Previous research has mentioned that Metabolic syndrome affects 33% of women with polycystic ovary syndrome (PCOS). Emerging evidence suggests that N-acetylcysteine (NAC) improves metabolic parameters in PCOS and may be a potential alternative to metformin.
A recent study published in Frontiers in Nutrition has concluded that N-acetylcysteine (NAC) effectively improves metabolic parameters in PCOS. This study highlights NAC to be a potent supplement in managing PCOS.

PCOS is a common endocrine disease. Metabolic disorders often accompany this hormonal condition. To improve the metabolic function of PCOS, Metformin is widely used. This insulin sensitizer may have gastrointestinal side effects.
In this study, researchers searched four online databases: PubMed, Embase, Web of Science, and Cochrane Library. The I statistic and Cochrane's Q test were used to determine heterogeneity between studies with a value >50% or p < 0.1 considered significant. The data were expressed as standardized mean differences and 95% confidence intervals.
Key findings of this study are:
The final analysis had 11 randomized controlled trials, including 869 women with PCOS.
NAC caused more changes in body mass index, body weight, fasting insulin, the ratio of fasting blood glucose to fasting insulin, total cholesterol, triglycerides and low-density lipoprotein with -0.16, -0.25, -0.24,-0.38, -0.11,-0.18 -0.09, respectively compared with metformin.
Compared with metformin or placebo, NAC significantly reduced fasting blood glucose levels.
NAC reduced total cholesterol when compared with placebo.
NAC reduced HDL levels in women with PCOS compared with metformin with SMD of -0.14.
Dr Liu J from The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China, said, In this study, we found that NAC is efficacious in improving metabolic parameters in PCOS. Based on the study findings, it is a promising nutritional supplement for treating PCOS.
Reference:
Liu, Jiajun, et al. "The Effects of N-acetylcysteine Supplement On Metabolic Parameters in Women With Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis." Frontiers in Nutrition, vol. 10, 2023, p. 1209614.