It’s really cool how lately in the last several years, more and more research on PCOS is becoming available, and the research is branching out into new areas and topics for PCOS and for women that have it and today’s episode and research review topic is one of these such studies. Today’s episode is reviewing a journal article titled, Effects of Melatonin Supplementation on Hormonal, Inflammatory, Genetic, and Oxidative Stress Parameters in Women with Polycystic Ovarian Syndrome. I just love that, first of all, we’re recognizing that there are hormonal and inflammatory and genetics and stressed components of the PCOS situation, as well as looking at a specific supplement, which we don’t often look at supplements in research for PCOS, and to actually look at one of the supplements to see how it affects things. While I find research extremely interesting, I will admit that sometimes reading through research can be a little tedious and not so exciting. My goal here on the podcast is to take some of the more recent research and to do my best to summarize the highlights and give you the practical takeaways. This research review was particularly interesting to me because it really does branch out into the study of things beyond just how the hormones are functioning or just the findings with PCOS and looking at how melatonin, a naturally occurring hormone that’s known for regulating our circadian rhythm, might be a beneficial supplement for women with PCOS. If you’re ready to learn more about this study, let’s dive in.

You’re listening to the PCOS Repair podcast, where we explore the ins and outs of PCOS and how to repair the imbalances in your hormones naturally with a little medical help sprinkled in. Hi, I’m Ashlene Korcek, and with many years of medical and personal experience with polycystic ovarian syndrome, it is my joy to watch women reverse their PCOS as they learn to nourish their body in a whole new way. With the power of our beliefs, our mindset, and our environment, and the understanding of our genetics, we can heal at the root cause.

Welcome back to the PCOS Repair podcast, where today we are going to be taking a look at a study about PCOS and melatonin. Now, before Before I get into reviewing this article, I do just want to give the caveat and the disclaimer that just because this article is pointing towards it may be beneficial to take melatonin, you’ll see as I go through how the research was done, it’s a small group of women that were used in this trial, and it does not mean that melatonin is the right choice for everyone, but definitely something that is going to give you some new information and some new grounds for conversation with your health care practitioner or healthcare team but at the very least, I do think it’s very interesting how melatonin levels might be a factor in PCOS health and towards the end of today’s episode, I will go through how to increase and regulate your melatonin naturally, even if you did not want to take a supplement or a supplement wasn’t a good choice for you.

First of all, in the introduction of this particular research article, and I felt like they did a really good job of talking about PCOS as an introduction, so I did want to share what they shared in their introduction that polycystic ovarian syndrome, PCOS, is one of the most prevalent endocrine disorders affecting women of reproductive age, with a reported prevalence of over 10%. It’s increasing in its prevalence, I think every year, probably partially because of awareness and more people being tested, but also more and more women are actually dealing with this disorder. I believe that that has a lot to do with the lifestyle that we have come accustomed to thinking is normal. PCOS is characterized by a spectrum of symptoms, including hyperandrogenism, which is basically high androgens or elevated imbalance hormones, ovulatory dysfunction, reproductive irregularities, PCOS presents a significant challenge in both diagnosis and management. It’s not a straightforward diagnosis. It’s not like blood pressure, where if you have a blood pressure above a certain amount on three or more readings, then you’re diagnosed with high blood pressure, this is a lot more of a moving target, it’s a lot more of a feel it out. Is it showing up as PCOS or not?

Despite decades of research, the precise etiology of PCOS remains elusive with multifactorial contributions from genetic predisposition, environmental factors, and hormonal dysregulation. The hallmark feature of PCOS, the hypo and hyperandrogenism, is believed to stem from abnormal ovarian beta cell function, resulting in excess androgen production. This hormone imbalance not only disrupts normal menstrual cycles and ovulation, but also contributes to the development of secondary symptoms such as hirsutism, acne, and alopecia. Moreover, emerging evidence suggests a pivotal role of inflammation and oxidative stress in the pathogenesis of PCOS, further complicating the clinical picture. Basically, they’re saying that our environmental factors are creating a more complex view, we already have these tendencies where our body is already going to have these tendencies, and then we add environmental factors that increase these tendencies, and we start to see the picture get even more intense, sometimes a little bit more confusing, sometimes a little bit more obvious, it depends on how those environmental factors, such as our stress, are playing into them in our inflammation, in our insulin, and how we’re eating, and all the different things that create our environment.

We may see also that we have elevated inflammatory markers, such C-reactive protein or CRP, have been observed in women with PCOS correlating with insulin resistance, obesity, and increased risk of cardiovascular disease or CVD. Again, these things are going to be changed and altered by our environment. So some women we will see these as more prominent, other women, we will not, depending on how extreme their body is reacting to their environment or how extreme their environment is, so these things are not necessarily seen in everyone with PCOS, which makes it confusing to the to the research person of are these things related or not because we’re not seeing them routinely, we’re seeing them in a hit and miss.

In light of these complexities, exploring novel therapeutic approaches of PCOS management is an important area of medical research. Melatonin, a hormone primarily synthesized by the pineal gland, has gained attention for its diverse physiological roles beyond regulating our circadian rhythm with potent antioxidant and anti-inflammatory properties, melatonin has emerged emerged as a promising candidate for alleviating some of the symptoms associated with PCOS. Moreover, studies have revealed dysregulated melatonin levels in women with PCOS implicating a potential role in the pathophysiology of this disorder. This is where whether or not a supplementation is in order or whether or not just paying special attention to how to rebalance melatonin as a hormone for women with PCOS in a more natural way, we can definitely say that this is area where we may want to pay attention when it comes to PCOS.

Okay, so how is the research designed for this particular study? First of all, this randomized control trial enrolled 56 women diagnosed with PCOS based on the Rotterdam criteria. Participants aged from 18 to 40 and received either melatonin supplementation or a placebo over a 12-week period. The participants that received melatonin were dosed at five milligram capsules muscles twice daily. Now, just caveat here, melatonin does make you drowsy. I don’t know how these people feel, they didn’t go into that from a practical standpoint, but I would say that personally, if I was going to take melatonin, I would take five milligrams at night only or before bedtime only because I don’t want to feel groggy throughout the day, which is a side effect of melatonin, even if you take it only at night.

In this study, they took it twice daily, so maybe you would need a higher dose to see the benefits of it, or you would take it in conjunction trying to elevate your melatonin naturally but again, the point of my review of this topic is just to point out that there are many different things being studied that may have some impact on our PCOS. Well, the control group received matching placebo capsules, so the participants weren’t sure who was getting what. The dosage regimen was selected based on previous studies demonstrating efficacy in other clinical contexts, and compliance with supplementation was monitored through a combination of self-reporting and periodic follow-up assessments. Additionally, participants were instructed to maintain their regular physical activity levels and refrain from taking other nutritional supplements throughout this study’s duration. So we tried to make a control of just focus on this one thing, let’s not add any other variables.

The assessment and the outcome here is the primary outcome measured in this study was the change in the malondialdehyde, which is the MDA levels, markers of oxidative stress, following the 12-week intervention period. Secondary outcome measured included alterations in serum testosterone, the Sex Hormone Binding Globulin or SHBG, High Sensitive C-reactive Protein or HS-CRP, plasma nitric oxide NO, total antioxidant capacity, the TAC, and total glutathione, which is abbreviated GSH, and the hirsutism score. Furthermore, gene expression analysis of interleukin 1 and interleukin 8, tumor necrosis factor alpha.

The conclusion was that the overall melatonin administration for 12 weeks for women with PCOS did significantly reduce, which is actually surprising to me because hair doesn’t change much in 12 weeks, to notice a difference in that is definitely interesting. They didn’t really go into how they measured that exactly or how much, but it was significantly different. That is the cool finding. Total testosterone was also significantly reduced, as well as high sensitivity C-reactive protein. That shows that both the total testosterone, which is one of our primary androgens that we deal with in PCOS that tends to be elevated. Also the C-reactive protein is a sign of inflammation. Then it also had the effect of increasing the malondialdehyde, the MDA and while those decreased over the 12-week period, we saw an increase in TAC. Remember, that was our total antioxidant capacity, which is going to help with oxidative stress and other oxidative stressors on the body, and total glutathione, so the GSH levels, which is a good thing. In addition, melatonin administration reduced gene expression of IL-1 and TNFA, so the tumor necrosis factor A and the interleukin factor I. So these were all positive findings over a fairly In 12 weeks, that’s like three months study.

That’s a decent amount of time, but also fairly short to see such improvement. So there you have it, my friend. That is our research article that I wanted to review. I think the findings are definitely interesting. Now, I do, again, want to point out that this is a small study. Over 56 participants here. Yes, 56 participants. That’s a small study, a small sampling of people. It was one demographic from Iran. Again, not a widespread study definitely opens the door, though, for doing more research and more clinical studies in this area in the future, but also sheds some light on something that we may want to be considering for ourselves and having a conversation about with our health care providers. Maybe something worth trying as long as there aren’t any contraindications or reasons not to try it but as I stated earlier, this isn’t necessarily grounds for going out and starting melatonin tonight, and I recommend talking to your health care provider first.

But before we wrap up today, I do want to go over some natural ways of increasing and managing your natural levels of melatonin. Like I said, this is a hormone that our body is produced naturally. It’s produced by the pineal gland, and it’s something that helps to regulate our circadian rhythm and as we have found, and why this study was conducted, is we have found that melatonin actually has a ton of other, besides circadian rhythm, purposes in our body. Ways that we can improve our melatonin levels naturally is to get sunlight in the morning. In the winter, this can be hard, especially if you live in the more northern states where the sun tends to come up later and later until around… Now, I’m getting close to April at the time of this recording, so it’s starting to come back, which is awesome but if you wake up much before 6:00 in the morning, it’s going to be a couple of hours before there’s really much sunlight to speak of but do your best to either get sunlight first thing in the morning or to get a light box for some in-home light therapy so that first thing in the morning, you are getting some direct sunlight. Usually, this can be 5 to 10 minutes outside. Ideally, you’re outside. It’s not just opening the window, but ideally, you’re actually not having any barriers between you and the sunlight, including sunglasses or anything like that. You’re really wanting your eyes to feel that wake up energy, and that helps our bodies to regulate the hormone of melatonin.

The other one is to sleep in a dark room. Just like we want to put ourselves into a, okay, it’s time to wake up state in the morning, we also want to put ourselves into, okay, it is time to go into hibernation sleep mode at night. Sleeping in a dark room is really important, getting blackout curtains, especially as we head in towards summer, where it can stay dark or stay light, take a while to get dark, it can stay light quite late. If you’re trying to go to bed between 9:00 and 10:00, it may not be that dark out. If you live in the city with a lot of city lights, again, blackout curtains for your bedroom are really important and trying to unplug electronic devices or anything that has some light in the room. Also keeping your phone or TV out of your room if possible. I use mine as my alarm clock, but I do turn it on do not disturb mode at night so that I’m not getting notifications, so it’s not lightening up the screen, I put it face down and I set it away from my bed with a long cord so that I can reach it when alarm goes off in the morning. Also reducing screen time at night. While it seems really nice to just relax in front of the TV in the evening, trying to turn off the screen, ideally two hours before, but at least 1 hour before going to bed is really important. So that would include TV, it would include scrolling your phone, and it would include anything on the computer, laptop, etc. The worst I have heard is to actually scroll social media and the reason is that it draws you in and it wakes up your brain in a way that, being a little bit more passive in front of a TV show or movie has less brain activity and so something about the actual scrolling through social media has an increased effect of this and so trying to reduce that before bedtime is very helpful in improving our melatonin levels.

Watching our caffeine intake. This is not saying caffeine is bad at all, but watching what time of day we drink our caffeine and watching how much over our day that we’re drinking. So one to two cups of coffee in the morning is completely and totally fine, there also has been other studies that show that there’s health benefits linked to that. So not saying skip the coffee altogether, but trying to cut it off earlier in the day. I would say somewhere between 10:00 and noon. The other thing that’s interesting about caffeine intake is to try to wait an hour to 2 hours, ideally 90 minutes, after waking up before you start your caffeine consumption. The reason is that this has to do with if you start to drink caffeine, it stops your adenosine absorption in the morning, and It actually will give you more of a slump in the afternoon. There’s a lot of science behind that. I’m not going to get into that. That’s not the point of today’s podcast but I will tell you that if you notice you have an afternoon slump, I want you to play around with not consuming your caffeine until 90 minutes after you’ve gotten out of bed and see if that makes a difference in your afternoon. Now, of course, there’s other factors that may go into that if you’re not eating enough nutrition so that you’re getting an afternoon slump or you’re having a sugar high and then getting an afternoon crash. There’s many things that can be going on there but if you play around with your caffeine consumption, do it for enough days that you can really see if it makes a difference, and wait 90 minutes after you get out of bed and see how your afternoon energy slump does, which will also help you to reduce consuming more caffeine before bedtime.

Try exercising in the morning. I think that exercise, anytime you can get it in is going to be beneficial but as far as our circadian rhythm and our melatonin levels, getting moving first thing in the morning is super helpful. Also, getting moving and trying to do a really intense workout just before bed can rub us up. Try to, similar to the TV, not do that then. Now, I think that something like a quieting down yoga or a stretch session or something that’s more calm and peaceful and doesn’t get your circulation and your heart rate up as much can be very beneficial in the evening to just round out your exercise as a whole but trying to exercise in the morning, getting that blood pumping in the morning, getting your energy up and running in the morning in the morning is very good, again, for your circadian rhythm.

Then foods that are high in melatonin, I’m going to include these in the show notes, and they include eggs, fish, milk, nuts, sprouted nuts and seeds, any sprouted breads. A lot of times they’ll have those, or Costco has some really good sprouted pumpkin seeds that are delicious on salad, and they’re raw so that you get all the benefits of the pumpkin seeds. Certain grains like oats and barley, mushrooms, dark green vegetables. Dark green vegetables are always just good for everything, but melatonin production included cherries, especially the tart cherries, and grapes, bananas, and pineapple. It’s worth noting that there’s other nutrients in these foods that are also beneficial, such as serotonin and tryptophan. They can also play a role in the production of melatonin.

All right, there you have it, these are all natural ways that you can boost your melatonin and support your PCOS. In light of this very interesting study, that may be something that women with PCOS find beneficial. Until next time, you, of course, can find me over on Instagram and get any questions you have answered over there. If you found this episode helpful, please be sure to hit the subscribe button and consider leaving a review because when you leave a review, it helps Apple and Spotify and all the podcasting platforms to also recommend this podcast to other women that may find it helpful. I really appreciate your support in that way. Until next time, bye for now.