One possible use for a malaria medication is to treat PCOS, a prevalent hormone disease.

The endocrine condition known as polycystic ovarian syndrome, which affects hundreds of millions of women worldwide who are of reproductive age, may also be treated with a typical antimalarial medication.

Researchers report in the June 14 Science that a small group of women with PCOS had healthier-looking ovaries and lower blood testosterone levels after receiving repeated doses of artemisinin. The findings imply that artemisinin molecules, which have already been shown to be useful in treating cancer, lupus, and malaria, may potentially be utilized to treat PCOS symptoms.


Elisabet Stener-Victorin, an endocrinologist at the Karolinska Institute in Stockholm who was not involved in the research, writes in a perspective in the same edition of Science that the discovery could “potentially change the landscape of PCOS treatment.” “The discovery of artemisinins as effective remedies for PCOS nonetheless represents a promising new approach, even though further studies will be needed.”

Even though PCOS is very common, its exact cause is unknown. Increased levels of androgens, which include testosterone, and a profusion of tiny cysts on patients’ ovaries are the main diagnostic criteria used by doctors. Specific symptoms like acne, excessive hair growth, irregular menstruation, or infertility are often the focus of treatments. Researchers now believe that underlying alterations to the systems regulating our metabolism, such as the insulin system, are responsible for both type 2 diabetes and PCOS, which are conditions that are associated with increased risk of metabolic disorders.

In 2016, Qi-Qun Tang, a medical researcher and molecular biologist at Fudan University in Shanghai, focused on the study of metabolic illnesses and adipocytes, or fat cells. After screening 3,000 medications, Tang and colleagues found that the Nobel Prize–winning medication artemisinin is a good option for treating obesity symptoms by converting white adipose tissue into brown or beige adipose tissue, which is simpler to shed (SN: 10/5/15). Interestingly, at the same time, another research discovered that PCOS in rats may be treated using brown adipose tissue.

Tang states, “We got interested in looking into the possible effects of artemisinins on PCOS.”

Using female mice as test subjects, the scientists injected dehydroepiandrosterone, an androgen, to cause PCOS symptoms in animals. Mice who received artemisinin concurrently with the hormone did not experience PCOS-related symptoms including ovarian cysts, a disrupted menstrual cycle, or high blood testosterone levels. The researchers tested the medication on PCOS patients in a short clinical trial after observing comparable outcomes in rats.

For three months, 19 patients took three times a day dihydroartemisinin, the type of artemisinin used to treat malaria. Twelve of the patients started having regular menstrual cycles after starting this treatment plan, and the majority of them also had lower blood testosterone levels and fewer follicles in their ovaries that were growing. In order to be fertilized, ovulation releases egg cells from the folliculles. PCOS is indicated by an excess of them; a follicle that does not release an egg may become a cyst.

According to biochemical testing, artemisinin aids in the breakdown of CYP11A1, a protein that makes testosterone and contains heme. This lowers the amount of testosterone in the blood, which prevents the ovaries from functioning normally. According to Yang Liu, a researcher at Fudan University, heme includes iron that, when combined with artemisinin, can produce hazardous forms of oxygen that can kill cancer cells or malarial parasites. It is most likely due to these heme-related interactions that artemisinin combats so many various types of illnesses.

Sireesha Reddy, an obstetrician and gynecologist at Texas Tech University Health Sciences Center El Paso, notes that more research is need to determine the exact location in the body where artemisinin is functioning. She also stresses that the data are very preliminary. She recommends assessing blood levels of lipids and insulin to see how the medication impacts cardiometabolic symptoms of PCOS. She also recommended looking into how the medication functions in patients with more severe PCOS, such as those who have greater weights and BMIs than the study participants.

Prior to perhaps advancing to more extensive clinical studies, the team intends to examine various dosages and types of artemisinin to see which one is most effective against PCOS. Tang expresses his curiosity on whether artemisinin can help people regain their fertility, which is one of the most severe symptoms of PCOS. “There is still more work to be done to determine how they can regain fertility.”