Berberine is an ancient supplement that has been used in China for thousands of years to treat diabetes, diarrhea, and infertility.

Researchers are starting to investigate its use in women with polycystic ovary syndrome (PCOS). So far, the results have been very encouraging.

This article explains what berberine is, how it may help with fertility and weight in PCOS, and what women need to know before trying it.

PCOS affects the ability of about one in 10 women of childbearing age to conceive.

PCOS causes women to develop cysts on their ovaries. These cysts can trigger multiple symptoms, including acne, irregular menstrual cycles, hirsutism (excess hair growth on the face and/or body), weight gain, and insomnia.

Women with PCOS may also experience metabolic syndrome, insulin resistance, high cholesterol, and hypertension (high blood pressure). PCOS may also increase the risk of heart disease, diabetes, and endometrial cancer.

There is no cure for PCOS. But the symptoms can be treated. And this is where berberine may make a difference.

Berberine is an alkaloid (a kind of organic compound) extracted from Chinese herbs such as:

Berberine can be taken in capsule or liquid form. It may improve an array of conditions, such as:

Berberine can offer numerous benefits to women with PCOS, including improved fertility, assistance with weight loss, and lowered risk for metabolic complications associated with the condition.

Berberine can provide an emotional lifeline to women who know the problems PCOS can create during pregnancy, including:

Taking berberine in no way guarantees that a woman will become pregnant. But it could help her feel more proactive and relaxed about the prospect. And some research suggests a link between stress and frustrated efforts at conceiving.

At least two studies show the promise between berberine and fertility. In one pilot study, 98 anovulatory women (women who do not ovulate) with PCOS took berberine. Ovulation improved by an average of 25% after four months.

A study published in Clinical Endocrinology showed that women with PCOS who were randomly selected to take berberine had higher pregnancy rates than those who took metformin (an insulin-sensitizing medication) or placebo.

They also felt fewer side effects 12 weeks prior to in vitro fertilization (IVF) treatment.

Perhaps berberine’s biggest role is as a potent insulin sensitizer. Women with PCOS typically have insulin resistance. Insulin allows the body's cells to use sugar for energy. With insulin resistance, the cells don't respond well to insulin, so insulin levels and blood sugar can rise.

Metformin is a medication that is often prescribed to women with PCOS to help manage insulin and glucose levels. However, many women experience side effects such as diarrhea, nausea, and stomach cramping with metformin. Long-term metformin use has also been shown to affect the absorption of vitamin B12.

The benefits of berberine have been compared to metformin in women with PCOS. In a study published in the European Journal of Endocrinology, researchers randomly selected 89 women with PCOS to receive either berberine (500 milligrams, three times a day), metformin (500 mg, three times a day), or a placebo for three months.

A nutritionist told the women to reduce their intake of carbohydrates and fats. A calorie range was not provided. Women were also instructed to do moderate to intense exercise for 30 minutes each day.

After three months of treatment, the women with PCOS who took berberine saw greater drops in body fat than those who took metformin or placebo. Berberine lowered insulin and glucose levels about as well as metformin.

Women with PCOS who took berberine also experienced significant drops in total cholesterol, LDL (bad cholesterol) levels, and triglycerides. They also recorded better HDL (good cholesterol) levels.

Many women with PCOS would say that losing weight is harder because of their condition. Weight loss is more difficult for many reasons, including increased insulin resistance and strong cravings for carbohydrates.

Berberine may offer hope to women with PCOS who struggle with their weight. Berberine has been shown to reduce the secretion of leptin, an appetite-stimulating hormone.

Berberine has also shown to be effective at assisting with weight and body fat loss by inhibiting the enzyme lipoprotein lipase, which is responsible for fat storage.

Many studies report weight loss, especially in the midsection of the body, and lower body mass index (BMI) levels.

Women with PCOS also face an increased risk of having fatty liver disease due to the relationship with high insulin levels. Berberine has been shown to reduce fatty liver.

A review of six randomized control trials involving 500 individuals found that berberine significantly reduced fatty liver in those with non-alcoholic fatty liver disease (NAFLD).

Berberine lowered triglycerides (the primary form of fat in the body) and liver function enzymes and improved overall liver functioning.

Berberine also improves NAFLD by preventing liver fat buildup and promoting fatty acid oxidation, or the breakdown of fatty acids. This is important because it releases energy.

Many people tolerate berberine well. But it can cause nausea and constipation, particularly when taken in high doses.

The typical dosage of berberine is 500 mg, three times each day (similar to that of metformin dosing). To avoid stomach upset, it may be best to inch up to that dosage by taking 500 mg per day the first week and then adding another 500 mg the second and third weeks.

Berberine may not interact well with other medications, such as antidepressants, MAOIs, blood thinners, and beta blockers. Regular monitoring of liver function tests is recommended for those taking berberine.

Since berberine is an insulin sensitizer, it may cause low blood sugar, especially when combined with other insulin-lowering medications, such as metformin, or supplements like inositol or n-acetylcysteine.

This is why it's important to consult with your healthcare provider before taking berberine. 

Berberine is not intended for long-term use. No data are available regarding the safety of berberine among young women or in early pregnancy. And women should not take berberine while they're pregnant or breastfeeding.

Like all supplements, berberine's effects can be difficult to trace. But research suggests that it could help women with PCOS conceive, manage their insulin and glucose levels, lose weight, and improve their liver health. Berberine can cause stomach upset, especially if it's taken in high doses.

You can buy berberine over the counter either online or at retail pharmacies in the supplements section.

Many product labels recommend taking a 500 milligram tablet with a meal three times a day. Check with your healthcare provider to verify how much and how often you should take berberine.

Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life.

Thank you, {{form.email}}, for signing up.

There was an error. Please try again.

Li Y, Ma H, Zhang Y, et al. Effect of berberine on insulin resistance in women with polycystic ovary syndrome: study protocol for a randomized multicenter controlled trial. Trials. 2013;14:226. doi: 10.1186/1745-6215-14-226

U.S. Department of Health and Human Services. Polycystic ovary syndrome.

Rooney KL, Domar AD. The relationship between stress and infertility. Dialogues in Clinical Neuroscience. 2018;March 20:41-47. doi:10.31887/DCNS.2018.20.1/klrooney

An Y, Sun Z, Zhang Y, Liu B, Guan Y, Lu M. The use of berberine for women with polycystic ovary syndrome undergoing IVF treatment. Clin Endocrinol (Oxf). 2014 Mar;80(3):425-31. doi:10.1111/cen.12294

Yang J, Yin J, Gao H, et al. Berberine improves insulin sensitivity by inhibiting fat store and adjusting adipokines profile in human preadipocytes and metabolic syndrome patients. Evid Based Complement Alternat Med. 2012:363845. doi:10.1155/2012/363845

Wei W, Zhao H, Wang A, et al. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. Eur J Endocrinol. 2012 Jan;166(1):99-105. doi:10.1530/EJE-11-0616

Chang X, Wang Z, Zhang J, et al. Lipid profiling of the therapeutic effects of berberine in patients with nonalcoholic fatty liver disease. J Transl Med. 2016 Sep 15;14:266. doi:10.1186/s12967-016-0982-x

Lin L, Li C, Pan P, et al. A single arm pilot study of effects of berberine on the menstrual pattern, ovulation rate, hormonal and metabolic profiles in anovulatory Chinese women with polycystic ovary syndrome. PLoS One. 2015; 10(12): e0144072. doi:10.1371/journal.pone.0144072

Thank you, {{form.email}}, for signing up.

There was an error. Please try again.