Polycystic ovary syndrome (PCOS) is an endocrine disorder found in women of childbearing age. The main underlying disordered metabolism issues in PCOS are insulin resistance and hyperandrogenism. Characteristic manifestations can include irregular or infrequent or no menses, infertility, hirsutism, hair loss, and weight gain. Underlying mechanisms can be addressed that can then dramatically alter the current issues as well as reduce the long term risks for cardiovascular disease, diabetes, and uterine cancer. Many symptoms can be managed with lifestyle changes that include weight loss for those patients who are overweight or obese, and regular aerobic and strength training exercise, as well as conventional pharmaceuticals such as oral contraceptives, metformin effects, and spironolactone. The literature is now quite robust with natural agents that lower androgens in women with PCOS and improve insulin resistance. Chamomile (Matricaria recutita syn. M. chamomilla, Asteraceae) flowers are used to treat anxiety, insomnia, digestive ailments, hay fever, and painful menstruation. Chamomile contains phytoestrogen compounds that have metabolic and hormonal effects. The purpose of this randomized, placebo-controlled clinical trial was to investigate the effect of chamomile supplementation on lipid and hormone levels in women who have PCOS.
Patients (n = 90, aged 15-45 years) with a diagnosis of PCOS were recruited at Shiraz University of Medical Sciences in Shiraz, Iran. Included patients had no history of seizures, cancer, asthma, liver disease, kidney disease, or gastrointestinal disease. Excluded patients had allergies, were using metformin or had used hormonal drugs in the month before starting the trial. Patients were randomly assigned to take chamomile or placebo capsules three times daily for 12 weeks. Each chamomile capsule contained 370 mg of dried flower material, which was obtained from Barij Essence Company in Tehran, Iran. No details were provided about the composition of the chamomile material. The chamomile and matching placebo capsules were prepared at the Pharmacology Department at Shiraz University of Medical Sciences. Patients completed a demographic survey at baseline. At baseline and 12 weeks, blood was drawn to measure triglycerides, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, the ratio of luteinizing hormone (LH) to follicle-stimulating hormone (FSH), testosterone, and dehydroepiandrosterone sulfate (DHEAS). Patients received weekly phone calls reminding them to take the capsules.
Age and body mass index (BMI) were similar between the two groups at baseline. A total of 80 patients completed the trial, with five patients withdrawing in each group. Three patients in each group were not willing to continue, and two patients in each group did not take the capsules as directed. Testosterone levels decreased significantly from baseline to 12 weeks in the chamomile group compared to the placebo group (P = 0.017). No statistically significant differences were found between the groups for changes in triglycerides, total cholesterol, LDL cholesterol, HDL cholesterol, and DHEAS or for the LH/FSH ratio after 12 weeks of treatment. No information was provided about adherence or adverse events during the trial.
The authors conclude that chamomile reduces levels of testosterone in women with PCOS. The authors hypothesize that chamomile flowers contain phytoestrogens and phytosterols that can improve dyslipidemia, weight gain, and hormone imbalances. The authors do not report whether the decrease in testosterone level is clinically significant. There were no significant changes in lipid parameters, LH/FSH ratio, or DHEAS concentration. However, the authors acknowledge that the sample size may have been too small to detect differences in the LH/FSH ratio between the two groups. The lack of effect on blood lipids is not consistent with previous reports. Differences between studies could contribute to the outcome. A significant limitation of this study is that the authors do not describe the composition or active components present in the chamomile material used. Future studies should focus on ovarian function and should use larger sample sizes.
The authors declare no conflicts of interest.
Heidary M, Yazdanpanahi Z, Dabbaghmanesh MH, Parsanezhad ME, Emamghoreishi M, Akbarzadeh M. Effect of chamomile capsule on lipid- and hormonal-related parameters among women of reproductive age with polycystic ovary syndrome. J Res Med Sci. April 2018;23:33. doi: 10.4103/jrms.JRMS_90_17.