Naltrexone in PCOS Patients: Research Summary

Naltrexone in PCOS (polycycstic ovary syndrome) has been well studied. As the #1 cause for infertility, women with PCOS often struggle to find successful treatment. At the end of this article, you will find a summary of 3 clinical studies specifically assessing the use of Naltrexone in PCOS patients.

What is Low Dose Naltrexone (LDN)?

Low Dose Naltrexone or LDN is a compounded prescription medication containing Naltrexone in doses usually from 0.5mg-4.5mg. As an opioid receptor antagonist, Naltrexone affects your brain’s response to narcotic medication and alcohol, and can even help curb cravings!

By blocking the OGF receptors, LDN helps to modulate your body’s immune system, and over time can boost your body’s natural production of endorphins while decreasing the inflammation related to disease caused by IL-6 & IL-12 pro-inflammatory cytokines.

Learn more on LDN’s Mechanism of Action.

For its unique ability to modulate the immune system and inflammatory processes throughout the body, LDN has been well studied in a variety of inflammation-based conditions such as crohn’s disease, ulcerative colitis, endometriosis, and PCOS.

Multiple studies have indicated Naltrexone has PCOS benefits. Other studies suggest its potential benefits for PMS, anxiety, depression, sleep disturbance, and low mood.

When patients work with expert pharmacists and health care professionals, they are more likely to achieve success while taking LDN. Makers’ experienced compounding pharmacists adhere to patient followup programs and stay up to date on the latest research and dosing guidelines.

Naltrexone Dosing

Patients are successful in LDN treatment protocols when they receive expert counsel through titration protocols. These protocols start the dose at 0.5-1.5mg taken once daily at bedtime and increasing by small increments every 7 days or so.

The patient and their health care team will closely monitor symptoms to identify each patient’s therapeutic or “happy” dose. For example, if the patient feels relief at 3.0 mg, and notices a return of symptoms at 3.5mg, the “happy” dose is likely at 3.0mg or between 3.0-3.5mg.

A pharmacy well versed in guiding patients through these titration programs is essential. Patient follow up and open communication between the prescriber, patient, and pharmacy will help each patient find success and relief on this treatment.

ALWAYS WORK WITH A LICENSED HEALTH CARE PROVIDER – THIS IS A PRESCRIPTION MEDICATION

If you are a health care provider, you can learn more about prescribing Low Dose Naltrexone at the 2020 LDN PNW Summit on October 17th, 2020.

Recent Studies – Naltrexone in PCOS

Study: Medical management of metabolic dysfunction in PCOS

About: PCOS is characterized by increased activity of sympathetic nervous system, altered central opioid tone and elevated beta-endorphin release. Therefore, researchers deemed naltrexone a viable option for this study. There is also a growing body of evidence demonstrating that beta-endorphins exert profound effects on insulin release.

Results/Conclusion: Oral administration of Naltrexone in PCOS patients resulted in a significant reduction of fasting insulin level following glucose load without adversely affecting glucose levels.

Study: Effect of long-term naltrexone treatment on endocrine profile, clinical features, and insulin sensitivity in obese women with polycystic ovary syndrome.

About: This clinical study reviewed Naltrexone in a higher dose (50mg), for a period of 6 months. It specifically evaluates the clinical and endocrine effects of prescribing naltrexone in obese women with PCOS.

Results/Conclusion: Every woman lost weight and BMI significantly decreased. 80% of the women showed a significant improvement in menstrual cyclicity, with cycle length decreasing from between 40 and 90 days to an average of 28-33 days. Significant plasma Estradiol level increase were observed throughout the study period. Additionally, this study observed a significant decrease in plasma Androgen, Testosterone, and DHEA levels.

Study: Naltrexone treatment in clomiphene resistant women with polycystic ovary syndrome

About: This study evaluated long-term inhibition of the opioid system using naltrexone in clomiphene citrate (CC)-resistant women with PCOS. It evaluates a group of 30 infertile PCOS patients; all subjects were obese, hyperandrogenic and hyperinsulinemic; 16 subjects were amenorrhic (absence of menstruation) while 14 were oligomenorrhic (infrequent menstrual periods). All patients received natrexone (50 mg daily) for 6 months. CC was added to the treatment protocol for those who did not ovulate after 12 weeks of naltrexone monotherapy. The dose started at 50 mg per day for the first five days, non responders increased the dosage all the way to 150 mg per day.

Results/Conclusion: Naltrexone improved endocrine and metabolic function in women with CC-resistant PCOS. Additionally, naltrexone restored CC sensitivity in the majority of subjects. There were no conceptions during naltrexone monotherapy, but 9 of 27 women (33.3%) conceived during naltrexone +CC; there was one missed abortion at 9 weeks, one preterm delivery at 34 weeks, and seven term live births.

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