Saw Palmetto for PCOS/PMOS: Benefits, Dosage and Facial Hair

Saw palmetto is one of my favourite natural androgen blockers for PCOS, or PMOS as it is now also called. It reduces the conversion of testosterone to DHT, its much more potent form, and promotes estrogen balance, which eases the acne, hirsutism (excess facial and body hair) and thinning hair that excess androgens cause. In my PCOS Repair Protocol it belongs to step one, the Anti-Androgen Plan.

Does the evidence match your goal?

• Facial hair or acne: Yes. I have used saw palmetto in combination with other natural androgen blockers, such as reishi, nettle and zinc, with my clients for many years and seen dramatic improvements to stubborn acne and frustrating hair growth.
• Lower testosterone or DHT in PCOS/PMOS: Saw palmetto works on DHT. In a 2023 trial, adults with hair loss who took saw palmetto oil capsules had lower DHT than the placebo group (Sudeep et al. 2023), and in rats with PCOS, a saw palmetto extract improved hormone levels and restored normal ovarian tissue (Taha et al. 2026).
• Cycles, ovulation, or fertility: If your cycle is irregular, you will benefit from adding inositol, whichever PCOS type you have.
• Scalp thinning: DHT drives thinning on your head too. I have seen the same combination improve thinning hair in my clients, and two trials found saw palmetto extracts increased hair density (Sudeep et al. 2023; Ablon 2026).

How saw palmetto blocks DHT

“Blocks DHT” is shorthand for what saw palmetto does: it reduces the activity of 5-alpha reductase, the enzyme that turns testosterone into dihydrotestosterone (DHT), so less of your testosterone becomes DHT. Like testosterone, DHT gets into your hair follicles and causes acne, hirsutism and hair thinning.

A testosterone blood test doesn't take into account how strongly this enzyme is working in your body, so even with normal testosterone levels, your body may be far more efficient at converting testosterone to DHT. That is why the best way to tell whether androgens are behind your symptoms is to look at the symptoms themselves: acne around your chin, jawline, upper lip, neck, chest and back, thinning hair at your crown or a widening part, a receding hairline, or hair growth around your chin, neck, jawline, chest, breasts or back.

What the human hair studies actually tested

Both trials found more hair with saw palmetto. The 2023 trial randomized 80 adults aged 18 to 50 with mild to moderate androgenetic alopecia to an oral capsule, oral placebo, topical formula, or topical placebo. The 400 mg oral capsule contained 100 mg of VISPO, the proprietary saw palmetto oil. Hair fall dropped and hair density rose in both saw palmetto groups, and the capsule group's DHT fell compared with placebo (Sudeep et al. 2023).

The 2026 trial enrolled 60 healthy adults with self-perceived thinning hair. Forty received a proprietary 160 mg extract and 20 received placebo for 180 days. By 90 days hair counts had risen more than with placebo and shedding had fallen (Ablon 2025), and by 180 days hair counts and density had improved across the group (Ablon 2026).

When symptoms need prompt assessment

If facial hair or acne is new, severe, or rapidly worsening, especially with voice deepening, increased muscle mass, or another sign of virilization, see your doctor promptly rather than waiting to find out whether a supplement helps. Current guidance uses the speed of change, virilization, biochemical severity, and assay quality to decide how urgently to investigate (Elhassan et al. 2025).

What is the saw palmetto dose for PCOS or female facial hair?

Take saw palmetto every day at the dosage on its label, whether it is for PCOS, female facial hair or hormonal acne. It is the third daily ritual of my Anti-Androgen Plan, the one for faster results, alongside two cups of spearmint tea and a PCOS Repair Breakfast.

I created AndroEase Plus for that ritual because my clients got sick of taking handfuls of pills each day. It is my daily androgen support blend for women with PCOS, with saw palmetto, reishi, nettle, green tea, zinc and copper in one convenient daily dose. Leave saw palmetto out if you are pregnant, breastfeeding or trying to conceive, when inositol is my choice instead, and check with your doctor first if you are on the pill or another regular medicine.

Is saw palmetto safe for women?

NCCIH says saw palmetto has generally been well tolerated in research, with mostly mild digestive symptoms, dizziness, or headache, but it may be unsafe during pregnancy or breastfeeding (NCCIH).

What to do next

Saw palmetto gives you relief from your symptoms while we dig deeper and heal your root cause, and my guide to reducing androgens in women naturally covers the other ways to bring them down in the meantime. Once your root cause is reversed, your body will stop over-producing androgens. My free root cause quiz tells you whether Insulin-Resistant, Adrenal, Post-Pill or Inflammatory PCOS is driving your symptoms, and The PCOS Repair Protocol walks you through treating it.