Does Saw Palmetto For PCOS Really Work? A Functional Medicine Perspective

Does Saw Palmetto For Pcos Really Work? A Functional Medicine Perspective Dr. Will Cole

In my telehealth functional medicine clinic, women make up the majority of my patient base with PCOS being one of the most common conditions that I see. Unfortunately, conventional medicine’s approach to treatment of this condition leaves a lot to be desired. From not getting to the root cause and medications with endless side effects, many women are left feeling like there is no hope for ever reclaiming their health.

I’m here to tell you there is another option. In fact, there are many natural solutions that functional medicine utilizes to treat PCOS, including supplements. One of my favorites is saw palmetto. But does saw palmetto PCOS support really work? Read on to learn more about this stand-out supplement for overcoming PCOS symptoms, naturally.


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What is saw palmetto?

Also known as Serenoa repens, saw palmetto is a type of palm tree found in Florida and other areas of the American Southeast. Saw palmetto is most commonly taken in supplement form and can be purchased online and in natural health food stores and vitamin shops. 

Since PCOS is characterized by high androgen hormone levels, saw palmetto is a popular supplement for PCOS as it has the ability to inhibit androgen production. Is saw palmetto an anti-androgen? 

Does saw palmetto help with PCOS?

Before we get into whether or not saw palmetto can help with PCOS, what exactly is PCOS? Polycystic ovarian syndrome is a hormone condition that affects women between the ages of 15-44 and is associated with the following symptoms:

  • Ovarian cysts
  • Low levels of female hormones - estrogen and progesterone
  • High levels of male hormones - androgens
  • Irregular or skipped periods

Other symptoms of PCOS can include obesity, hair loss, excess facial hair growth, painful periods, and infertility. Researchers don’t know for sure what causes PCOS but they believe it is due to insulin resistance and chronic inflammation causing this imbalance ratio of female to male hormones.

According to studies, saw palmetto PCOS support works to reduce 5-alpha-reductase activity, the enzyme that makes the androgen DHT, due to its fatty acid content of liposterols like lauric, oleic, myristic, and linoleic acids. High levels of DHT are linked to the tell-tale symptoms of PCOS including hair loss, acne, irregular periods, and abnormal facial hair growth in women.

The hormone prolactin also tends to be high with PCOS and is what can inhibit follicle maturation and ovulation that leads to ovarian cysts. However, saw palmetto has been shown to be an effective tool at lowering the prolactin receptor response on ovarian cells.

Saw palmetto vs traditional drugs

In conventional medicine, treatment for PCOS is less focused on the root cause behind your condition and instead is focused on managing symptoms. Typically, if you have PCOS you’ll be told to lose weight (which is a symptom of PCOS - not the cause - so this is usually counter intuitive) and prescribed medication like birth control to regulate your hormones.

Unfortunately, birth control comes with a lot of side effects including anxiety, depression, and additional weight gain. This is really just acting as a bandaid rather than providing true, sustainable healing.

And since your root problem is not being addressed, many women are prescribed additional medication in order to help overcome infertility - another symptom of PCOS:

  • Clomiphene: An anti-estrogen medication
  • Letrozole: A breast cancer medication designed to stimulate your ovaries.
  • Metformin: A medication for type 2 diabetes prescribed to lower high insulin levels often associated with PCOS

Needless to say, these medications also have their own not-so-great side effects.

On the other hand, saw palmetto PCOS support offers an alternative solution with minimal (if any) side effects. And because it acts as an anti-androgen to lower androgen levels - the direct cause of PCOS - taking it can help you put your condition into remission more effectively than medication.

How much saw palmetto should a woman take for PCOS?

There is no official recommended daily dosage of saw palmetto however, anywhere between 160 to 450 mg per day is the standard recommendation. With anything new, start off small and gradually increase over time. I suggest working with your doctor who can look at your labs and health history to determine the right dosage for your particular health case. Also, if you are pregnant, breastfeeding, or taking any medications, always check with your doctor as saw palmetto might not be the right fit for you at this time.

Other supplements for PCOS

While saw palmetto for PCOS is one of the more researched supplements for this condition, there are a handful of other options that are also backed by clinical research for their ability to ease PCOS-related symptoms.

1. Myo-inositol

One of my all-time favorite PCOS supplements is Myo-inositol. This supplement has been shown to reduce the size of polycystic ovaries (1) and increase egg quality (2) — two of the main causes of PCOS-related infertility. Myo-inositol is so effective that in one controlled trial, researchers found that women with PCOS taking myo-inositol supplements achieved a natural pregnancy rate of 30% over a 6-month period (3) compared to just 18% on metformin, a diabetes drug that has become the go-to treatment for PCOS in the conventional medicine world.

2. N-Acetyl-cysteine

Often called NAC, N-acetyl-cysteine is a plant antioxidant found in onions. It has been used as a drug since the 1960s and with multiple studies looking at its ability to help boost fertility. One study found that NAC was able to improve both oocyte and embryo quality in women with PCOS. (4) NAC can also help improve insulin sensitivity.

3. Chromium

Chromium is an often overlooked micronutrient with deficiencies being linked to an increased risk of insulin resistance and high triglyceride levels. Supplementing (5) with chromium can be a simple way to improve the function of blood sugar receptors.

4. Resveratrol

This powerful antioxidant can be found naturally in foods like berries and grape skins. Supplementation has shown promise for managing (6) PCOS due to its ability to support healthy inflammation levels, regulate the production of androgens, and improve insulin sensitivity.

To learn more about PCOS and for a complete list of the best supplements for PCOS, check out my article here.

Can diet help PCOS?

In functional medicine, we understand just how powerful diet is to your overall health. After all, you can’t supplement your way out of a poor diet. Knowing that PCOS is correlated with high blood sugar, a diet focused on addressing insulin levels is one way to address PCOS-related symptoms for long-term, sustainable healing. These are my best tips for using food to manage your blood sugar.

1. Cut back on sugar

Sugar of all kinds - refined sugar, natural sweeteners, and even too much fruit - can spike your blood sugar. While it's ok to have some natural sweeteners and fruit on occasion, I see far too many people reliant on sugar to get them through their days, starting with fruit and sugar-loaded coffee in the morning followed by sugary snacks all throughout the day.

2. Eat more healthy fats

Healthy fats are a slow, sustainable form of energy, unlike the sugary roller coaster many find themselves on when their diets are primarily carb-based. If you look at the human being from infancy, you can see that biology knows best: as babies, we were all born relying on fat in the form of high-fat breast milk for brain development and energy. Calm the blood sugar storm and add in more healthy fats like avocados, wild-caught seafood, nuts and seeds to your diet.

3. Limit your “healthy” carbs

Carbohydrates are quickly converted to glucose in your body. While you may be avoiding bread and pasta, starchy vegetables like sweet potatoes are still carbs and can impact blood sugar. Fill up your plate instead with non-starchy options like mushrooms, dark leafy greens, and broccoli. These vegetables are loaded with nutrients that help your body lower inflammation and regulate detox pathways.

Since everyone is different your particular diet might vary from someone else’s, but these are good general rules to follow when looking to stabilize your blood sugar.

Seeking treatment for PCOS

If you are struggling with PCOS, a functional medicine practitioner can walk with you in a more natural approach to healing. In my telehealth functional medicine clinic, we run comprehensive hormone labs to determine if there are any hormone imbalances, insulin resistance, or chronically high inflammation levels contributing to your PCOS symptoms. 

Since we believe in bioindividuality and that there is no “one-size-fits-all” formula for healing, it is our job to take into consideration your entire health case in order to tailor recommendations for what works for you and your body. Whether that is saw palmetto, a combination of other supplements, or dietary changes alone, functional medicine offers a customized approach to PCOS that aims to address the root cause behind this condition.

So if you are ready to address your PCOS symptoms, schedule a telehealth consultation today to learn how we can help you using functional medicine.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe.


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  1. Ozay, Ali Cenk et al. “Different Effects of Myoinositol plus Folic Acid versus Combined Oral Treatment on Androgen Levels in PCOS Women.” International journal of endocrinology vol. 2016 (2016): 3206872. doi:10.1155/2016/3206872
  2. Ciotta, L et al. “Effects of myo-inositol supplementation on oocyte's quality in PCOS patients: a double blind trial.” European review for medical and pharmacological sciences vol. 15,5 (2011): 509-14.
  3. Raffone, Emanuela et al. “Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women.” Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology vol. 26,4 (2010): 275-80. doi:10.3109/09513590903366996
  4. Cheraghi, Ebrahim et al. “N-Acetylcysteine improves oocyte and embryo quality in polycystic ovary syndrome patients undergoing intracytoplasmic sperm injection: an alternative to metformin.” Reproduction, fertility, and development vol. 28,6 (2016): 723-31. doi:10.1071/RD14182
  5. Richard A Anderson, Nanzheng Cheng, Noella A Bryden, Marilyn M Polansky, Nanping Cheng, Jiaming Chi, Jinguang Feng; Elevated Intakes of Supplemental Chromium Improve Glucose and Insulin Variables in Individuals With Type 2 Diabetes. Diabetes 1 November 1997; 46 (11): 1786–1791.
  6. Banaszewska, Beata et al. “Effects of Resveratrol on Polycystic Ovary Syndrome: A Double-blind, Randomized, Placebo-controlled Trial.” The Journal of clinical endocrinology and metabolism vol. 101,11 (2016): 4322-4328. doi:10.1210/jc.2016-1858

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Dr. Will Cole, DNM, IFMCP, DC is a leading functional medicine expert who consults people around the globe, starting one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Dr. Will Cole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is the host of the popular The Art Of Being Well podcast and the New York Times bestselling author of Intuitive Fasting, Ketotarian, The Inflammation Spectrum and the brand new book Gut Feelings: Healing the Shame-Fueled Relationship Between What You Eat and How You Feel.

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