Shatavari and PCOS

Polycystic ovary syndrome (PCOS) affects 5%-15% of reproductive age women.   The underlying pathophysiology of PCOS is complex but encompasses hyperandrogenism, insulin resistance, ovulatory dysfunction, dyslipidemia, central abdominal fat and multiple cysts on the ovaries.  It is a leading cause of infertility and metabolic dysfunction.  It also often presents with  irregular or infrequent or no menses, acne, excess body hair on face/arms/legs/chest/abdomen and male pattern hair thinning.

The current study evaluated the efficacy of a standardized extract of Asparagus racemosa, a.k.a. Shatavari in women with PCOS.  These women were diagnosed using the Rotterdam criteria, a standard conventionally accepted set of criteria for diagnosing PCOS.  Patients received either 100 mg daily of the Shatavari extract or placebo for 84 consecutive days.

After 84 days, Shatavari significantly reduced the mean ovarian volume size by 20.98%, ovarian cyst size by 40.9% and follicle number by 20.56% as compared to the placebo group.  The Shatavari group showed indications of improved insulin sensitivity and hormonal profiles and modest changes in menstrual patterns and abdominal body fat.

Commentary:  These findings are promising and I would consider adding this herb to a PCOS natural medicine plan.  I would not, however, only rely on Shatavari until we have more research.  I also think the compelling research and effects of N-acetylcysteine (NAC) and inositol cannot be ignored as they have a comprehensive effect on the hyperandrogenism and insulin resistance.  Other natural therapies that have emerged in the research are also typically a part of my comprehensive plan and can include green tea catechins, licorice root extract, chamomile, marjoram, chromium, and cinnamon.  A higher protein, lower carbohydrate diet with robust aerobic exercise and muscle mass building round out the natural medicine approach.  Some patients will need conventional therapies that can include Metformin, spironolactone, and progestogens, either with or without the nutraceuticals and/or botanicals.

Reference:  Kondamudi S, Sadu S, Deva S, et al.  CL22209, a standardized Asparagus racemosus root extract, demonstrates improved ovarian morphology, menstrual regularity, and metabolic parameters in women with polycystic ovary syndrome in a randomized controlled trial.  Food and Nutrition Research 2025. 69:13244.