How to Reduce AMH Levels in PCOS?

Table of Contents

AMH is essential for the proper functioning of the ovarian system, along with other hormones in the reproductive system. When AMH levels become abnormal, whether high or low, it causes changes in the normal function of ovaries, leading to certain fertility issues.

In this article, you can learn how PCOS impacts AMH levels, the consequences of these changes, and effective ways to reduce them.

What is the Role of AMH?

Anti-Mullerian Hormone (AMH) are produced by granular cells that are presented in the surroundings of oocytes inside the follicle. In normal physiology, AMH stops development of male characteristics in female embryos during foetal development. In adult women, it plays other roles in reproduction such as:

  • Maintains ovarian reserve (indicates how many eggs remain in the ovary)
  • Regulates follicular growth and development
  • Helps select dominant follicles to release mature egg
  • Inhibits excessive follicular growth (more follicles form without dominant follicle)

However, when AMH levels are higher in ovaries, it will disturb the normal follicular development process, affect ovulation, cause irregular menstrual cycle and fertility issues. High AMH levels are often observed with PCOS and let’s see why in the following lines.

The Connection between PCOS and AMH Levels

When your AMH levels are high in the test results, it doesn’t mean you have a greater number of eggs and therefore higher chances of fertilisation. Instead, it actually represents a hormonal imbalance due to PCOS and other reasons. To explain in simple terms, PCOS disturbs normal follicular development, where many follicles grow but don’t mature, so the follicles struggle to release an egg.

When ovulation doesn’t occur, eggs get trapped inside follicles and form cysts. But the granulosa cells in the follicles continue to produce AMH regardless of ovulation. This high level of AMH indicates many small follicles (cysts) in the ovaries, and ultimately, no eggs get released, leading to infertility and irregular periods.

It is clear how high AMH levels impact the health of the reproductive system. Before looking at the ways to reduce AMH levels in PCOS, it is obvious to understand the range of AMH levels.

Normal AMH Levels

  • Young adults (18-30): 1.2- <4 ng/mL
  • Adults (31-40): 1-2.5 ng/mL
  • Advanced reproductive age (41+): <1 ng/mL

AMH levels in PCOS

  • Mild PCOS: 4-5 ng/mL (elevated)
  • Moderate PCOS: 5-7 ng/mL (high)
  • Severe PCOS: 7+ ng/mL (very high)

But these are general ranges and it can vary from person to person.

Dietary Changes

It is possible to bring positive changes by adding certain foods into your diet to regulate egg release, menstrual cycle and balance hormone levels.

  1. Take Omega-3 rich foods that will help regulate ovulation, enhance oocyte quality, increase pregnancy success in PCOS patients and regulate AMH levels. Foods such as sardines, mackerel, salmon, walnuts and flax seed are filled with omega 3 content.
  2. Take one type of green leaves everyday alternatively like spinach, kale,  which balance hormone levels, regulate menstrual cycle and promote overall healthy ovarian system 
  3. You can relish some berries like blueberries, raspberries and strawberries that are rich in antioxidants. They ensure ovulation and regularity menstrual cycle
  4. Prefer brown rice, black rice, whole wheat to regular white rice or refined wheat in your diet. Fibre and protein content in brown rice regulate blood sugar level and insulin. Notably, insulin resistance is related to high AMH levels
  5. Chickpeas, peanuts, dals and other legumes are always superfood to support fertility by regulating hormone levels
  6. Body needs good fats also to restore energy. You can add avocados, olive oil, dairy products and nuts in your food routine to boost overall reproductive health
  7. Probiotics play a vital role in preventing inflammation and infections in the reproductive tract and also, they support ovulation 
  8.   Sip green tea with lemon with added taste for its anti-inflammatory benefits and moreover they create a good environment for reproductive well being.

Lifestyle Modifications

  • Stress and AMH are inter-related, so try to alleviate stress levels through various practices. Learn meditation, yoga, and other exercises and implement them in your self-care journey gradually.
  • Socialise with people, join clubs, play games to keep yourself physically and emotionally sound.
  • Limit the daily intake of caffeine.
  • Reduce the addition of sugary substances.
  • Cut down aerated drinks and processed packed foods.
  • Do exercises to strengthen pelvic muscles.
  • Break down the smoking habits.
  •  Avoid consuming alcohol, which can disrupt hormone levels badly.
  • Make a regular sleep pattern, like going to bed at the correct time and waking up early, and maintain this every day to restore hormone levels.
  • You can use self-care and wellness tracking apps to remind you to take water and go for a walk.
  • Practise good posture and don’t spend too much time before screens without breaks.
  • Most importantly, stay positive and hopeful that with consistent effort you can achieve the results

Supplements and Herbal Remedies

Consider taking supplements in the form of capsules, powder or concentrate and these are available in the pharmacies. Additionally, you can take home remedies like herbal tea.

However, before implementing them, consult a health care provider to know about dosage and time period to follow these supplements.

Omega-3 fatty acids: You may be familiar with fish oils available in the drug stores. You can consume those pills if you are not able to get Omega 3s through edible food.

Berberine: It is a natural plant extract that you can get in tablet forms. They show good results when taken as a supplement to reduce insulin resistance, which causes high AMH levels.

Vitamin D3: Studies show that Vitamin D3 as dietary supplements impact AMH levels in women with PCOS and it gradually decreases AMH levels.

CoQ10: You can take Coenzyme Q10 supplements in tablet form. It plays a major role in improving insulin sensitivity, enhancing ovarian function and maintaining optimal AMH levels.

Medical Interventions to Reduce AMH Levels

Birth Control Pills

Contraceptive pills have three major functions in women with PCOS; to control menstrual cycles, decrease androgen levels and consequently decrease AMH levels. The treatment depends on the requirements of the patient and their history of illness. Generally, AMH levels drop after 3-6 months thus frequent check-up and tests are needed.

Anti-Androgen Medications

Anti-androgen medications like Spironolactone, Finasteride, and Flutamide reduce androgen hormone (AMH) levels, minimise PCOS symptoms like hirsutism and acne. They are often prescribed in combination with other treatments to get results, moreover, regular monitoring is needed to find side effects.

Metformin

Metformin as a medicine used in type 2 diabetes and PCOS treatment improves insulin sensitivity and decreases the levels of androgens and AMH. It comes in the dosage of 500-2000 mg/day and the duration of treatment is not known accurately. Thus, women may experience a decrease in AMH within 3-6 months with regular tests, and blood glucose level control.

Gonadotropin-Releasing Hormone Agonists

GnRH agonists include Leuprolide, Nafarelin, and Triptorelin: they have positive effects on ovarian function and decrease AMH levels in women with PCOS, but they are used often for short-term therapy; the duration and dosage of therapy depend on the patient’s health condition.

Conclusion

From the above discussion, you might get a clear view about AMH levels and its link to PCOS. When you find that you have high AMH levels in PCOS, you need not worry about that. It is not only you undergoing this condition; many women in the world are facing this issue, and many have surpassed these challenges.

Try to understand what elevates your AMH levels, whether food or stress, and bring changes according to that to reduce AMH levels. It is possible that with consistent effort, you can regulate AMH levels and achieve success in fertilisation.

FAQs

A healthy weight, balanced diet, and exercise are therefore a few of the lifestyle modifications that could help decrease the AMH levels. Adoption of stress-reduction practices like yoga or meditation would also help to reduce AMH levels.

Genetics, hormonal imbalance, obesity, insulin resistance, and environmental factors are the main contributors for high AMH levels in PCOS.

Elevated levels of AMH disturb ovulation, therefore preventing conception. Furthermore, it can suggest an increased risk of ovarian cysts, follicles congestion and poor egg quality, which all further affect the woman’s fertility.

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Dr. Rukkayal Fathima

Dr Rukkayal Fathima, India's Leading Gynaecologist and the best fertility doctor in Chennai. She has 11+ years of experience and treated 1000+ patients. She finished her M. S., Obstetrics and Gynaecology from the Institute of Obstetrics & Gynaecology (Madras Medical College), Chennai. She is a visiting consultant at St. Isabelle Hospital, Motherhood Hospital, Rainbow Hospital & Mehta Hospital. Dr Rukkayal Fathima specialises in Obstetrics care, Early Pregnancy Scan, IVF, ICSI, TESA/Micro TESE, Menopause advice, Gynaecological surgeries and endoscopy. She is a Co-Founder of Hive Fertility, the Best Fertility Center in Chennai.

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