N-acetylcysteine, simply known as NAC, is a powerful antioxidant that may provide the following benefits for people withpolycystic ovary syndrome(PCOS):

Known in Europe for decades as an immune-boosting supplement and a popular treatment for bronchitis, NAC is emerging as a promising integrative treatment for women who are having complications from PCOS.

This article discusses these five potential benefits of NAC for PCOS.

Paul Bradbury / Getty Images

Woman holding a supplement

Boosts Fertility

For the approximately 70% of women with PCOS who experienceinfertility, NAC may offer some hope.

A 2015 systematic review and meta-analysis published in theJournal of Obstetrics and Gynecologylooked at the benefits of NAC in eight randomized controlled trials involving 910 women with PCOS. The review showed that NAC provided significant improvements in ovulation, as well as pregnancy and live birth rates as compared to a placebo alone.

NAC has been shown to have similar benefits as metformin for improving pregnancy rate, spontaneous ovulation, and improving menstrual regularity in women with PCOS.

For women who are resistant to Clomid, NAC may help to improve their fertility as well. A 2014 study published in theEuropean Journal of Obstetrics, Gynecology, and Reproductive Biologyfound that NAC users had a nine times higher ovulation rate and a five times higher pregnancy rate in Clomid-resistant women as compared to a placebo.

Improves Insulin Resistance

NAC can protect insulin receptors and influence insulin receptor activity secretion from the pancreas cells. As a result, NAC can improve insulin resistance.

Although it’s not FDA approved for its use, metformin remains a commonly-prescribed medication to help women with PCOS who have insulin resistance.Several studies have compared NAC and metformin in women with PCOS.

Women who took NAC showed similar results to metformin for improving insulin resistance as well as loweringcholesterol levels, and without experiencing the common gastrointestinal side effects that metformin can cause.

Restores Hormone Balance

A surprising benefit of NAC is that it may have the potential to balance certain hormones.

In a 2019 study published inThe Journal of Obstetrics and Gynecology of India, researchers randomized women with PCOS to take metformin (1500 milligrams per day, mg/day) or NAC (1800 mg/day) for 24 weeks.

The group that received NAC showed better improvements in their metabolic and hormonal profiles, which included a greater reduction of total testosterone.

Fights Inflammation

Women with PCOS have been shown to have higher levels of oxidative stress than women without PCOS.High levels of oxidative stress can damage cells and promoteinflammationwhich in turn worsens the metabolic aspects of PCOS.

As a powerful antioxidant, NAC works to fight oxidative stress and reduce inflammation.

Helps Your Liver

Sometimes women with PCOS developmetabolic dysfunction-associated steatotic liver disease(MASLD, formerly known as nonalcoholic fatty liver disease or NAFLD).This type of fatty liver disease can result from high insulin and triglyceride levels. It can be reversed with modifications in your diet.

Summary

Overall, NAC is a well-tolerated dietary supplement that offers numerous benefits to people with PCOS.

If you’re interested in trying NAC to see if it will help you get pregnant or reduce some of the metabolic consequences of PCOS, such as fatty liver and insulin resistance, talk with your healthcare provider and registered dietitian nutritionist. They can determine what dose is appropriate for you.

10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mokhtari V, Afsharian P, Shahhoseini M, Kalantar SM, Moini A.A review on various uses of n-acetyl cysteine.Cell J. 2017;19(1):11-17. doi:10.22074/cellj.2016.4872Melo AS, Ferriani RA, Navarro PA.Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice. Clinics (Sao Paulo). 2015;70(11):765-9.Thakker D, Raval A, Patel I, Walia R.N-acetylcysteine for polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled clinical trials.Obstet Gynecol Int. 2015;2015:817849. doi:10.1155/2015/817849Ismail AM, Hamed AH, Saso S, Thabet HH.Adding L-carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate. A randomized clinical trial.Eur J Obstet Gynecol Reprod Biol. 2014;180:148-52. doi:10.1016/j.ejogrb.2014.06.008Johnson NP.Metformin use in women with polycystic ovary syndrome. Ann Transl Med. 2014;2(6):56. doi:10.3978/j.issn.2305-5839.2014.04.15Javanmanesh F, Kashanian M, Rahimi M, Sheikhansari N.A comparison between the effects of metformin and N-acetyl cysteine (NAC) on some metabolic and endocrine characteristics of women with polycystic ovary syndrome.Gynecol Endocrinol. 2016;32(4):285-9. doi:10.3109/09513590.2015.1115974Chandil N, Pande S, Sen SS, Gupta D.Comparison of metformin and N acetylcysteine on clinical, metabolic parameter and hormonal profile in women with polycystic ovarian syndrome.J Obstet Gynecol India. 2019;69(1):77-81. doi:10.1007/s13224-018-1135-3Mohammadi M.Oxidative stress and polycystic ovary syndrome: a brief review.Int J Prev Med. 2019;10:86. doi:10.4103/ijpvm.IJPVM_576_17Vassilatou E.Nonalcoholic fatty liver disease and polycystic ovary syndrome.World J Gastroenterol. 2014;20(26):8351-63. doi:10.3748/wjg.v20.i26.8351Dludla PV, Nkambule BB, Mazibuko-Mbeje SE, et al.N-acetyl cysteine targets hepatic lipid accumulation to curb oxidative stress and inflammation in NAFLD: a comprehensive analysis of the literature.Antioxidants. 2020;9(12):1283. doi:10.3390/antiox9121283Additional ReadingOner G et al. Clinical, endocrine and metabolic effects of metformin vs N-acetyl-cysteine in women with polycystic ovary syndrome. Euro J Obst Gynecol Biol. Nov 2011;159(1):127-131.

10 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mokhtari V, Afsharian P, Shahhoseini M, Kalantar SM, Moini A.A review on various uses of n-acetyl cysteine.Cell J. 2017;19(1):11-17. doi:10.22074/cellj.2016.4872Melo AS, Ferriani RA, Navarro PA.Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice. Clinics (Sao Paulo). 2015;70(11):765-9.Thakker D, Raval A, Patel I, Walia R.N-acetylcysteine for polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled clinical trials.Obstet Gynecol Int. 2015;2015:817849. doi:10.1155/2015/817849Ismail AM, Hamed AH, Saso S, Thabet HH.Adding L-carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate. A randomized clinical trial.Eur J Obstet Gynecol Reprod Biol. 2014;180:148-52. doi:10.1016/j.ejogrb.2014.06.008Johnson NP.Metformin use in women with polycystic ovary syndrome. Ann Transl Med. 2014;2(6):56. doi:10.3978/j.issn.2305-5839.2014.04.15Javanmanesh F, Kashanian M, Rahimi M, Sheikhansari N.A comparison between the effects of metformin and N-acetyl cysteine (NAC) on some metabolic and endocrine characteristics of women with polycystic ovary syndrome.Gynecol Endocrinol. 2016;32(4):285-9. doi:10.3109/09513590.2015.1115974Chandil N, Pande S, Sen SS, Gupta D.Comparison of metformin and N acetylcysteine on clinical, metabolic parameter and hormonal profile in women with polycystic ovarian syndrome.J Obstet Gynecol India. 2019;69(1):77-81. doi:10.1007/s13224-018-1135-3Mohammadi M.Oxidative stress and polycystic ovary syndrome: a brief review.Int J Prev Med. 2019;10:86. doi:10.4103/ijpvm.IJPVM_576_17Vassilatou E.Nonalcoholic fatty liver disease and polycystic ovary syndrome.World J Gastroenterol. 2014;20(26):8351-63. doi:10.3748/wjg.v20.i26.8351Dludla PV, Nkambule BB, Mazibuko-Mbeje SE, et al.N-acetyl cysteine targets hepatic lipid accumulation to curb oxidative stress and inflammation in NAFLD: a comprehensive analysis of the literature.Antioxidants. 2020;9(12):1283. doi:10.3390/antiox9121283Additional ReadingOner G et al. Clinical, endocrine and metabolic effects of metformin vs N-acetyl-cysteine in women with polycystic ovary syndrome. Euro J Obst Gynecol Biol. Nov 2011;159(1):127-131.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Mokhtari V, Afsharian P, Shahhoseini M, Kalantar SM, Moini A.A review on various uses of n-acetyl cysteine.Cell J. 2017;19(1):11-17. doi:10.22074/cellj.2016.4872Melo AS, Ferriani RA, Navarro PA.Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice. Clinics (Sao Paulo). 2015;70(11):765-9.Thakker D, Raval A, Patel I, Walia R.N-acetylcysteine for polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled clinical trials.Obstet Gynecol Int. 2015;2015:817849. doi:10.1155/2015/817849Ismail AM, Hamed AH, Saso S, Thabet HH.Adding L-carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate. A randomized clinical trial.Eur J Obstet Gynecol Reprod Biol. 2014;180:148-52. doi:10.1016/j.ejogrb.2014.06.008Johnson NP.Metformin use in women with polycystic ovary syndrome. Ann Transl Med. 2014;2(6):56. doi:10.3978/j.issn.2305-5839.2014.04.15Javanmanesh F, Kashanian M, Rahimi M, Sheikhansari N.A comparison between the effects of metformin and N-acetyl cysteine (NAC) on some metabolic and endocrine characteristics of women with polycystic ovary syndrome.Gynecol Endocrinol. 2016;32(4):285-9. doi:10.3109/09513590.2015.1115974Chandil N, Pande S, Sen SS, Gupta D.Comparison of metformin and N acetylcysteine on clinical, metabolic parameter and hormonal profile in women with polycystic ovarian syndrome.J Obstet Gynecol India. 2019;69(1):77-81. doi:10.1007/s13224-018-1135-3Mohammadi M.Oxidative stress and polycystic ovary syndrome: a brief review.Int J Prev Med. 2019;10:86. doi:10.4103/ijpvm.IJPVM_576_17Vassilatou E.Nonalcoholic fatty liver disease and polycystic ovary syndrome.World J Gastroenterol. 2014;20(26):8351-63. doi:10.3748/wjg.v20.i26.8351Dludla PV, Nkambule BB, Mazibuko-Mbeje SE, et al.N-acetyl cysteine targets hepatic lipid accumulation to curb oxidative stress and inflammation in NAFLD: a comprehensive analysis of the literature.Antioxidants. 2020;9(12):1283. doi:10.3390/antiox9121283

Mokhtari V, Afsharian P, Shahhoseini M, Kalantar SM, Moini A.A review on various uses of n-acetyl cysteine.Cell J. 2017;19(1):11-17. doi:10.22074/cellj.2016.4872

Melo AS, Ferriani RA, Navarro PA.Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice. Clinics (Sao Paulo). 2015;70(11):765-9.

Thakker D, Raval A, Patel I, Walia R.N-acetylcysteine for polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled clinical trials.Obstet Gynecol Int. 2015;2015:817849. doi:10.1155/2015/817849

Ismail AM, Hamed AH, Saso S, Thabet HH.Adding L-carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate. A randomized clinical trial.Eur J Obstet Gynecol Reprod Biol. 2014;180:148-52. doi:10.1016/j.ejogrb.2014.06.008

Johnson NP.Metformin use in women with polycystic ovary syndrome. Ann Transl Med. 2014;2(6):56. doi:10.3978/j.issn.2305-5839.2014.04.15

Javanmanesh F, Kashanian M, Rahimi M, Sheikhansari N.A comparison between the effects of metformin and N-acetyl cysteine (NAC) on some metabolic and endocrine characteristics of women with polycystic ovary syndrome.Gynecol Endocrinol. 2016;32(4):285-9. doi:10.3109/09513590.2015.1115974

Chandil N, Pande S, Sen SS, Gupta D.Comparison of metformin and N acetylcysteine on clinical, metabolic parameter and hormonal profile in women with polycystic ovarian syndrome.J Obstet Gynecol India. 2019;69(1):77-81. doi:10.1007/s13224-018-1135-3

Mohammadi M.Oxidative stress and polycystic ovary syndrome: a brief review.Int J Prev Med. 2019;10:86. doi:10.4103/ijpvm.IJPVM_576_17

Vassilatou E.Nonalcoholic fatty liver disease and polycystic ovary syndrome.World J Gastroenterol. 2014;20(26):8351-63. doi:10.3748/wjg.v20.i26.8351

Dludla PV, Nkambule BB, Mazibuko-Mbeje SE, et al.N-acetyl cysteine targets hepatic lipid accumulation to curb oxidative stress and inflammation in NAFLD: a comprehensive analysis of the literature.Antioxidants. 2020;9(12):1283. doi:10.3390/antiox9121283

Oner G et al. Clinical, endocrine and metabolic effects of metformin vs N-acetyl-cysteine in women with polycystic ovary syndrome. Euro J Obst Gynecol Biol. Nov 2011;159(1):127-131.

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