Evidence based

CBD and PCOS: Current Research and Understanding

Can CBD help with polycystic ovarian syndrome (PCOS)? What does the current research suggest? We’ll explore this connection in more detail.

Article By
Justin Cooke , posted 2 months ago

Polycystic ovarian syndrome (PCOS) affects roughly 10% of women in the United States. It’s one of the main causes of infertility in women in the Western world [1].

This chronic health condition is poorly understood by modern medicine — making it especially difficult to diagnose and treat. Pharmaceuticals used to manage this condition bring their own risk of side-effects — and many are simply ineffective for some women.

This has prompted a search for alternative health supplements to support their condition.

One supplement with promise is cannabidiol (CBD) — the primary non-psychoactive therapeutic compound in the cannabis plant.

Can CBD really be used to benefit PCOS? In this article, we’ll investigate how PCOS works, and explore the potential role CBD may play for this chronic health condition.

  • MEDICALLY REVIEWED BY

    Abraham Benavides, M.D.,Medical Doctor

    Updated on October 31, 2019

  • Table of Contents

Quick Summary: Potential Role of CBD For PCOS

  1. CBD may help maintain optimal insulin levels
  2. CBD may promote weight loss in PCOS sufferers
  3. CBD May relieve conditions that often present alongside PCOS (like anxiety)

What is PCOS?

PCOS stands for polycystic ovarian syndrome. It’s a collection of symptoms (syndrome), involving multiple (poly) fluid sacs (cysts) in the ovaries. It’s widely considered an endocrine disorder — which means it causes a problem with hormone levels. The most common hormones affected by PCOS is insulin, testosterone, and female reproductive hormones like estrogen, luteinizing hormone (LH), and follicle-stimulating hormone (FSH).

PCOS is characterized by the formation of cysts (fluid-filled sacs) in the ovaries — but not everybody diagnosed with this condition have these cysts.

PCOS is Not a Disease, It’s a Syndrome — What Does This Mean?

A syndrome is a collection of symptoms that occur simultaneously — often without a known cause and aren’t connected to each other. There are many different types of syndromes. An example of a syndrome you may have heard of is premenstrual syndrome — which is not a disease, but a set of symptoms.

Conversely, a disease is a specific abnormal condition that negatively affects the function of an organ or body system.

As a syndrome, there are no defining lines that group PCOS sufferers together to understand its cause and treatment. The only thing grouping them together is an overlap in the symptoms — which can vary quite a bit from one PCOS sufferer to the next.

This condition should not be confused with PCOD (polycystic ovarian disease) which has a clear cause. We’ll cover the differences between the two in more detail below.

What’s The Difference Between PCOS and PCOD?

PCOS and PCOD have similar symptoms but are very different from each other when you take a closer look.

PCOD (polycystic ovarian disease) is characterized by enlarged ovaries, usually caused by problems ejecting immature eggs from the ovaries during the menstrual cycle. This can cause the ovaries to enlarge and may begin producing excess testosterone, estrogen, or both. Many cases of PCOD have no noticeable symptoms and are only discovered by routine examination. This condition can usually be controlled by diet and lifestyle changes.

PCOS (polycystic ovarian syndrome) affects the entire body, and has a strong metabolic component and is much more severe than PCOD. With this condition, a dozen or more new cysts form in the ovaries each month. The cause of these cysts remains unknown. As cysts form, the ovaries produce more testosterone and other androgens (male hormones), which can cause dramatic changes to the body over time.

Although both conditions involve the formation of cysts in the ovaries, and changes in hormone levels — the changes involved with PCOS are much more severe. Both conditions can have a negative impact on fertility. 

What Are The Symptoms of PCOS?

Only women can experience PCOS as it’s a disorder characterized by cyst formation on the ovaries (female reproductive organ). This condition can bring many symptoms, some of which seem unrelated.

Additionally, PCOS symptoms can vary a lot from one woman to the next. This makes it incredibly difficult for researchers to study the condition. PCOS in one woman could be completely different than PCOS in another woman — and likely involves a completely separate underlying cause.

Symptoms of PCOS May Include:

  • Male-pattern hair growth (hirsutism)
  • Acne
  • Fatigue
  • Headaches
  • Infertility
  • Mood disorders
  • Pelvic pain
  • Sleeping disorders
  • Thinning of the hair on the head
  • Weight gain

What Causes PCOS?

There’s a lot of debate about the true cause of PCOS — and the truth is that there are likely to be many different causes.

What we do know is that this condition is predominantly an endocrinedisorder. Some symptoms relying on a dysfunction of the female reproductive hormones (HPO-axis), others focus more on the metabolic system (thyroid and pancreatic hormones).

All of these hormone systems rely on complex feedback loops to remain in balance. Even mild shifts in this balance can result in significant side-effects.

How does the body keep hormones in balance?

The answer is in something called a negative feedback loop — the brain tells other organs to release hormones, and only stops when it detects adequate levels of these hormones in the bloodstream (feedback).

This works in a similar way to the heating system in your house. When temperatures drop too low, the thermostat kicks the furnace on. Once it detects temperatures are within the set range, it tells the furnace to turn off again to avoid overheating the house.

If anything goes wrong during this negative feedback loop with the brain and endocrine organs (there are a lot of things that can go wrong), hormone levels can fall out of balance. This is what causes the symptoms of PCOS.

The symptoms involved with PCOS will largely rely on the endocrine organs affected.

Simplified Breakdown of Common PCOS Symptoms and Potential Causes:

Symptom Adrenal Glands Pancreas Ovaries Thyroid Gland
Male-pattern hair growth    
Acne  
Fatigue  
Headaches    
Infertility    
Mood disorders
Pelvic pain      
Sleeping disorders
Thinning of the hair on the head  
Weight gain  

PCOS and Male Hormones (Androgens)

One of the key drivers of PCOS symptoms is an excess of male hormones known as androgens.

Both men and women produce androgens like testosterone naturally. The difference is that women convert testosterone into estrogen. The most important factor is the ratio of estrogen to testosterone. In women, the ratio is heavily weighted in favor of estrogen, while men have much higher concentrations of testosterone.

With PCOS, there could be one of two problems:

  1. Excessive production of testosterone
  2. Lack of conversion into estrogen

Both result in the same thing — high testosterone levels in comparison to estrogen.

Excess androgen levels can inhibit menstruation (leading to a lack of menstruation and infertility), resulting in excess hair growth on the upper lip and back, trigger the formation of acne, and lead to changes in mood [11].

The only reliable way to find out what may be causing your symptoms is to visit a doctor.

How is PCOS Diagnosed?

If you think you may have PCOS and have not been diagnosed by a doctor, it’s important that you schedule an appointment right away.

PCOS is difficult to diagnose and is usually done through a process of elimination using advanced medical diagnostic equipment. It’s nearly impossible for someone to accurately diagnose PCOS at home.

Doctors will start with a blood test, and perform other diagnostic testing before coming to a diagnosis.

Common Tests Used to Help Diagnose PCOS:

  • Fasting insulin — PCOS patients often experience hyperinsulinemia (too much insulin in the blood)
  • Luteinizing hormone (LH): Follicle Stimulating Hormone (FSH) ratio — These hormones are key regulators of the female menstrual cycle. PCOS patients may have a ratio greater than 1:1 (usually around 2:1).
  • SHBG levels — Sex hormone-binding globulin is often low with PCOS
  • Ultrasound — This is to look for cysts on the ovaries. Cysts on the ovaries are not a confirmed diagnosis of PCOS. There are other causes for this as well.
  • Thyroid Stimulating Hormone (TSH) and thyroid hormones — This is done to rule out other causes for the symptoms like hypo or hyperthyroidism.
  • CRP — C-reactive protein is a good indicator of inflammation in the body, which can be used to identify other causes for the symptoms
  • Full blood count — By taking a look at the concentration and size of red and white blood cells, doctors may identify other causes for the condition.
  • Liver function test — In some cases, similar symptoms can be explained by problems with the liver, such as fatty liver disease.

Once the doctor has explored other options and taken family history and the patients symptoms into consideration, they’ll consider a set of criteria used to diagnose PCOS known as the Rotterdam Criteria (2003).

According to the Rotterdam Criteria, PCOS diagnosis must include at least two of the following:

  1. Oligoovulation and/or anovulation — ovulating less than normal or not at all
  2. Excess androgen activity — high concentration of male hormones in the blood
  3. Polycystic ovaries — multiple cysts found on the ovaries

Other endocrine disorders must be ruled out before a doctor will make a PCOS diagnosis.

What the Research Says: CBD and PCOS

The main target of PCOS treatment is to reduce excess androgen levels — something CBD is of little help towards.

However, the other main focus of treatment involves hyperinsulinemia (too much insulin) — which is something CBD may be useful for, according to recent research.

Secondary treatments will often focus on symptoms such as anxiety and weight loss — both of which may see benefit from cannabinoid supplements like CBD.

With that said, it’s important to always consult with your doctor when using CBD for PCOS as you’ll likely need to combine this supplement with other medications or treatment options. It’s critical you speak with your doctor first to make sure CBD or other compounds in the supplement won’t have a negative interaction with your condition or any other medications you’re taking.

There are no specific studies involving the use of CBD or other cannabinoids for PCOS at this time. There are also no signs of research in this area in the foreseeable future — so everything remains speculation for now.

Now let’s have a look at what the research says about CBD and its potential implications for a PCOS diagnosis.

1. CBD May Reduce Hyperinsulinemia (High Insulin Levels)

Hyperinsulinemia is characterized by excessive insulin levels in the bloodstream — which has a lot of overlap with diabetes.

A recent study involving more than 4600 participants diagnosed with diabetes or prediabetes had their self-reported use of marijuana and fasting insulin levels compared (a marker for hyperinsulinemia). Researchers found that participants using marijuana on a regular basis had a 16% lower insulin resistance score than non-users [2].

Researchers in this study suggested CBD as one of the key compounds responsible for producing this effect through the modulation of CB1 receptors. Other studies have shown that by blocking CB1 receptors in animal models, insulin sensitivity was improved [3]. This suggests the endocannabinoid system and CB1 receptors play a critical role in the function of insulin.

The idea is that if we’re more sensitive to the effects of insulin, we’ll have greater blood sugar regulation and improved negative feedback control of insulin balance. This is important because of the correlation of insulin imbalance with PCOS. 

2. CBD May Support Weight Loss

Roughly 80 percent of PCOS sufferers are considered overweight [4]. There are a few reasons for this:

  • Fatigue leading to less exercise
  • Hyperinsulinemia and diabetes leading to excess fat production
  • Genetic predispositions to increased weight

This suggests excess weight gain as a potential contributing factor to the underlying cause of PCOS. One of the key goals of treatment in overweight PCOS patients is to cut excess weight.

CBD may be useful for supporting weight loss in a few ways:

  1. Regulation of mitochondrial function to improve the burning of excess sugar and fat as energy [5].
  2. Reducing insulin resistance to improve blood sugar regulation and support beta-oxidation of fat [2]
  3. Reducing appetite to help lower calorie intake [6]

3. CBD May Alleviate Anxiety Symptoms

One of the main side-effects of PCOS is anxiety. This can result from stress caused by the discomfort of the condition itself, or issues involving the adrenal glands where stress hormones like cortisol are produced.

Anxiety is one of the most common reasons people are taking CBD supplements — and there’s a lot of research to back this up.

A double-blind, placebo-controlled study comparing the anti-anxiety effects of CBD to benzodiazepine anxiety medications concluded that “CBD [has] anxiolytic properties in human volunteers submitted to a stressful situation” [7].

Other studies investigating the immediate effects of CBD in the treatment of anxiety used a public speaking model to induce an anxious state in study participants. The study noted a dramatic improvement in anxiety scores compared to placebo control [8].

There are a few ways CBD provides relief from anxiety symptoms, with the most important being a potentiation of GABA in the brain [9,10], which is the primary inhibitory neurotransmitter.

When the brain becomes hyperactive it’s GABA that slows it back down again — preferably before reaching levels high enough to cause an anxiety attack.

CBD & PCOS: Considerations to Make Before Using This Supplement

Although there isn’t enough research available investigating the effects of CBD for PCOS, there are some indications that this cannabinoid may offer benefit to PCOS sufferers. Because of this, it’s important to speak with your doctor before you start using CBD to support your condition.

Let’s go over some of the other factors to consider before using CBD.

1. Take Time To Identify The Correct Dose

The correct dose of CBD will vary from one person to the next. Some people find they need a large dose to achieve the desired effects, while others may need a much smaller dose for the same results.

Although factors such as weight, age, and muscle to fat ratio are important, other factors like genetics, liver enzyme activity, underlying health conditions, digestive function, and medication use can all affect CBD supplementation.

The best way to find the right dose of CBD for your body is to start low and increase slowly over time until you achieve a dose that works for you.

Most people will start at a very low dose around 2.5 mg of CBD and increase by 2.5 mg every day until they receive the level of benefit they’re looking for. As you become familiar with how CBD works for your body, you’ll be able to adjust this dose as needed.

Doses of CBD by Weight & Strength (in mg)

Weight (lbs)Low StrengthMedium StrengthHigh Strength

100 lbs

10 mg

30 mg

60 mg

125 lbs

13 mg

38 mg

75 mg

150 lbs

15 mg

45 mg

90 mg

175 lbs

17 mg

52 mg

105 mg

200 lbs

20 mg

60 mg

120 mg

225 lbs

22 mg

67 mg

135 mg

250 lbs

25 mg

75 mg

150 mg

2. Opt for a CBD Isolate if Using Other Medications or Supplements

One of the most challenging aspects of using CBD and cannabis extracts is determining how they interact with other medications you may be using. Full-spectrum hemp extracts often contain hundreds of different compounds, any of which may have an interaction with another supplement or medication.

Therefore, it’s easier to assess drug-on-drug interactions with simpler supplements like a pure CBD isolate.

CBD isolates only contain one active ingredient (CBD) instead of many — making it much easier for a doctor to identify potential interactions with other medications or supplements in your health regimen.

3. Track Your Progress

PCOS is a chronic health condition — meaning that it doesn’t appear overnight, and won’t go away overnight either. It can take months or years to improve symptoms of PCOS, so you need to be patient.

It’s difficult to see improvement in the short term for conditions like PCOS that move slowly — so it helps to keep notes of your symptoms. This way you can compare your notes over longer periods of time to spot any changes — for good or for worse.

Think of it like this — when you’re growing up, you don’t notice that you’re a little bit taller every day, yet when you compare height measurements from a year ago you may notice a big difference. It’s the same with chronic health conditions. If you were to be asked how you feel every day, you may have the same answer — “same as yesterday”. Yet if you were to compare how you feel now, to 3 months ago, there may be a significant change — you just didn’t notice.

The best way to track your progress is to keep a journal of your symptoms. You can choose to do this every day, every few days, or even once per week.

Here are some important questions to keep in mind while tracking progress in a journal:

  1. What are your current symptoms?
  2. How would you rate each symptom on a scale of 1–10? (10 being the most severe)
  3. Did you have your period this month? If so, when did it start and stop?
  4. What foods did you eat today?
  5. What was your dose of CBD? Was there any noticeable improvement?
  6. What was your temperature upon rising in the morning? (Helpful if thyroid issues are thought to be an issue, or if you’re no longer menstruating)

Summing it All Up: CBD & PCOS

PCOS is a collection of symptoms involving the endocrine system and the formation of   cysts on the ovaries. It can significantly affect the quality of life of those affected and remains one of the leading causes of infertility in women.

This condition has a lot of overlap with diabetes, characterized by heightened insulin levels in the blood and higher than normal male hormone production.

There are no direct studies on the effects of CBD for PCOS — but there are some speculative effects we can make from other areas of research.

The most relevant effects of CBD for PCOS involve its regulating effect on insulin levels, as well as its potential to promote weight loss and support other side-effects of the condition like anxiety.

If you’re interested in trying CBD to help manage symptoms, we highly recommend visiting your doctor first. This is important to make sure the use of CBD (or any supplement) won’t interact with any of your other medications and to assess any other factors that may interfere — such as other underlying health conditions.

More research is needed to assess the specific effects of CBD for PCOS. Stay up to date with any updates in this field of study by signing up for our newsletter below.


References

  1. Asunción, M., Calvo, R. M., San Millán, J. L., Sancho, J., Avila, S., & Escobar-Morreale, H. F. (2000). A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. The Journal of Clinical Endocrinology & Metabolism, 85(7), 2434-2438.
  2. Weiss, L., Zeira, M., Reich, S., Har-Noy, M., Mechoulam, R., Slavin, S., & Gallily, R. (2006). Cannabidiol lowers incidence of diabetes in non-obese diabetic mice. Autoimmunity, 39(2), 143-151.
  3. Migrenne, S., Lacombe, A., Lefevre, A. L., Pruniaux, M. P., Guillot, E., Galzin, A. M., & Magnan, C. (2009). Adiponectin is required to mediate rimonabant-induced improvement of insulin sensitivity but not body weight loss in diet-induced obese mice. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 296(4), R929-R935.
  4. Sam, S. (2007). Obesity and polycystic ovary syndrome. Obesity management, 3(2), 69-73.
  5. Ryan, D., Drysdale, A. J., Lafourcade, C., Pertwee, R. G., & Platt, B. (2009). Cannabidiol targets mitochondria to regulate intracellular Ca2+ levels. Journal of Neuroscience, 29(7), 2053-2063.
  6. Scopinho, A. A., Guimarães, F. S., Corrêa, F. M., & Resstel, L. B. (2011). Cannabidiol inhibits the hyperphagia induced by cannabinoid-1 or serotonin-1A receptor agonists. Pharmacology Biochemistry and Behavior, 98(2), 268-272.
  7. Zuardi, A. W., Cosme, R. A., Graeff, F. G., & Guimarães, F. S. (1993). Effects of ipsapirone and cannabidiol on human experimental anxiety. Journal of psychopharmacology, 7(1_suppl), 82-88.
  8. Bergamaschi, M. M., Queiroz, R. H. C., Chagas, M. H. N., De Oliveira, D. C. G., De Martinis, B. S., Kapczinski, F., … & Martín-Santos, R. (2011). Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naive social phobia patients. Neuropsychopharmacology, 36(6), 1219.
  9. Banerjee, S. P., Snyder, S. H., & Mechoulam, R. A. P. H. A. E. L. (1975). Cannabinoids: influence on neurotransmitter uptake in rat brain synaptosomes. Journal of Pharmacology and Experimental Therapeutics, 194(1), 74-81.
  10. Bakas, T., Van Nieuwenhuijzen, P. S., Devenish, S. O., McGregor, I. S., Arnold, J. C., & Chebib, M. (2017). The direct actions of cannabidiol and 2-arachidonoyl glycerol at GABAA receptors. Pharmacological research, 119, 358-370.
  11. Apparao, K. B. C., Lovely, L. P., Gui, Y., Lininger, R. A., & Lessey, B. A. (2002). Elevated endometrial androgen receptor expression in women with polycystic ovarian syndrome. Biology of reproduction, 66(2), 297-304.

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