different phenotypes of the polycystic ovary syndrome. J Clin Endocrinol Metab. 2013; 98(4): E628–E637.
    CrossRefPubMed
  12. Dapas M, Lin FTJ, Nadkarni GN, et al. Distinct subtypes of polycystic ovary syndrome with novel genetic associations: An unsupervised, phenotypic clustering analysis. PLoS Med. 2020; 17(6): e1003132.
    CrossRefPubMed
  13. Saria S, Goldenberg A. Subtyping: What It is and Its Role in Precision Medicine. IEEE Intell Syst. 2015; 30(4): 70–75.
    CrossRef
  14. Franks S, Stark J, Hardy K. Follicle dynamics and anovulation in polycystic ovary syndrome. Hum Reprod Update. 2008; 14(4): 367–378.
    CrossRefPubMed
  15. Lebbe M, Woodruff TK. Involvement of androgens in ovarian health and disease. Mol Hum Reprod. 2013; 19(12): 828–837.
    CrossRefPubMed
  16. Pappalardo MA, Vita R, Di Bari F, et al. Gly972Arg of IRS-1 and Lys121Gln of PC-1 polymorphisms act in opposite way in polycystic ovary syndrome. J Endocrinol Invest. 2017; 40(4): 367–376.
    CrossRefPubMed
  17. Rodriguez Paris V, Bertoldo MJ. The Mechanism of Androgen Actions in PCOS Etiology. Med Sci (Basel). 2019; 7(9).
    CrossRefPubMed
  18. Neag MA, Mocan A, Echeverría J, et al. Berberine: Botanical Occurrence, Traditional Uses, Extraction Methods, and Relevance in Cardiovascular, Metabolic, Hepatic, and Renal Disorders. Front Pharmacol. 2018; 9: 557.
    CrossRefPubMed
  19. Gao Yu, Wang F, Song Y, et al. The status of and trends in the pharmacology of berberine: a bibliometric review [1985-2018]. Chin Med. 2020; 15: 7.
    CrossRefPubMed
  20. Chen C, Yu Z, Li Y, et al. Effects of berberine in the gastrointestinal tract - a review of actions and therapeutic implications. Am J Chin Med. 2014; 42(5): 1053–1070.
    CrossRefPubMed
  21. Feng X, Sureda A, Jafari S, et al. Berberine in Cardiovascular and Metabolic Diseases: From Mechanisms to Therapeutics. Theranostics. 2019; 9(7): 1923–1951.
    CrossRefPubMed
  22. Shou JW, Shaw PC. Therapeutic Efficacies of Berberine against Neurological Disorders: An Update of Pharmacological Effects and Mechanisms. Cells. 2022; 11(5).
    CrossRefPubMed
  23. Zhou H, Mineshita S. The effect of berberine chloride on experimental colitis in rats in vivo and in vitro. J Pharmacol Exp Ther. 2000; 294(3): 822–829.
    PubMed
  24. Rabbani GH, Butler T, Knight J, et al. Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae. J Infect Dis. 1987; 155(5): 979–984.
    CrossRefPubMed
  25. Liang Y, Ye C, Chen Y, et al. Berberine Improves Behavioral and Cognitive Deficits in a Mouse Model of Alzheimer's Disease via Regulation of β-Amyloid Production and Endoplasmic Reticulum Stress. ACS Chem Neurosci. 2021; 12(11): 1894–1904.
    CrossRefPubMed
  26. Wang Y, Tong Q, Ma SR, et al. Oral berberine improves brain dopa/dopamine levels to ameliorate Parkinson's disease by regulating gut microbiota. Signal Transduct Target Ther. 2021; 6(1): 77.
    CrossRefPubMed
  27. Zeng XH, Zeng XJ, Li YY. Efficacy and safety of berberine for congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol. 2003; 92(2): 173–176.
    CrossRefPubMed
  28. Meng S, Wang LS, Huang ZQ, et al. Berberine ameliorates inflammation in patients with acute coronary syndrome following percutaneous coronary intervention. Clin Exp Pharmacol Physiol. 2012; 39(5): 406–411.
    CrossRefPubMed
  29. Holick MF, Lamb JJ, Lerman RH, et al. Hop rho iso-alpha acids, berberine, vitamin D3 and vitamin K1 favorably impact biomarkers of bone turnover in postmenopausal women in a 14-week trial. J Bone Miner Metab. 2010; 28(3): 342–350.
    CrossRefPubMed
  30. Ming J, Yu X, Xu X, et al. Effectiveness and safety of Bifidobacterium and berberine in human hyperglycemia and their regulatory effect on the gut microbiota: a multi-center, double-blind, randomized, parallel-controlled study. Genome Med. 2021; 13(1): 125.
    CrossRefPubMed
  31. Zhang Y, Li X, Zou D, et al. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab. 2008; 93(7): 2559–2565.
    CrossRefPubMed
  32. Yang J, Yin J, Gao H, et al. Berberine improves insulin sensitivity by inhibiting fat store and adjusting adipokines profile in human preadipocytes and metabolic syndrome patients. Evid Based Complement Alternat Med. 2012; 2012: 363845.
    CrossRefPubMed
  33. Wei W, Zhao H, Wang A, et al. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. Eur J Endocrinol. 2012; 166(1): 99–105.
    CrossRefPubMed
  34. Li L, Li C, Pan P, et al. A Single Arm Pilot Study of Effects of Berberine on the Menstrual Pattern, Ovulation Rate, Hormonal and Metabolic Profiles in Anovulatory Chinese Women with Polycystic Ovary Syndrome. PLoS One. 2015; 10(12): e0144072.
    CrossRefPubMed
  35. An Y, Sun Z, Zhang Y, et al. The use of berberine for women with polycystic ovary syndrome undergoing IVF treatment. Clin Endocrinol. 2013; 80(3): 425–431.
    CrossRef
  36. Orio F, Muscogiuri G, Palomba S, et al. Berberine improves reproductive features in obese Caucasian women with polycystic ovary syndrome independently of changes of insulin sensitivity. e-SPEN Journal. 2013; 8(5): e200–e204.
    CrossRef
  37. Li J, Cao Bo, Liu X, et al. Berberine suppresses androgen receptor signaling in prostate cancer. Mol Cancer Ther. 2011; 10(8): 1346–1356.
    CrossRefPubMed
  38. Horman S, Vertommen D, Heath R, et al. Insulin antagonizes ischemia-induced Thr172 phosphorylation of AMP-activated protein kinase alpha-subunits in heart via hierarchical phosphorylation of Ser485/491. J Biol Chem. 2006; 281(9): 5335–5340.
    CrossRefPubMed
  39. Zhang SW, Zhou J, Gober HJ, et al. Effect and mechanism of berberine against polycystic ovary syndrome. Biomed Pharmacother. 2021; 138: 111468.
    CrossRefPubMed
  40. Manna PR, Stetson CL, Slominski AT, et al. Role of the steroidogenic acute regulatory protein in health and disease. Endocrine. 2016; 51(1): 7–21.
    CrossRefPubMed
  41. Heidarzadehpilehrood R, Pirhoushiaran M, Abdollahzadeh R, et al. A Review on , , and Polymorphism Studies: Candidate Susceptibility Genes for Polycystic Ovary Syndrome (PCOS) and Infertility. Genes (Basel). 2022; 13(2).
    CrossRefPubMed
  42. Goodman NF, Cobin RH, Futterweit W, et al. American Association of Clinical Endocrinologists (AACE), American College of Endocrinology (ACE), Androgen Excess and PCOS Society (AES). AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ANDROGEN EXCESS AND PCOS SOCIETY DISEASE STATE CLINICAL REVIEW: GUIDE TO THE BEST PRACTICES IN THE EVALUATION AND TREATMENT OF POLYCYSTIC OVARY SYNDROME--PART 1. Endocr Pract. 2015; 21(11): 1291–1300.
    CrossRefPubMed
  43. Cignarella A, Mioni R, Sabbadin C, et al. Pharmacological Approaches to Controlling Cardiometabolic Risk in Women with PCOS. Int J Mol Sci. 2020; 21(24).
    CrossRefPubMed
  44. Brahm J, Brahm M, Segovia R, et al. Acute and fulminant hepatitis induced by flutamide: case series report and review of the literature. Ann Hepatol. 2011; 10(1): 93–98.
    PubMed
  45. Moghetti P, Castello R, Negri C, et al. Flutamide in the treatment of hirsutism: long-term clinical effects, endocrine changes, and androgen receptor behavior. Fertil Steril. 1995; 64(3): 511–517.
    CrossRefPubMed
  46. Hage M, Plesa O, Lemaire I, et al. Estrogen and Progesterone Therapy and Meningiomas. Endocrinology. 2022; 163(2).
    CrossRefPubMed
  47. Dinicola S, Unfer V, Facchinetti F, et al. Inositols: From Established Knowledge to Novel Approaches. Int J Mol Sci. 2021; 22(19).
    CrossRefPubMed
  48. Milewska EM, Czyzyk A, Meczekalski B, et al. Inositol and human reproduction. From cellular metabolism to clinical use. Gynecol Endocrinol. 2016; 32(9): 690–695.
    CrossRefPubMed
  49. Jensterle M, Goricar K, Janez A. Metformin as an initial adjunct to low-dose liraglutide enhances the weight-decreasing potential of liraglutide in obese polycystic ovary syndrome: Randomized control study. Exp Ther Med. 2016; 11(4): 1194–1200.
    CrossRefPubMed
  50. Elkind-Hirsch K, Marrioneaux O, Bhushan M, et al. Comparison of single and combined treatment with exenatide and metformin on menstrual cyclicity in overweight women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2008; 93(7): 2670–2678.
    CrossRefPubMed
  51. Mishra N, Verma R, Jadaun P. Study on the Effect of Berberine, Myoinositol, and Metformin in Women with Polycystic Ovary Syndrome: A Prospective Randomised Study. Cureus. 2022; 14(1): e21781.
    CrossRefPubMed
  52. Wu XK, Wang YY, Liu JP, et al. Reproductive and Developmental Network in Chinese Medicine. Randomized controlled trial of letrozole, berberine, or a combination for infertility in the polycystic ovary syndrome. Fertil Steril. 2016; 106(3): 757–765.e1.
    CrossRefPubMed
  53. Li MF, Zhou XM, Li XL. The Effect of Berberine on Polycystic Ovary Syndrome Patients with Insulin Resistance (PCOS-IR): A Meta-Analysis and Systematic Review. Evid Based Complement Alternat Med. 2018; 2018: 2532935.
    CrossRefPubMed
  54. Rondanelli M, Riva A, Petrangolini G, et al. Berberine Phospholipid Is an Effective Insulin Sensitizer and Improves Metabolic and Hormonal Disorders in Women with Polycystic Ovary Syndrome: A One-Group Pretest-Post-Test Explanatory Study. Nutrients. 2021; 13(10).
    CrossRefPubMed

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl