Comparative advantage and efficacy of natural products for polycystic ovary syndrome

BACKGROUND: Natural products including Korean Medicine, Traditional Chinese Medicine and Campo medicine have been suggested to be suitable for polycystic ovary syndrome (PCOS), which is known to be a multifactorial disease, since current treatment for PCOS focuses on the amelioration of symptoms with adverse effects. AIM OF THE STUDY: In this review, the ethnopharmacology and mechanisms of natural remedies including herbs, herbal formulation and acupunctures are introduced, providing a comprehensive insight for its advantage on PCOS. MATERIALS AND METHODS: We conducted a comprehensive literature search using PubMed, MEDLINE, and Google Scholar databases. Search terms included combinations of "polycystic ovary syndrome," "PCOS," "natural product," "herbal medicine," "phytotherapy," "acupuncture," and "alternative and complementary medicine". RESULTS: A total of 2,514 articles were identified. After removing duplicates, we screened titles and abstracts for relevance. Studies were included if they involved: (1) preclinical in vivo or in vitro experiments using natural products in PCOS models; (2) randomized controlled trials (RCTs) or meta-analyses involving herbal, acupuncture, or combined treatments for PCOS; or (3) mechanistic evaluations. A total of 69 studies were selected for full-text analysis. Articles were excluded if they were non-original (e.g., reviews, commentaries), unrelated to PCOS, or did not include natural treatment modalities. CONCLUSION: The current status of the potential target pathway of natural products was assigned to three categories: research on the improvement of ovary and uterus quality, fertility and the weight loss for PCOS. However, there is no continuous study from basic research including in vitro and in vivo, and clinical trials. Large scale and more in-depth research are needed to verify their potential benefits for treating PCOS as a new drug.