Introduction Multi-ingredient nutritional supplements combining insulin-sensitizing and anti-androgenic compounds are increasingly used in polycystic ovary syndrome (PCOS), yet evidence on their combined clinical effects remains limited. This study aimed to evaluate whether the use of a multi-ingredient nutritional supplement blend containing myo-inositol, α-lipoic acid, N-acetylcysteine, saw palmetto, and folic acid was associated with six-month changes in body mass index (BMI), menstrual-cycle characteristics, and Ferriman-Gallwey hirsutism scores in women with PCOS. Methods Thirty-five Lebanese women with PCOS aged 18 to 40 and not receiving metformin or hormonal therapy were enrolled. BMI, menstrual cycle frequency, and Ferriman-Gallwey hirsutism scores were assessed at baseline. Hirsutism was reassessed at two and six months, while BMI and cycle regularity were reassessed at six months. Paired analyses and a linear mixed-effects model for repeated Ferriman-Gallwey scores were applied as appropriate, with significance set at p < 0.05. Three participants were lost to follow-up. Results At six months (N=32), mean BMI decreased significantly from 26.5 ± 2.8 to 25.7 ± 2.5 kg/m² among participants with complete paired BMI data (mean change = -0.88 ± 1.56 kg/m²; p = 0.003). Ferriman-Gallwey scores declined from 15.3 ± 3.2 at baseline to 15.1 ± 3.0 at 2 months and 14.4 ± 2.6 at 6 months. In a linear mixed-effects model, the baseline-to-six-month reduction remained statistically significant (mean difference: -1.08; 95% CI: -1.38 to -0.77; Holm-adjusted p < 0.001), while the smaller baseline-to-two-month change did not remain statistically significant after adjustment for multiple comparisons. Menstrual cycle regularity showed a non-significant improving trend (regular cycles: 8.6% to 18.8%; p=0.250). Conclusions Six months of using the supplement blend was associated with a modest reduction in BMI and a statistically significant but small baseline-to-six-month reduction in Ferriman-Gallwey hirsutism scores, with no statistically significant improvement in menstrual-cycle regularity. These observational findings should be interpreted as preliminary and support further randomized controlled trials with standardized lifestyle monitoring, objective metabolic and hormonal outcomes, and systematic safety assessment.