Is Low-Dose Naltrexone a Treatment Option for PCOS?

If you have PCOS and are taking birth control pills, metformin, or other prescription drugs to manage your symptoms, you'll want to read this.

Have you heard of "naltrexone"? It is a drug used primarily to treat drug and alcohol addiction. But in low doses, some clinicians have been using naltrexone as an "off label" treatment for AIDS, cancer, autoimmune diseases and central nervous system disorders.

You would think that naltrexone has nothing to do with polycystic ovary syndrome. But research suggests otherwise.

PCOS - Naltrexone Study

The Benha School of Medicine in Egypt studied 30 women with PCOS and infertility. They were treated with naltrexone for 6 months. Three of the women ovulated on naltrexone alone. When Clomid (a drug used to stimulate ovulation) was combined with naltrexone, 19 more women ovulated and 9 of them became pregnant.

The particularly interesting thing about this study was not just the good news about pregnancy rates.

The interesting thing was that naltrexone was shown to be helpful for weight loss, and reductions in insulin and testosterone levels. It also improved LH/follicle-stimulating hormone ratio.  In addition, the study said that the women experienced less hirsutism (unwanted hair growth) and acne.

All of these factors are problem areas in polycystic ovarian syndrome. All of them appear to be improved by naltrexone.

The authors of the study concluded: "In summary, we propose that naltrexone therapy either alone or in combination with CC may improve a broad range of clinical, endocrine and metabolic derangements characteristic in PCOS."

Should you take naltrexone? That is a decision you and your doctor must make. Like most drugs, it has side effects. So the dosage is an important consideration. But it's something to consider as another treatment option.

What Is Naltrexone?

The technical name is naltrexone hydrochloride.  It is an opiate antagonist and in fairly high doses, has been used for many years for the treatment of opiate addiction and alcohol abuse.  

However, our interest here is in the low-dose form of naltrexone.  In low doses, it appears to regulate the immune system in some way.  As such, it has been used for some time to treat various autoimmune diseases, especially multiple sclerosis.

PCOS and Your Immune System

It should be noted that immune system dysregulation is common in polycystic ovarian syndrome.  One aspect of this dysregulation is the presence of autoimmune disease, especially autoimmune thyroiditis (Hashimoto's Disease).  Another aspect is that it appears that the high levels of male hormones in polycystic ovary syndrome tend to make components of the immune system hyper-sensitive to certain stimuli. 

Almost no one talks about the immune system in relation to polycystic ovary syndrome.  Immune dysfunction is an overlooked aspect of this disease. 

So, anything you can do to calm and normalize the immune system is probably a good thing in terms of managing your symptoms.  Low-dose naltrexone may help you with this problem.

Your Opioid System

Opioids are substances in your brain that help regulate pain and pleasure. 

Opioids in other areas of your body help to regulate function of your pancreas and liver, as well as glucose metabolism and insulin resistance.  They also interact with sex hormones.

According to a University of Illinois study, women with PCOS are more likely to have dysregulation of the opioid system both in the brain and elsewhere in the body, with complex interactions.   Obesity is a complicating factor. 

The authors of this study reported that "naltrexone has been demonstrated to successfully augment traditional ovulation induction regimens".  That is, if naltrexone can help to regulate your opioid system, your symptoms might diminish and you could possibly improve your fertility.

We suggest you do your own research and then ask your doctor about it.  The low-dose form (3-4.5 mg) is virtually free of side effects.  The low-dose form can be obtained from a compounding pharmacy with a doctor's prescription.

Click here if you want to learn more about low-dose naltrexone.

Return to Medical Therapies Page


Sources:
Ahmed MI et al. Naltrexone treatment in clomiphene resistant women with polycystic ovary syndrome.Hum Reprod. 2008 Nov;23(11):2564-9.
Holden JE et al. The endogenous opioid system and clinical pain management. AACN Clin Issues. 2005 Jul-Sep;16(3):291-301.


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