This is an early access version
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Department of Physiology, Faculty of Medical Sciences, University of Kragujevac , Kragujevac , Serbia
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Department of Physiology, Faculty of Medical Sciences, University of Kragujevac , Kragujevac , Serbia
Department of Human Pathology, 1st Moscow State Medical University, University IM Sechenov , Moscow , Russia
Center of Excellence for Redox Balance Research in Cardiovascular and Metabolic Disorders , Kragujevac , Serbia
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Faculty of Medicine, University of Montenegro , Podgorica , Montenegro
Department for Gynecology and Obstetrics, Clinical Center of Montenegro , Podgorica , Montenegro
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Department for Gynecology and Obstetrics, Clinical Center of Montenegro , Podgorica , Montenegro
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Montefarm, Apotekarske ustanove Crne Gore , Podgorica , Montenegro
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Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac , Kragujevac , Serbia
University Clinical Center Kragujevac , Kragujevac , Serbia
Department of Physiology, Faculty of Medical Sciences, University of Kragujevac , Kragujevac , Serbia
University Clinical Center Kragujevac , Kragujevac , Serbia
Polycystic ovary syndrome (PCOS) is a complex endocrine disorder that affects the reproductive, metabolic, and psychological health of women of reproductive age. Conventional therapies for PCOS primarily focus on symptom management; however, their associated side effects have led many women to explore complementary approaches. This review aimed to evaluate the clinical efficacy and safety of herbal medicines in the management of PCOS based on data from clinical trials and preclinical models. An extensive literature search was conducted using PubMed, ScienceDirect, Scopus, and the Cochrane Library, covering studies published between 1995 and 2025. Inclusion criteria encompassed clinical trials and randomized controlled trials investigating herbal interventions for PCOS, as well as relevant in vivo and in vitro preclinical studies. The main outcomes analyzed were hormonal regulation, insulin sensitivity, ovarian function, and anti-inflammatory effects. Numerous herbs demonstrated therapeutic potential in PCOS management, including Nigella sativa L. (Ranunculaceae), Vitex agnus-castus L. (Lamiaceae), Trigonella foenum-graecum L. (Fabaceae), and Cinnamomum verum J.Presl (Lauraceae). These herbs exhibited diverse mechanisms of action, including modulation of insulin signaling pathways, reduction of oxidative stress, hormonal regulation, and anti-androgenic effects. Clinical studies reported improvements in menstrual regularity, insulin resistance, and hirsutism, with generally favorable safety profiles. Herbal medicine appears to be a promising adjunctive or alternative strategy for the management of PCOS. However, while existing evidence supports its efficacy, variability in study designs, dosage regimens, and outcome measures limits definitive conclusions. Future standardized, high-quality clinical trials are needed to confirm these therapeutic benefits and safety profiles.
Data curation, G.Ž. and J.J.J.; Formal Analysis, G.Ž. and J.J.J.; Investigation, G.Ž., A.Ć., R.Č.Ć., N.J. and J.J.J.; Methodology, G.Ž.; Writing – original draft, G.Ž.; Supervision, V.J., S.R. and J.J.J.; Visualization, V.J., S.R., A.Ć., R.Č.Ć., N.J. and J.J.J.; Writing – review & editing, V.J., S.R., A.Ć., R.Č.Ć., N.J. and J.J.J.; Conceptualization, J.J.J. All authors have read and agreed to the published version of the manuscript.
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