Regular yoga helps cut testosterone levels in PCOS

Women with PCOS* who practised mindful yoga thrice weekly had significantly lower free testosterone levels, a main criterion for the diagnosis of PCOS, a small study shows, suggesting yoga as a potential non-pharmacologic complementary treatment option for women with PCOS.

“There are effective pharmacologic options for managing PCOS. However, they come with the potential for some significant side effects,” said principal investigator Dr Diana Speelman of Lake Erie College of Osteopathic Medicine in Erie, Pennsylvania, US. “Mindful yoga appears to be a promising option for treating PCOS in a way that can improve several aspects of the disorder.”

The study randomized 31 women with PCOS aged 23–42 years (mean age 31 years) to receive mindful yoga intervention or no intervention (control) for 3 months. Yoga intervention comprised 1-hour group sessions of mindful yoga, thrice weekly. Participants were assessed on endocrine, cardiometabolic, and psychological measures at baseline and after the intervention ended. [J Am Osteopath Assoc 2020;doi:10.7556/jaoa.2020.050]

After 3 months, women who completed the yoga sessions saw significant drop by 29 percent in free testosterone levels from 5.96 to 4.24 pg/mL (p<0.05), while those in the control group remained at similar levels after the intervention (p=0.96).

Levels of dehydroepiandrosterone (DHEA), another androgen which may be elevated in women with PCOS, also trended lower after the yoga intervention (359.7 vs 316.6 ng/dL; p=0.574) compared with no change in the control group.

“Improved testosterone may persist for several months after completion of … [the] yoga intervention,” observed Speelman and co-authors.

Some participants also reported improvements in reproductive and endocrinological aspects after the yoga intervention, including more regular menstrual cycle and fewer acne breakouts.

In addition, anxiety and depression levels, as indicated by changes in the BAI** (p=0.0365) and BDI*** scores (p<0.0001), respectively, were significantly lowered after the yoga intervention while no significant changes were seen in the control group.

“Despite having PCOS for many years and experiencing some of the associated reproductive and metabolic dysfunction, our results indicate that women with established PCOS and metabolic dysfunction can benefit from regular mindful yoga practice, with potential improvement in androgen profile,” noted Speelman and co-author.

“Furthermore, these benefits were observed without daily yoga practice, but rather with a more feasible 3-times-per-week practice,” they added.

“[PCOS] is the most common cause of anovulatory infertility,” according to the researchers, who noted that the condition can affect up to 15 percent of women of reproductive age.

Typical symptoms of PCOS may include irregular menstrual cycles, acne, hirsutism, male-pattern hair loss, and subfertility. Therefore, reducing androgen levels is key to managing the symptoms associated with PCOS.

As the number of participants were small and of varying ages and BMI, the researchers suggested that larger randomized studies be conducted in the future, and in specific age or BMI groups of women.      

“Despite these limitations, the results suggest that mindful yoga practice can provide therapeutic benefit to women with PCOS,” the researchers concluded. “Furthermore, the improvements in androgen levels are a promising finding, as these hormones may contribute to the pathogenesis of the disorder itself.”

“Yoga has so many benefits,” pointed out Speelman. “One of its best qualities is that it is accessible to such a wide array of ages and fitness levels.”