Targeting PCOS-related inflammation with bioactive compounds of Syzygium polyanthum (Wight) Walp. leaves extract: An in silico study

Aims: Polycystic Ovary Syndrome (PCOS) is an endocrine disorder that primarily affects women of reproductive age, associated with hormonal imbalances and metabolic irregularities, often leading to various health complications. PCOS is associated with elevated levels of androgens, which are male hormones that women also produce, and this hormonal imbalance can result in various symptoms such as irregular menstruation, excessive hair growth, acne, and even infertility. Some herbal plants have shown promise in managing PCOS symptoms due to their anti-androgenic and anti-inflammatory properties. Spearmint (Mentha spicata) has long been recognized for its potential therapeutic properties in managing PCOS. Therefore, this study aimed at investigating the phytochemicals in Mentha spicata that specifically targets specific key protein molecules associated with PCOS using Molecular docking analysis. Methodology: The target proteins used in this study were: androgen receptor, FSH receptor, LHCG receptor, Insulin receptor and Anti-mullerian hormone Results: The results revealed potential binding affinities and interaction patterns, highlighting spearmint's role in the management of PCOS. The analysis identified oleanolic acid as the phytochemical with the best binding affinity across all five proteins used in the study amongst others. This suggests that oleanolic acid may be a good candidate of spearmint in targeting the key proteins associated with PCOS, potentially helping to reduce the effects of the condition. These findings are consistent with previous research showing that spearmint may have anti-androgenic effects. Conclusion: While the results of this molecular docking analysis seem promising, it is important to note that these findings are computational. Further in vitro and in vivo experiments are needed to validate these computational findings.

Polycystic Ovarian Syndrome (PCOS) is a prevalent reproductive endocrinopathy which presents a significant clinical and public health problem (Morgante et al. 2015). PCOS can affect females throughout their lifespan leading to serious complications such as obesity, infertility, type two diabetes mellitus and cardiovascular disease (De Leo et al. 2016). The conventional approach to treating PCOS is guided by what symptoms affect the patient most such as infertility, hirsutism, acne and so forth. Many of the conventional treatments for PCOS such as metformin, anti-androgens and oral contraceptives can cause harmful adverse side-effects (Lamba et al 2018:65). Adverse side-effects, complications, dissatisfaction in various aspects of the patient- practitioner experience and failed therapies are among the main reasons that patients opt for Complementary and Alternative Medicine (CAM) therapy. CAM fulfils the expectations not met by conventional medicine, particularly the psychological impact of PCOS on patients, which are assessed by only a few conventional practitioners (Fauser et al. 2012). Aim of the study This study aimed to document existing therapeutic protocols in the management of PCOS from diagnosis to treatment used by practitioners within various disciplines of CAM in the context of their unique philosophical background. Furthermore, this information may be valuable in bridging any potential gap in information across the five CAM modalities investigated in this research with regards to PCOS. These modalities were: homoeopathy, Ayurveda (AV), Unani Tibb (UT), Traditional Chinese Medicine (TCM) and naturopathy. Methodology A qualitative approach was used to document the perceptions and protocols used in the diagnosis and management of PCOS by practitioners of the five selected CAM v modalities practicing within the boundaries of the eThekwini municipality. Stratified purposive sampling was implemented in order to select a sample frame of 12 participants. Data was collected by means of personalised, semi-structured interviews and the data collected was analysed using Tesch’s (Tesch 1990:329) and Creswell’s (Creswell 2014) methods. Results CAM philosophies are underpinned by the principles of innate healing, an individualised constitution and governing factors which manage homeostasis. TCM philosophy is guided by the yin and yang concept, homoeopathy by the vital force and miasms, AV by three doshas. UT by four humours and naturopathy by lifestyle factors. PCOS patients were generally classified as being sycotic and/or cancerinic (miasmatically) according to homoeopathy, having a melancholic, sanguineous temperament according to UT, presenting with excessive kapha and vata according to Ayurveda and a predominant yang deficiency with heat and moisture according to TCM. PCOS is a multi-faceted reproductive endocrinopathy which requires extensive management. The different roles of a family physician, endocrinologist, dermatologist, dietitian and gynaecologist in the diagnosis and holistic management of PCOS is performed collectively by a CAM practitioner. PCOS is considered an affliction of the woman and not merely as a disease of the ovaries and therefore much attention is drawn to the emotional drivers, particularly stress and abuse which affect these patients’ quality of life (QoL). Diagnostics reported by participants included: 1) A clinical diagnosis congruent with established diagnostic criteria such as the Rotterdam criteria which identified the pathognomonic features of PCOS and 2) A CAM-specific diagnosis which evaluated the entirety of the patient’s symptoms, emotions and characteristics in order to determine a constitutional weakness. vi This study found that management of PCOS, according to CAM participants, was aimed at correcting hormonal, ovulatory and menstrual imbalances, improving fertility, reducing obesity, managing infertility and improving the patient’s QoL. Management strategies generally comprised: 1) CAM-specific therapy which included medicines and/or procedures, 2) Adjunctive therapy which included supplements and the use of other modalities and 3) Lifestyle intervention which included dietary counselling, physical activity recommendations and emotional counselling. Conclusion In conclusion, PCOS is a multi-faceted condition which requires emotional support concomitantly with therapeutic support due to the clinical spectrum of changes that can have an impact on females’ psychological health.

BackgroundPolycystic ovary syndrome (PCOS) is a prevalent, complex endocrine disorder characterised by polycystic ovaries, chronic anovulation and hyperandrogenism leading to symptoms of irregular menstrual cycles, hirsutism, acne and infertility. Evidence based medical management emphasises a multidisciplinary approach for PCOS, as conventional pharmaceutical treatment addresses single symptoms, may be contra-indicated, is often associated with side effects and not effective in some cases. In addition women with PCOS have expressed a strong desire for alternative treatments. This review examines the reproductive endocrine effects in PCOS for an alternative treatment, herbal medicine. The aim of this review was to identify consistent evidence from both pre-clinical and clinical research, to add to the evidence base for herbal medicine in PCOS (and associated oligo/amenorrhoea and hyperandrogenism) and to inform herbal selection in the provision clinical care for these common conditions.MethodsWe undertook two searches of the scientific literature. The first search sought pre-clinical studies which explained the reproductive endocrine effects of whole herbal extracts in oligo/amenorrhoea, hyperandrogenism and PCOS. Herbal medicines from the first search informed key words for the second search. The second search sought clinical studies, which corroborated laboratory findings. Subjects included women with PCOS, menstrual irregularities and hyperandrogenism.ResultsA total of 33 studies were included in this review. Eighteen pre-clinical studies reported mechanisms of effect and fifteen clinical studies corroborated pre-clinical findings, including eight randomised controlled trials, and 762 women with menstrual irregularities, hyperandrogenism and/or PCOS. Interventions included herbal extracts of Vitex agnus-castus, Cimicifuga racemosa, Tribulus terrestris, Glycyrrhiza spp., Paeonia lactiflora and Cinnamomum cassia. Endocrine outcomes included reduced luteinising hormone (LH), prolactin, fasting insulin and testosterone. There was evidence for the regulation of ovulation, improved metabolic hormone profile and improved fertility outcomes in PCOS. There was evidence for an equivalent effect of two herbal medicines and the pharmaceutical agents bromocriptine (and Vitex agnus-castus) and clomiphene citrate (and Cimicifuga racemosa). There was less robust evidence for the complementary combination of spirinolactone and Glycyrrhiza spp. for hyperandrogenism.ConclusionsPreclinical and clinical studies provide evidence that six herbal medicines may have beneficial effects for women with oligo/amenorrhea, hyperandrogenism and PCOS. However the quantity of pre-clinical data was limited, and the quality of clinical evidence was variable. Further pre-clinical studies are needed to explain the effects of herbal medicines not included in this review with current clinical evidence but an absence of pre-clinical data.Electronic supplementary materialThe online version of this article (doi:10.1186/1472-6882-14-511) contains supplementary material, which is available to authorized users.

Polycystic ovarian syndrome (PCOS), a lifestyle disorder that occurs due to hyperandrogenism in women. In this, FSH (follicle stimulating hormone) levels decrease whereas testosterone levels increase at once. There are many reasons for which PCOS occurs. Etiology and pathophysiology are discussed briefly in the present article. Aloe vera (Aloe barbadensis Mill.) is a renowned medicinal herb among the whole world for its pharmacological activities like ‘anti-diabetogenic’, ‘anti-microbial’, ‘anti-inflammatory’, ‘anti-obesity’ and clinical activities including ‘PCOS management’ and ‘wound healing’, ‘skin protection’ etc. The present paper objects to summarize the impact of aloe vera in PCOS management and other PCOS-induced disorders. It inhibits the genes that induce PCOS and aloe vera also regulates the activity of insulin. Several bioactive phytochemicals, present in aloe vera like ‘barbaloin’, ‘aloe-emodin-9-anthrone’, ‘lsobarbaloin’ ,’Anthrone-C-glycosides’ and ‘chromones’, ‘phytosterols’, ‘aloin’, ‘anthrone’, ‘aloe emodin’ , ‘aloetinic acid’ , ‘choline’ and ‘choline salicylate’ etc., which are responsible for its efficacy in PCOS and PCOS-induced disorders management.

The role of vitamin D in polycystic ovary syndrome

To harmonise the diagnostic processes of polycystic ovary syndrome (PCOS) and enable clinicians to provide better patient care, it is critical to understand the knowledge gaps in PCOS diagnosis. We evaluated how clinicians in endocrinology, family medicine, general practice and gynaecology diagnose PCOS. This cross-sectional survey involved 208 clinicians from specific subspecialties across various healthcare settings in Singapore. A total of 160 responses were included in the final analysis. Among all the diagnostic criteria, the Rotterdam 2003 criteria was most frequently used (66.3%). More than half of the gynaecologists reported having a standardised workplace protocol while the majority from other specialties reported otherwise. A large percentage of respondents (60.5%) were unable to identify the correct PCOS clinical features, which is concerning. Only 8.8% of respondents used clinical and biochemical hyperandrogenism, menstrual disturbances and pelvic ultrasound to diagnose PCOS without performing unnecessary and incorrect investigations. Most clinicians recognised insulin resistance/type 2 diabetes mellitus and fertility problems as complications while only a few recognised psychological complications. Many clinicians (37.3%) sought standardisation of PCOS diagnosis and management guidelines for improvement in PCOS care and 81.9% of respondents would appreciate standardised educational materials. This is the first study to the best of our knowledge that gives an insight into the diagnostic and management processes of PCOS among various healthcare institutions in Singapore. This study calls for greater harmonisation of diagnostic processes and holistic evidence-based management of patients with PCOS through standardised workplace protocols and patient education resources.

36. Primary Care Provider Behaviors, Attitudes and Beliefs In the Diagnosis and Management of Polycystic Ovary Syndrome in Adolescents

Background: Poly Cystic Ovarian Syndrome (PCOS), in Siddha terms known as Sinaipaineer Katti, is the most common hormonal and reproductive disorder affecting women. It is marked by hyperandrogenism, hyperinsulinemia, and menstrual irregularities and also significantly contributes to mental health issues. The genes CYP11A, CYP17, and CYP19 encode enzymes involved in the steroidogenic pathway and are considered potential contributors to PCOS, leading to hyperandrogenism. Persistent hyperandrogenism causes menstrual irregularities such as amenorrhea (Soothaga Thadai), chronic anovulation, hirsutism, and infertility. Aim: To evaluate the interaction between phytoconstituents of the Siddha formulation Soothagathai Udaika Kudineer (SUK) and the target enzyme CYP-17α-hydroxylase through molecular docking analysis. Methods: A docking study was carried out to assess the interaction of nine phytocompounds found in SUK with CYP-17α-hydroxylase. Essential hydrogen atoms, Kollman united atom type charges, and solvation parameters were added using Auto Dock tools. Results: The bioactive compounds present in SUK- Chlorogenic acid, gingerenone-A, kaempferitrin, diosgenin, and oleic acid- showed interaction with the active amino acids of CYP-17α-hydroxylase and exhibited strong binding affinity toward the enzyme. Conclusion: The inhibition of the target enzyme by these compounds suggests that they may act as therapeutic agents in the management of PCOS. SUK could serve as a safer alternative to existing treatments, which are often less effective or associated with adverse effects. 0 Major Findings: Key phytoconstituents in SUK showed strong binding with CYP-17α-hydroxylase, indicating their potential to inhibit androgen synthesis and help manage PCOS symptoms.

Polycystic Ovary Syndrome (PCOS) is a common endocrine and metabolic disorder affecting women of reproductive age and is characterized by insulin resistance, hyperandrogenism, irregular menstrual cycles, and ovulatory dysfunction. Conventional management of PCOS mainly includes lifestyle modification and pharmacological treatments such as metformin and anti-androgenic drugs. However, long-term use of these therapies may cause side effects, leading to increasing interest in herbal and complementary medicines. Licorice (Glycyrrhiza glabra) is a widely used medicinal plant known for its anti-androgenic, estrogen-like, anti-inflammatory, and insulin-sensitizing properties. This review highlights the potential role of licorice in the management of PCOS by summarizing its botanical profile, active constituents, traditional uses, and mechanisms of action. Studies from in vitro experiments, animal models, and human clinical trials indicate that licorice and its bioactive compounds, such as glycyrrhizin and glycyrrhetinic acid, may help reduce elevated androgen levels, improve insulin sensitivity, regulate menstrual cycles, and support ovarian function. Additionally, licorice has shown potential benefits as an adjuvant therapy when used with conventional treatments. Despite these promising findings, concerns related to dosage standardization, safety, and long-term use remain. Further well-designed clinical studies are required to establish the efficacy and safety of licorice in PCOS management. Keywords PCOS, Licorice, Insulin, Resistance, Hyperandrogenism, Herbal, Therapy, Ovarian, Metabolism, Hormones, Phytoestrogens, Antiandrogenic, Inflammation, Fertility, Endocrine, Complementary, Medicine.

Background: Polycystic ovary syndrome (PCOS) is a complex endocrine and metabolic disorder affecting up to 20% of women of reproductive age. Characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology, PCOS is frequently accompanied by insulin resistance, chronic inflammation, and an increased risk of cardiometabolic diseases. Objective: This narrative review synthesizes current evidence on the role of dietary patterns, specific nutrients, and physical activity in the management of PCOS. The aim is to highlight lifestyle strategies that target the underlying metabolic and hormonal disturbances and to support their use as first-line therapeutic interventions. Methods: A structured literature search was conducted in PubMed, Scopus, and Web of Science (2010–2025) using terms related to PCOS, nutrition, exercise, insulin resistance, and supplementation. Articles were selected based on relevance, methodological quality, and adherence to PRISMA 2020 guidelines. Results: Evidence supports the efficacy of low glycemic index, Mediterranean, and DASH diets in improving insulin sensitivity, reducing hyperandrogenism, and restoring menstrual regularity. Specific nutrients such as inositols, omega-3 fatty acids, and vitamin D show additional benefits, particularly in improving metabolic and reproductive outcomes. Physical activity—including aerobic, resistance, and high-intensity interval training—enhances insulin action, reduces visceral adiposity, and improves ovulatory function. Lifestyle interventions also lower long-term risks of type 2 diabetes and cardiovascular disease in PCOS. Conclusion: Diet and exercise are powerful, evidence-based tools in the management of PCOS. Integrating nutritional biochemistry and exercise physiology into clinical care offers a non-pharmacological, multifaceted approach that improves both short- and long-term outcomes.

Women of reproductive age who suffer from PCOS, a multifactorial endocrine illness, are characterized by ovulatory failure, hyperandrogenism, and polycystic ovaries. The etiology of PCOS is intricate, involving insulin resistance (IR), hormonal imbalances, and chronic low-grade inflammation. Increased luteinizing hormone (LH) levels, hyperinsulinemia, and altered ovarian steroidogenesis contribute to anovulation and excessive androgen production and Current understanding of how anti-Mullerian hormone (AMH) contributes to PCOS. These pathophysiological alterations result in clinical manifestations such as hyperandrogenism, acne, hirsutism, and infertility. Utilizing phytoconstituents has gained interest as a natural and holistic approach for managing PCOS as they possess insulin-sensitizing and anti-inflammatory properties, modulate oxidative stress and enhance glucose metabolism, and exhibit estrogenic effects that aid in hormonal balance, menstrual irregularities. A thorough literature search was conducted using internet sources like PubMed. Scholar by Google, various reviews, research articles, and reports on biochemical, hormonal, and histological changes after phytoconstituent administration. The search focused on research, both preclinical and clinical, assessing the effectiveness of phytoconstituents in treating PCOS. This review demonstrates the intricate pathophysiology of PCOS in addition to exploring the therapeutic potential of phytoconstituents in its management. It may also offer a safer and more effective alternative to conventional treatments.

Do contraception use, pregnancy outcome and number of children differ in women with and without polycystic ovary syndrome (PCOS)? Women with PCOS were less likely to report use of contraception and more likely to report a miscarriage, whilst number of children was similar between groups. The oral contraceptive pill is used in the management of PCOS, but the patterns of contraception use in women with PCOS is not known. In women with PCOS who undergo assisted reproduction, the risk of pregnancy loss appears higher, yet pregnancy loss and family size among community-based women with PCOS is not known. This is a cross-sectional analysis of a longitudinal cohort study. Mailed survey data were collected at five time points (years 1996, 2000, 2003, 2006 and 2009). Data from respondents to Survey 4 (2006), aged 28-33 (n = 9145, 62% of the original cohort aged 18-23 years) were analysed. This study was conducted in a general community setting. Data from participants who responded to the questions on PCOS, contraception and pregnancy outcome were analysed. The main outcome measures were self-reported PCOS, body mass index (BMI), contraception use, pregnancy loss and number of children. In women aged 28-33 years, women with PCOS were less likely to be using contraception (61 versus 79%, P < 0.001) and more likely to be trying to conceive (56 versus 45%, P < 0.001), compared with women not reporting PCOS. A greater proportion of women with PCOS reported pregnancy loss (20 versus 15%, P = 0.003). PCOS was not independently associated with pregnancy loss; however, BMI was independently associated with pregnancy loss in the overweight and obese groups (OR 1.2, 95% CI 1.04-1.4, P = 0.02 and OR 1.4, 95% CI 1.1-1.6, P = 0.001, respectively). Fertility treatment use was also independently associated with pregnancy loss (adjusted OR 3.2, 95% CI 2.4-4.2, P < 0.001). There was no significant difference in number of children between women with and without PCOS. PCOS, contraception use and pregnancy outcome data were self-reported. Attrition occurred, but is reasonable compared with similar longitudinal cohort studies. This community-based cohort aged 28-33 years provides insights into the contraceptive use, pregnancy loss and family size of a large cohort of unselected women. Women reporting PCOS had lower rates of contraception use and were more likely to be currently trying to conceive, suggesting that they may be aware of potential fertility challenges, yet in those not planning to conceive, contraceptive use was low and further education may be required. Despite prior reports of higher rates of pregnancy loss in PCOS, usually from infertility services, in this community-based population, PCOS was not independently associated with pregnancy loss, yet independent risk factors for pregnancy loss included higher BMI, were higher in PCOS. The number of children per woman was similar in the both groups, albeit with more infertility treatment in PCOS. This may reassure women with PCOS that with access to fertility treatment, family sizes appear similar to women not reporting PCOS.

Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder and the most prevalent gynecological condition among women of reproductive age. Current treatment options primarily focus on managing symptoms and fail to fully prevent long-term complications. Astaxanthin (ASX), a red carotenoid pigment, is known for its potent antioxidant, anti-inflammatory, anti-proliferative, and anti-apoptotic properties. This review aims to evaluate the efficacy of astaxanthin supplementation in PCOS management. Our team conducted a comprehensive search of relevant databases up to May 2024, including human clinical trials and animal studies investigating astaxanthin’s effects on PCOS. Of the 45 articles retrieved, 8 met the inclusion criteria (4 animal studies and 4 clinical trials). The majority of the studies demonstrated that astaxanthin has a beneficial impact on ovarian histo morphology and follicular development, with notable reductions in oxidative stress and inflammation among patients with PCOS. Although astaxanthin showed improvement in dyslipidemia, it had no significant effect on weight loss. It is suggested that astaxanthin’s therapeutic potential in PCOS is primarily due to its antioxidant and anti-inflammatory properties rather than its effects on weight. Thus, astaxanthin may be considered a promising therapeutic agent for alleviating PCOS complications; however, further research is warranted due to the limited availability of high-quality clinical trials.

Rosiglitazone treatment alleviates inflammation and improves liver function in overweight women with polycystic ovary syndrome: a randomized placebo-controlled study

Polycystic ovarian syndrome (PCOS) is a complex reproductive endocrinopathy affecting 4-20% of females of reproductive age. PCOS and its consequent complications such as infertility, diabetes mellitus and cardiovascular disease significantly impact clinical management. Complementary and alternative medicine (CAM), including homeopathy, is gaining recognition in PCOS management. There remains a paucity of formal protocols for managing PCOS within homeopathy and other CAM systems. This study aimed to explore and document existing therapeutic practices in the management of PCOS from diagnosis to treatment used by practitioners within various disciplines of CAM: viz., homeopathy, ayurveda, unani tibb, traditional Chinese medicine (TCM) and naturopathy, in the context of their unique philosophical background. In this explorative, descriptive study, data were collected from CAM practitioners in eThekwini Municipality, KwaZulu Natal, South Africa, using semi-structured interviews and analysed using Tesch's and Creswell's methods for qualitative analysis. Four themes emerged from the data, namely: CAM philosophical perspectives on PCOS, contributing factors, diagnosis of PCOS, and management of PCOS. Five sub-themes emerged: clinical diagnosis of PCOS, CAM-specific characterisation of PCOS, CAM-specific treatment of PCOS, adjunctive therapies, and lifestyle interventions. Homeopathic management comprised several prescribing methods, the most common ones being miasmatic/constitutional, keynote and clinical, alongside adjunctive therapies and lifestyle interventions. Other CAM modalities adopted similar holistic approaches. This paper offers a comprehensive exploration of the perceptions, clinical investigations and management practices in PCOS by homeopaths and four other CAM modalities - ayurveda, unani tibb, TCM and naturopathy - as documented in the study. Homeopaths and other CAM practitioners employed CAM-specific therapies, along with adjunctive therapies and lifestyle interventions, adopting holistic approaches. Enhancing the quality of life through emotional counselling, stress reduction and lifestyle improvements emerged as shared objectives across modalities. Our findings underscore the need to further explore inter-disciplinary collaboration in PCOS management among registered CAM practitioners, with the potential to expand the scope of comprehensive care for PCOS patients.