Zinc

Anti-androgen/skin effects (acne & hirsutism): Zinc can inhibit 5-α-reductase, the enzyme that converts testosterone to the more potent DHT in skin—mechanistically relevant to acne and excess facial/body hair. (This is in-vitro, but biologically plausible.) Oxford Academic

Antioxidant/anti-inflammatory: Oxidative stress and inflammation are elevated in many people with PCOS; zinc is a cofactor for antioxidant enzymes (e.g., SOD) and has anti-inflammatory actions. SpringerLink

Insulin sensitivity & lipids: Small RCTs suggest zinc may modestly improve fasting glucose/insulin, HOMA-IR, and triglycerides in PCOS—pathways tied to weight gain and metabolic features. (Important caveat below.) Thieme

Low zinc status in PCOS: Multiple meta-analyses report women with PCOS often have lower circulating zinc than controls, which provides a rationale for repletion (though it doesn’t prove benefit). SpringerLink

1) Dose & duration (adults):

• The RDA for women 19+ is 8 mg/day; the UL (max long-term without medical supervision) is 40 mg/day. Office of Dietary Supplements
• PCOS RCTs that reported benefits typically used 50 mg elemental zinc daily for ~8 weeks (often as 220 mg zinc sulfate). Note this exceeds the UL and should be short-term and medically supervised. Thieme
• A reasonable self-care approach is a short trial of 15–30 mg elemental zinc daily for 8–12 weeks, then reassess with your clinician (particularly if you’re targeting acne or mild hirsutism), keeping total zinc intake ≤ 40 mg/day unless supervised. (UL source: NIH ODS.) Office of Dietary Supplements

2) Form & how to take it:

• Zinc citrate or gluconate are well-absorbed; absorption from citrate ≈ gluconate and > oxide. Take with food to reduce nausea. Office of Dietary Supplements
• Timing with other pills: Separate zinc from quinolone or tetracycline antibiotics by at least 2 hours before or 4–6 hours after; separate from penicillamine by ≥ 1 hour. Consider spacing from high-dose iron supplements to avoid competitive absorption. Office of Dietary Supplements

3) Diet first when possible:

• Good sources include oysters, beef, shellfish, dairy, eggs, legumes, and fortified cereals; plant-rich diets absorb less zinc due to phytates, so total intake may need to be higher from foods. Office of Dietary Supplements

PCOS-specific randomized trials

• Insulin resistance & lipids: RCT (n=52) using 50 mg elemental zinc/day for 8 weeks reported improved fasting glucose, insulin, HOMA-IR and triglycerides vs placebo. A journal “Note of Concern” has been issued regarding this trial, so interpret cautiously. Thieme
• Hirsutism/alopecia & oxidative stress: RCT (n=48) using 50 mg/day for 8 weeks reported reductions in hirsutism scores and alopecia and lower MDA (oxidative stress) vs placebo. This article is under editorial investigation for trial integrity—again, caution. SpringerLink

Combination supplementation in PCOS

• Magnesium + calcium + vitamin D + zinc (only 4 mg zinc per dose): In a 12-week double-blind RCT in 60 PCOS patients, the combo reduced hirsutism and inflammatory markers vs placebo. Because it’s a combination, the independent effect of zinc is unknown. https://www.peoplespharmacy.com/

Systematic reviews/meta-analyses

• 2024 systematic review/meta-analysis (PCOS, zinc supplementation): Synthesized RCTs of zinc in PCOS for hormonal/metabolic outcomes. (Access limitations aside, this indicates an emerging but still limited evidence base.) Clinical Nutrition ESPEN
• Trace-element status in PCOS: Several meta-analyses show lower serum zinc in PCOS vs controls—supporting a potential role for repletion, not definitive for symptom control. SpringerLink

Acne evidence (not limited to PCOS)

• Mechanistic and clinical literature suggests zinc can reduce acne severity (anti-inflammatory, antimicrobial, 5-α-reductase inhibition). Quality varies; effects are generally modest. Oxford Academic