by Amy Medling, founder of PCOS Diva
Hormone disruption is at the root of PCOS symptoms. Insulin is the most commonly discussed hormone when it comes to PCOS, but recently melatonin has been attracting the attention of patients and researchers alike.
So, what is melatonin? What does it do? How does it affect women with PCOS?
What is Melatonin?
Melatonin is a hormone which primarily controls the sleep and wake cycles. In this regard, melatonin is closely associated with the circadian rhythm otherwise known as the body clock. In addition to the regular day/night sleep cycles, melatonin adjusts accordingly when it comes to people who live in areas that have four seasons (i.e. higher levels in autumn and winter and lower levels in spring and summer).
Melatonin alone doesn’t knock you out; it just puts your body in a state that makes it want to fall asleep. When melatonin is suppressed, sleep is delayed because a certain level of melatonin is needed to achieve the optimum condition for sleeping. This melatonin build-up usually starts from mid to late evening and remains at high levels for most of the night until it drops in the morning, right when you’re about to wake up.
Interestingly, melatonin levels also decrease with age and is one of the reasons that older adults have frequent sleep disturbances, especially if coupled with dementia. 
Other Functions of Melatonin
Melatonin is more than just “a sleep hormone.” It is also responsible for your body’s daily upkeep including eye and digestive health, reproduction, and even regulation of mood, especially when it comes to depression. [2-5]
Melatonin can directly affect weight loss by increasing metabolism as well as the presence of specific fats that actually encourage fat loss. Indirectly, melatonin secretion also allows your body to get into “rest & repair” mode during periods of sleep which includes balancing hormones that have do to with fat metabolism and appetite. 
The imbalance of hormones makes women with PCOS more susceptible to insulin resistance and Type 2 Diabetes. A variety of health issues can occur as a result, from infertility and hair loss to obesity and diminished sex drive, but all of them are notably based in hormonal imbalances including melatonin.
Because of its benefit on weight loss, researchers have concluded that melatonin supplementation could help solve the metabolic syndrome problem that afflicts millions of people all over the world. That said, melatonin supplementation is only effective if melatonin secretion is impaired to begin with. 
Melatonin is secreted by your pineal gland, a tiny endocrine gland positioned between the two hemispheres of your brain. With regard to fertility, melatonin is also produced by your follicles (eggs) within an ovary, the mass of cells that surround the follicles, and in the immature follicle itself.
That explains why melatonin supplementation is now being looked into when it comes to treating PCOS. Recent studies have demonstrated melatonin’s role in our menstrual cycles. This is important considering some of the more common effects of PCOS are irregular or infrequent periods and difficulties with ovulation. Studies have shown a clear link between these symptoms and melatonin. [8, 9]
Melatonin’s unique anti-oxidative characteristics and safety also make it a valuable therapeutic agent for patients undergoing in vitro fertilization in whom infertility occurs due to poor oocyte quality and anovulation.
Melatonin’s precursor is the neurotransmitter serotonin, which is a significant player in managing and uplifting your mood and mindset. Like serotonin, melatonin is essential for your physical and emotional well-being. For that reason, melatonin has been suggested to help improve depression treatment and help support a healthy sleep cycle. 
Women with PCOS often struggle with a lack of or a poor quality of sleep. If you find yourself constantly having bad sleep, or at least have difficulty sleeping continuously, it may be due to the body over producing melatonin at night. Yes, low melatonin can cause sleep issues, but apparently too much melatonin could be bad for sleep quality too. 
One study measured melatonin levels and the sleep patterns in those with PCOS and found that there is significantly increased oxidative stress. Since melatonin is an antioxidant, the increased levels of this hormone at night could mean that the body is trying to respond to the PCOS-induced oxidative stress by secreting more melatonin than you need.
“Numerous books, magazines, and articles have praised melatonin as a “miraculous cure-all” for ailments ranging from sleeplessness, to aging, without any clinical evidence of efficacy. Very little attention has been paid to the possible side effects of melatonin. Nightmares, hypotension, sleep disorders, abdominal pain, etcetera, have been reported.”
PCOS patients usually have excess testosterone or androgens. Recent findings suggest that an increase in testosterone mirrors an increase in melatonin production because both hormones are synthesized by the ovaries. 
However, it is still undetermined whether the increase in testosterone increases melatonin, if it’s the other way around, or if it’s a separate symptom altogether.
How to Maximize Melatonin Benefits Naturally
- Eat the right foods. Melatonin is available in small amounts in foods. Most of these foods are fruits and vegetables such as bananas, cherries, olives, grapes, and even broccoli.
- Practice meditation. Reducing stress means the body won’t have to expend its melatonin reserves to beat it. Meditating a few minutes a day, especially after a stressful event, can help reduce cortisol, the stress hormone.
- Conduct sleep rituals. Sleeping properly and according to our natural circadian rhythm is an excellent way to help balance hormones. Sleep rituals help get the body in the mood to sleep even if your melatonin isn’t functioning properly. Rituals such as meditation, a short read, or simply dimming the lights (melatonin needs darkness to trigger) and eliminating noise helps ready your body for its much-deserved sleep.
- Exercise regularly. Exercising helps optimize hormonal balance. Just don’t exercise too hard a few hours before sleeping, or it could do more harm than good.
- Reduce stimulants like caffeine. Caffeine activates certain enzymes, hormones, and chemicals in the body that effectively prevents melatonin from doing its job. Avoid caffeine, especially after lunch. If you do manage to sleep despite the caffeine intake, don’t expect to have a good night’s rest since your body is now confused whether it should be awake or asleep.
You can always supplement with melatonin, but make sure the supplement you’re buying is of high quality. Also, it’s important to know how much melatonin you are already producing. This is tricky for those of us with PCOS because our hormones are out of balance and fluctuate already, so being sure about melatonin levels is challenging. If you choose to supplement, work with your doctor.
Amy Medling, best-selling author of Healing PCOS and certified health coach, specializes in working with women with Polycystic Ovary Syndrome (PCOS), who are frustrated and have lost all hope when the only solution their doctors offer is to lose weight, take a pill, and live with their symptoms. In response, Amy founded PCOS Diva and developed a proven protocol of supplements, diet, and lifestyle programs that offer women tools to help gain control of their PCOS and regain their fertility, femininity, health, and happiness.
- Deschenes CL, McCurry SM. Current Treatments for Sleep Disturbances in Individuals With Dementia. Current psychiatry reports. 2009;11(1):20-26.
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- Shreeve N, Cagampang F, Sadek K, et al. Poor sleep in PCOS; is melatonin the culprit?. Hum Reprod. 2013;28(5):1348-53.
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