What is PCOS?
Polycystic ovarian syndrome (PCOS for short) is extremely common, with a 2011 study reporting that PCOS affects 12-21% of women in reproductive age. In this study, it was apparent that 70% of women with PCOS were undiagnosed. (1)
Unlike the name suggests, PCOS refers to having multiple follicles/eggs (not cysts) on the ovaries which is actually quite common and normal. PCOS occurs when there is excess amounts of androgen hormones (male hormones), thus it is an endocrine disorder. (2)
Symptoms of PCOS include irregular or no periods, cystic acne on the jaw line, hirsutism or male hair growth, weight gain and recurrent miscarriages. (2)
Diagnosis
Diagnosis of PCOS according to the Rotterdam Criteria is having 2 out of these 3 key clinical features:
1. Irregular, or anovulation (no periods).
2. Hyperandrogenism (indicated by high levels of androgens in the blood or clinical signs such as jaw line acne and hirsutism)
3. Multiple follicles on the ovaries on ultrasound (just having this does NOT mean you have PCOS; women often have many follicles which may lead to PCOS overdiagnosis). (1)
PCOS Types
There are different types of PCOS depending on the underlying driving cause. These include post-pill PCOS (a transient condition from coming of the oral contraceptive pill), inflammatory PCOS, insulin-resistant PCOS and adrenal PCOS. (2)
Treatment with Spearmint Tea
Mentha spicata Labiatae (Spearmint) is one herbal management approach that has demonstrated some positive clinical research for PCOS.
In herbal medicine, spearmint is commonly utilised for its antispasmodic and carminative actions, deeming it useful in digestive disorders. (3)
Women with PCOS have elevated androgens, often coupled with elevated luteinising hormone (LH) and lowered follicular stimulating hormone (FSH).
One study randomised forty two women with PCOS and hirsutism to have either 2 cups of chamomile or spearmint tea a day for one month. (4) Hormone levels were assessed at 0, 15 and 30 days. At the end of the 30 days, free and total testosterone levels were significantly lowered in the spearmint tea group. LH and FSH also increased significantly.
Subjective assessments of hirsutism severity were also significantly reduced in the spearmint tea group. Despite this, there were no significant reduction in the objective Ferriman-Gallwey ratings of hirsutism between the two groups however this may be due to the short study duration. (4)
One animal study examined rats who were administered with spearmint essential oil or placebo for twenty days. (3) Rats were divided into those with normal reproductive cycles or those with induced-PCOS. After the study duration it was found that in PCOS rats, spearmint oil significantly reduced body weight, testosterone levels, ovarian cysts and atretic follicles whilst increasing Graafian follicles. (3)
Another shorter five day study in twenty one females (12 with PCOS and 9 with idiopathic hirsutism) examined the effects of consuming two cups of spearmint tea per day in the follicular phase of their menstrual cycles. After the five days, a significant decrease in free testosterone levels was seen whilst there was an increase in luteinizing hormone, follicle-stimulating hormone and estradiol. There were also significant reductions in triglyceride levels. (5)
A study published this year demonstrated the combined effects of spearmint and flaxseed extract on rats with normal cycles or PCOS-induced rats for 30 days. (6) At the end of treatment, a significant rise in progesterone and a decrease in both testosterone and estradiol was seen in PCOS-induced treated rats. A significant increase in primary, pre-antral and antral follicles was seen and granulosa cell thickness grew in those administered with spearmint and flaxseed extract. The amount of cystic follicles reduced in the treatment group also. (6)
The Take Home
These studies demonstrate clinically significant anti-androgen effects of spearmint on females with PCOS. Based on the above studies, if you have PCOS or elevated androgen levels, consuming 2 cups of spearmint tea daily may help normalise your levels. As always, speak to your naturopath or healthcare provider for individualised treatment.
Written by Annabel Murray @inadayjournal
References:
1. Boyle J, Teede JH. Polycystic ovarian syndrome: An update. Melbourne, Victoria: Australian Family Physician; 2012 Oct [cited 2020 Oct 19]. Available from https://www.racgp.org.au/afp/2012/october/polycystic-ovary-syndrome/
2. Briden L. Lara Briden - The period revolutionary [Internet]. Christchurch; 2020 Sep 1 [cited 2020 Oct 19]. Available from Available from https://www.larabriden.com/4-types-of-pcos-a-flowchart/
3. Sadeghi Ataabadi M, Alaee S, Bagheri MJ, Bahmanpoor S. Role of essential oil of mentha spicata (spearmint) in addressing reverse hormonal and folliculogenesis disturbances in a polycystic ovarian syndrome in a rat model. Adv Pharm Bull [Internet]. 2017;7(4):651-654. doi:10.15171/apb.2017.078
4. Grant P. Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome: A randomized controlled trial. Phytotherapy Research [Internet]. 2009; 24(2): 186-188. doi:10.1002/ptr.2900
5. Akdoğan M, Tamer MN, Cüre E, Cüre MC, Köroğlu BK, Delibaş N. Effect of spearmint (Mentha spicata Labiatae) teas on androgen levels in women with hirsutism. Phytother Res. 2007 May;21(5):444-7. doi: 10.1002/ptr.2074
6. Mehraban M, Jelodar G, Rahmanifar F. A combination of spearmint and flaxseed extract improved endocrine and histomorphology of ovary in experimental PCOS. J Ovarian Res. 2020 March; 13(32). doi:10.1186/s13048-020-00633-8