Table 6.
Clinical studies in human trials verify the efficacy of natural products in the treatment of PCOS.
| Classification | Compound/Extract | Source | Experimental Model | Dose; Duration | Efficacy | Mechanism | Reference |
|---|---|---|---|---|---|---|---|
| Isoflavone | Puerarin | Pueraria lobate (Wild) Ohwi | 51 patients with PCOS, aged 18-39 | 150 mg/day; 3 months | Reduction of PCOS risk | ↑SHBG, SOD ↓TC, |
[73] |
| Terpene | Thymoquinone | Nigella sativa | 207 overweight and obese PCOS patients, aged 18-35 | 500 mg; 6 months. | Reduction of PCOS risk | ↑SOD; ↓Body weight, MDA |
[74] |
| Plant | Agnugol, Castleberry dry extract |
Vitex agnus-castus | 120 women with PCOS and oligomenorrhea, married, not pregnant, aged 20-45 | 3.2–4.8 mg/day; 3 months |
Reduction of PCOS risk | ↓menstrual cycle interval | [75] |
| Plant | Canola oil | Brassica napus L. | 72 patients with PCOS aged 18–45 years | 25 g; 10 weeks |
Reduce fatty liver grade. | ↓TG, TC/HDL, LDL/HDL, TG/HDL | [76] |
| Plant | Chamomile | Anthemis L. | 80 women of childbearing age with PCOS. | 370 mg; 3 months |
Decrease in testosterone level | ↓Testosterone | [77] |
| Plant | Cinnamon | Cinnamomum verum J. Presl | 66 women were diagnosed with PCOS | 1, 1.5 g/day; 12 weeks |
Reduce fasting insulin and insulin resistance | ↓HOMA-IR, LDL, HDL | [78] |
| Plant | Common flax | Linum usitatissimum L. | 48 women aged 18–44 years old with PCOS | 30 g/day; 12 weeks |
Increase of menstrual regularity, QUICKI. Decrease of fasting blood glucose, and body weight. |
↑QUICKI, HDL, adiponectin ↓TG, IL-6, TNF-α, insulin, HOMA-IR, hs-CRP, leptin |
[79] |
| Plant | Common flax | Linum usitatissimum L. | 60 women aged 18–40 years old with PCOS | 1000 mg; 12 weeks |
Decrease of Insulin level | ↓Insulin, serum triglycerides, VLDL-cholesterol, hs-CRP | [80] |
| Plant | Common sage | Salvia officinalis L. | 60 patients diagnosed with PCOS | 330 mg/day; 8 weeks | Inhibition of insulin resistance in patients with PCOS | ↑QUICKIE; ↓Body Mass Index, Insulin levels (P < 0.001), and HOMA-IR |
[81] |
| Plant | Fennel | Foeniculum vulgare Mill | 61 women with oligomenorrhea complaints and with PCOS, aged 18-35 | 5 g/day; 6 months | Reduction of oligomenorrhea and PCOS risk | ↓The mean pain severity | [82] |
| Plant | Lilac chaste tree | Vitex agnus-castus L. | A 21-year-old female with a history of PCOS | 400 mg; 10 months |
Increase of estrogen and progesterone activity. | ↓Endometrial hyperplasia | [83] |
| Plant | Marjoram | Origanum majorana | 25 patients diagnosed with PCOS, aged 16-35 | 1.3–1.5 g; 1 month. | Reduction of PCOS risk | ↓DHEA-S | [84] |
| Plant | Olive oil | Canarium L. | 72 patients with PCOS aged 18–45 years | 25 g; 10 weeks |
Reduce fatty liver grade. | ↓HOMA-IR | [76] |
| Plant | Sickle fruit fenugreek (Furocyst) | Trigonella foenum-graecum L. | 50 premenopausal women (18–45 years, BMI<42) with PCOS | 500 mg; 3 months |
Reduced ovary volume and cyst size. Return of regular menstrual cycle. |
↑ LH, FSH | [85] |
| Plant | Walnut | Juglans regia | 60 women with PCOS | 150 gm/day; 90 days | Reduction of PCOS risk | ↓TC, LDL, TG | [86] |
| Decoction | Cinnamon, Cultivated licorice, Common St. Johnswort, Chinese peony |
Cinnamomum verum J. Presl, Glycyrrhiza glabra L. Hypericum perforatum L. Paeonia lactiflora Pall. |
122 women aged 18–44 years with PCOS with a confirmed medical diagnosis | 3 months | Inhibition of oligomenorrhea, amenorrhoea. Improved insulin and luteinizing hormone, blood pressure, quality of life, depression, anxiety and stress, and pregnancy rates. |
↓fasting insulin | [71] |
| Decoction | Cinnamon, Spearmint, Ginger, Sweet orange | Cinnamomum aromaticum Nees, Mentha spicata L., Zingiber officinale Roscoe, Citrus × sinensis (L.) Osbeck | 60 women with PCOS aged 18–35 years old with primary and secondary infertility | 700 mg; 3 months |
Increase in rate of pregnancy, antioxidant, and anti-inflammatory properties | ↑CAT, GPx, SOD ↓Insulin, MDA, FBS |
[72] |
| Decoction | Celery, Anise burnet saxifrage |
Apium graveolens L. Pimpinella anisum L. |
72 women aged between 18 and 40 years from PCOS with a chief complaint of oligomenorrhea | 4.5 g; 15 days. |
Increase of menstrual cycle's regularity. Improvement of oligomenorrhea |
↓BMI, Testosterone | [87] |
| Decoction | Dihuang, Huanglian, Baishao, Huangqin, Ejiao, Fuling |
Radix Rehmanniae, Rhizoma Coptidis, Radix Paeoniae Alba, Radix Scutellariae Baicalensis, Colla Corii Asini, Poria |
95 women aged 18–33 years old with PCOS | 4 capsules; 6 months |
Decrease in BMI, WHR, and blood glucose levels. Improvement of insulin resistance. |
↑HDL-C, IS ↓TG, LDL-C, insulin, HOMA-IR |
[88] |
| Decoction | Femitex-SP4 | Saraca indica L., Vitex agnus castus L., Embelica officinalis L., Symplocos racemosa Roxb. | 150 patients, aged 18-44 | 500 mg; 1 year | Reduction of PCOS risk | ↓Testosterone | [89] |
| Decoction | Individualized Chinese herbal formula (Bai Shao, Chai Hu, Chen Pi, Chuan Xiong, Dang Gui Wei, Gan Cao, Gou Qi Zi, Gui Zhi, Hong Hua, Tao Ren, Tu Si Zi, Xiang Fu, Yi Mu Cao, Zhi Ke) | Paeonia japonica, Bupleurum falcatum L., Citri unshius Pericarpium, Cnidium officinale Makino, Angelicae sinensis Radix, Glycyrrhiza uralensis Fisch, Lycium chinense Mill., Cinnamomum cassia Presl, Carthamus tinctorius L., Prunus persica (L.) Batsch, Cuscuta japonica Choisy, Cyperus rotundus L., Leonurus sibiricus L., Citrus aurantium L. | 40 women presented with oligomenorrhea or amenorrhoea with a diagnosis of PCOS, aged 18–44 | 16 g/day; 6 months | Reduction of PCOS risk | ↓waist-to-hip ratio | [90] |
| Decoction | Lilac chaste tree, Sweet fennel, Queen Anne's lace |
Vitex agnus-castus L. Foeniculum vulgare Mill. Daucus carota L. |
150 women aged between 18 and 43 years | 500 mg; 3 months |
Induction of menstrual. Increase of menstrual bleeding. |
↑Menstrual cyclicity | [91] |
| Decoction | Persian herbal remedy | Foeniculum vulgare, Urtica dioica, Daucus carota, Trifolium pratense, Curcuman longa | 80 overweight women with PCOS | 5 g/day; 12 weeks | Reduction of PCOS risk | ↓TC, LDL-C, TG, AST, ALT, HDL-C, | [92] |
| Decoction | Shouwu Jiangqi Decoction | Fallopia multiflora, Radix puerariae, Batryticated silkworm, Astragalus propinquus Schischkin, Dioscorea oppositifolia L., Euonymus alatus, Cyperus rotundus L., Cuscutae semen. | 81 participants diagnosed with PCOS, aged 18-35 | 3 months | The expectation of efficacy of SWJQD on the treatment of PCOS with kidney deficiency, phlegm, and blood stasis | ↑Insulin sensitivity | [93] |
| Decoction | Yijin-tang |
Pinellia ternata Breitenbach, Citrus unshiu Markovich, Poria cocos Wolf, Glycyrrhiza uralensis Fisch, Zingiber officinale Roscoe |
15 PCOS women with oligomenorrhea | 6 g; 12 weeks |
Decrease in the menstrual cycle and follicle number. Improvement of oligomenorrhea. |
↓Number of ovarian follicles | [94] |
SHBG, sex hormone binding globulin; SOD, superoxide dismutase; TC, total cholesterol; TG, triglycerides; HDL, high-density lipoprotein; LDL, low-density lipoprotein; HOMA-IR, homeostatic model assessment of insulin resistance; QUICKI, quantitative insulin-sensitivity check index; IL-6, interleukin 6; TNF-α, tumor necrosis factor-α; hs-CRP, high-sensitivity C-reactive protein; VLDL-cholesterol, very-low-density lipoprotein-cholesterol; DHEA-S, dehydroepiandrosterone sulfate; CAT, catalase; GPx, glutathione peroxidase; MDA, malondialdehyde; FBS, Fast blood sugar; HDL-C, low-density lipoprotein cholesterol; LDL-C, low-density lipoprotein-cholesterol; AST, aspartate aminotransferase; ALT, alanine aminotransferase; ISI, insulin-sensitive index; ↑, up-regulation; ↓, down-regulation.