N Acetyl Cysteine, A novel Remedy for Poly Cystic Ovarian Syndrome

Background: Poly cystic ovarian syndrome (PCOS) is the most prevalent endocrinopathy among women and the most common underlying diagnosis for anovulatory infertility. The role of insulin-resistance (IR) and hyperinsulinemia in pathophysiology and clinical manifestations of the syndrome depicts the importance of evaluation of the efficacy of insulin reducing medications. N acetyl cysteine (NAC) inhibits oxidative stress and prevents hyperglycemia induced insulin resistance. This study aims at evaluating the effects of NAC on manifestations of the disease as well as improvement of fertility status. Materials and Methods: Through a prospective double-blind clinical trial, 46 patients were randomly divided into one intervention and one control group. The two groups were treated for six weeks after similarity was allocated. All clinical and biochemical indicators were recorded in the early follicular phase both before and after treatment. Results: From each group, 18 patients were ultimately evaluated. In the first group, ovulation rate increased as compared to the control group. A significant decrease in weight, body mass index (BMI), and waist/hip ratio was also observed. Fast blood sugar (FBS), serum insulin, total cholesterol, low density lipoprotein (LDL) levels, and HOMA-IR index also dropped while high density lipoprotein HDL levels elevated significantly. No significant change was reported in luteinizing hormone (LH), FSH, PRL, LH/FSH levels and glucose/insulin ratio. The control group remained unchanged. Conclusion: N- Acetyl Cysteine improves lipid profile, hormonal levels, ovulation status, and longterm health of women with PCOS. Considering its limited adverse effects, it can be regarded as a substitute for insulin reducing medications in treatment of these patients.