• The body's natural antioxidant defenses became stronger — The review found that astaxanthin activated the Nrf2 pathway, one of your body's primary defense systems against oxidative damage. This increased production of protective antioxidant enzymes. Studies also reported higher total antioxidant capacity together with lower levels of damaging reactive oxygen species inside ovarian tissue.

Rather than simply neutralizing harmful molecules itself, astaxanthin helped cells strengthen their long-term defense system.

• Inflammation fell while communication between the brain and ovaries improved — Researchers reported that astaxanthin lowered inflammatory messengers by suppressing the NF-κB inflammatory pathway.

The review also described evidence that astaxanthin crosses the blood-brain barrier and was linked in animal research to healthier communication within the hypothalamic-pituitary-ovarian axis, the hormone signaling network connecting your brain and ovaries — a finding that hasn't yet been confirmed in human studies. By calming inflammation throughout these systems, astaxanthin may help create conditions that better support normal ovarian function.

• Insulin sensitivity and hormone balance improved together — Several studies included in the review found that astaxanthin improved glucose handling by increasing GLUT4 activity, allowing cells to move more glucose out of the bloodstream and use it for energy. GLUT4 is a transporter that acts like a door on the surface of muscle and fat cells.

Animal research summarized in the review also found that astaxanthin activated AMPK, often called cells' energy sensor because it regulates how efficiently energy is produced.

Clinical research summarized in the review found reductions in fasting insulin, HOMA-IR, body mass index, luteinizing hormone, testosterone, and anti-Müllerian hormone after three months of supplementation. Those improvements show that metabolic health and hormone balance often improve together instead of separately.

• Healthier ovarian cells supported better egg development — The review found that astaxanthin protected granulosa cells, the specialized cells that surround and nourish developing eggs. Researchers observed less oxidative damage, fewer cells undergoing programmed death, healthier mitochondria, and improved production of the steroid hormones these cells are designed to make.

Mitochondria are the energy-producing structures inside every cell, and granulosa cells depend heavily on them to fuel the months-long process of egg development. Studies also reported improvements in egg maturation, embryo development, and embryo quality together with higher antioxidant capacity inside follicular fluid, creating a healthier environment for reproduction. (These cellular and mitochondrial findings are drawn primarily from animal and cell-culture research.)

• The greatest promise came from combining astaxanthin with broader metabolic support — The review discussed animal research in which astaxanthin was combined with omega-3 fatty acids and metformin in a PMOS rat model, showing additional improvements — including better endometrial receptivity and lower oxidative damage — compared to conventional treatment alone.

At the same time, the authors emphasized that larger, longer-term clinical trials are still needed because many existing studies involved relatively small groups of participants. They also noted that improving astaxanthin's stability and absorption remains an important goal for future research.

• The greatest improvements occurred inside the egg's support system — Women receiving astaxanthin showed significant improvements in several laboratory markers linked to healthier cell function. Those biological changes occurred before noticeable differences appeared in pregnancy outcomes, suggesting that stronger ovarian cells develop before larger reproductive improvements become visible.

• Egg quality improved even though pregnancy rates did not — After 60 days of supplementation, women taking astaxanthin produced significantly more mature oocytes, higher-quality oocytes, and higher-quality embryos than those receiving the placebo. Oocytes are immature egg cells that need to fully mature before fertilization.

However, the total number of eggs retrieved, fertilization rates, and pregnancy-related outcomes didn't differ significantly between the two groups during the study period. These findings show that astaxanthin improved the quality of developing eggs rather than simply increasing the number of eggs produced.

• The protective environment surrounding each egg became healthier — Researchers also found significantly higher total antioxidant capacity inside follicular fluid, the nutrient-rich liquid surrounding each developing egg. Because eggs remain inside the ovary for months before ovulation, they depend on this fluid for nutrients and protection throughout their development.

Improving the antioxidant environment helps shield these delicate cells from ongoing damage, creating healthier conditions long before fertilization occurs. Rather than changing the egg directly, astaxanthin strengthened the environment supporting its development.

• Several cellular stress signals became quieter while protective responses remained active — The researchers measured multiple markers involved in the unfolded protein response, the emergency system cells activate when damaged proteins begin accumulating.

Women taking astaxanthin had much lower levels of several biological markers that indicate cells are under stress, showing their ovarian cells were healthier than those in the placebo group. Notably, results suggest astaxanthin didn't simply shut every stress pathway down. Instead, it reduced harmful stress while preserving the protective responses healthy cells still need.

• Healthier protein production offered another explanation for stronger egg development — Every cell constantly builds proteins that perform thousands of essential jobs. The endoplasmic reticulum serves as the cell's manufacturing and quality-control center, ensuring those proteins are assembled correctly before they are released. When that system becomes overloaded, damaged proteins accumulate and interfere with normal cell function.

Women taking astaxanthin had lower levels of several markers of this cellular stress, allowing granulosa cells to spend less energy responding to damage and more energy supporting healthy egg development. Although the study found improvements in egg maturity and embryo quality, pregnancy rates did not significantly increase during the 60-day trial.

A more recent review reached the same conclusion, noting that astaxanthin consistently improves biological markers and early reproductive outcomes, but larger, longer studies are still needed to determine whether those improvements ultimately lead to higher pregnancy and live birth rates.⁴

• One of astaxanthin's biggest strengths is improving cell health — A review published in Discover Medicine evaluated eight studies (four clinical trials and four animal studies) investigating astaxanthin for PMOS.⁵ The researchers concluded that astaxanthin consistently improved ovarian structure, follicle development, oxidative stress, inflammation, and markers of dyslipidemia such as cholesterol balance, but found little evidence that it promotes meaningful weight loss.

They also cautioned that the current evidence remains limited because most of the human studies came from the same research group, some reused the same participants and larger independent clinical trials are still needed to establish the optimal dose and confirm the findings in broader populations.

1. Build your meals around antioxidant-rich whole foods — I recommend getting antioxidants from food first because nature packages them with hundreds of other protective compounds that work together.

Colorful seafood such as wild salmon and shellfish naturally contain astaxanthin, while brightly colored fruits and vegetables supply additional antioxidants that help reduce the ongoing cellular stress described in the research. Make it a daily challenge to include at least three different naturally colorful foods on your plate each day.

2. Choose the same form of astaxanthin used in human research — If you decide to supplement, I recommend selecting a product derived from the microalgae Haematococcus pluvialis, the natural source used in most human studies. Avoid products made from synthetic petrochemical processes or genetically engineered yeast, since those differ from the form found naturally in foods and used in clinical research.

Most studies reporting health benefits have used between 4 and 12 mg daily, with 8 to 12 mg appearing to provide the greatest benefit for most adults.

Because astaxanthin is fat-soluble, research suggests it may be better absorbed when taken with a meal that contains healthy fat. Better yet, include natural food sources regularly, such as wild salmon, sardines, and krill oil. Krill oil also supplies naturally occurring astaxanthin together with omega-3 fats, and the astaxanthin may help protect those fragile fats from oxidation before your body uses them.

3. Rebuild your metabolism instead of chasing individual symptoms — PMOS involves far more than the ovaries, with underlying hormonal and metabolic dysfunction contributing to many of the condition's symptoms and health effects.

Progress is usually seen once you begin to improve insulin sensitivity, lower chronic inflammation, and restore healthier communication between your gut, metabolism, and reproductive hormones. As those systems begin working together again, symptoms often stop moving in multiple unhealthy directions at once.

Your diet becomes one of your strongest tools. Build your meals around whole, minimally processed foods that support steady energy production instead of ultraprocessed convenience foods. If your digestion feels compromised with frequent bloating or irregular bowel movements, start with easier-to-digest carbohydrates such as fruit and white rice while your digestive system recovers.

At the same time, eliminate foods that keep inflammation active, especially restaurant meals and products made with soybean, corn, canola, sunflower, and cottonseed oils. These seed oils contain large amounts of linoleic acid (LA), which accumulates in your tissues and interferes with your mitochondria. When your mitochondria struggle to produce energy efficiently, hormone signaling, blood sugar regulation, and inflammation all become harder to control.

I recommend replacing seed oils with traditional fats such as grass fed butter, ghee, or tallow. This directly supports what the research found inside ovarian cells — when mitochondria produce energy more efficiently, the same improvements in hormone signaling and inflammation that astaxanthin promoted at the cellular level begin happening throughout your entire body.

4. Use daily movement and stress recovery to reset hormone signaling — Your muscles become one of your most powerful metabolic tools once you start using them consistently. Every walk and every strength-training session helps your muscles absorb more glucose directly from your bloodstream, lowering the amount of insulin your pancreas needs to release. Lower insulin levels help reduce one of the major drivers behind excess androgen production and ovarian dysfunction.

The research showed that astaxanthin improved insulin sensitivity by increasing GLUT4 activity and activating AMPK inside cells. Regular movement triggers those same pathways throughout your muscle tissue, amplifying the metabolic shift astaxanthin supports at the ovarian level. If your energy feels low, keep your routine simple instead of pushing harder.

Aim for about 60 minutes of walking each day, add strength training two or three times each week and avoid sitting for long uninterrupted periods. Give your nervous system daily recovery time as well. Chronic stress keeps cortisol elevated, which disrupts communication between your brain and ovaries, worsens insulin resistance, increases cravings and interferes with restorative sleep.

Morning sunlight helps regulate your circadian rhythm and supports healthy mitochondrial energy production, while meditation, mindfulness, emotional processing, and limiting screen exposure before bed all help restore healthier hormone rhythms.

5. Protect yourself from everyday hormone disruptors — Food is only part of the equation. Many women overlook environmental chemicals that behave like hormones inside the body. These compounds, called xenoestrogens, mimic estrogen and interfere with your body's normal signaling.

The studies reviewed in this article showed that astaxanthin helped restore healthier communication within the hypothalamic-pituitary-ovarian axis, the hormone network connecting your brain and ovaries. Xenoestrogens disrupt that same signaling network from the outside, which means reducing your chemical exposure protects the hormonal improvements you're working to build from the inside. I recommend reducing those exposures wherever practical.

Store food in glass containers instead of plastic, avoid drinking from disposable plastic water bottles, avoid microwaving food in plastic, and choose natural-fiber clothing whenever possible. Personal care products and household cleaners without synthetic fragrances also reduce unnecessary chemical exposure. Every step that lowers inflammation and supports healthier hormone signaling gives your body a stronger foundation for long-term improvement.