Pomegranate juice supplementation has been found to effectively decrease testosterone levels in overweight and obese women diagnosed with polycystic ovary syndrome.

2023 Phytotherapy Research The effect of concentrated pomegranate juice on biomarkers of inflammation, oxidative stress, and sex hormones in overweight and obese women with polycystic ovary syndrome: A randomized controlled trial Abedini M, Ramezani‐Jolfaie N, Ghasemi‐Tehrani H, Tarrahi MJ, Amani R

Randomised Controlled Trial PCOS Pomegranate Testosterone

In the methodology, the study employed a randomized controlled trial which involved 44 participants. The women, aged between 18 and 40 years, had all been diagnosed with polycystic ovary syndrome and had a body mass index exceeding 25 kg/m. They were randomly divided, with one group consuming 45 ml/day of concentrated pomegranate juice and the other group receiving no intervention. A variety of biomarkers for sex hormones, inflammation, and oxidative stress were measured before starting the trial and again after eight weeks.

Further discussion of the results revealed a significant decrease in testosterone levels among the overweight and obese women with polycystic ovary syndrome who took concentrated pomegranate juice over the eight week period, in contrast to those in the control group. Apart from testosterone, no significant changes were observed for luteinizing hormone, sex hormone-binding globulin levels or for markers of inflammation and oxidative stress between the two groups.

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Green tea helps alleviate symptoms in multiple benign gynecological disorders, primarily due to a compound called Epigallocatechin-3-gallate.

2023 Nutrients Green Tea and Benign Gynecologic Disorders: A New Trick for An Old Beverage? Hazimeh D, Massoud G, Parish M, Singh B, Segars J, Islam MS

Review Article Adenomyosis EGCG PCOS

The paper reviews the role of the compound Epigallocatechin-3-gallate found in green tea, and its effects on various benign gynecological conditions. The compound is noted for its antioxidant and prooxidant qualities, allowing it to interact with multiple cellular pathways that are crucial for disease pathogenesis. The studied conditions include uterine fibroids, endometriosis, dysmenorrhea, adenomyosis, menopause, and polycystic ovary syndrome. The research accounts for the specific mechanisms through which the compound might affect each condition, such as anti-fibrotic, anti-angiogenic, and pro-apoptotic mechanisms.

The results suggest that green tea consumption can lead to improved symptom management in these disorders. It was found to lessen the intensity of symptoms associated with uterine fibroids and endometriosis, by invoking anti-fibrotic, anti-angiogenic, and pro-apoptotic mechanisms. It also helped manage pain linked with dysmenorrhea and adenomyosis through reducing uterine contractility and widely felt pain. Additionally, it showed efficacy in weight and osteoporosis control during menopause, and showed potential benefits in managing polycystic ovary syndrome. However, claims regarding its influence on fertility were deemed controversial.

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The compounds apocarotenoids and carotenoids found in saffron extract could potentially interact with multiple targets, helping to manage the symptoms of polycystic ovary syndrome.

2023 Medicine Network pharmacology-based strategic prediction and target identification of apocarotenoids and carotenoids from standardized Kashmir saffron (Crocus sativus L.) extract against polycystic ovary syndrome Tiwari A, Modi SJ, Girme A, Hingorani L

Network Pharmacology PCOS Saffron

The study utilized a network pharmacology-based approach to identify the possible therapeutic pathways for apocarotenoids and carotenoids in Crocus sativus on polycystic ovary syndrome. The Ultra-High-Performance Liquid Chromatography with Photodiode Array detector (UHPLC-PDA) standardized stigma-based Crocus sativus extract (CSE) was analyzed for these phytochemicals.

Information about polycystic ovary syndrome related genes was collected from a knowledge database and networks were established between these targets and Crocus sativus extract phytochemicals to understand its mechanism of action.

Through network analysis and screening conditions, the study found four significant targets, including serine/threonine kinase 1, signal transducer and activator of transcription, and two types of mitogen-activated protein kinases. Gene ontology and Kyoto Encyclopaedia of genes and genomes analysis showed that MAP kinase and serine-threonine pathways were crucial targets in polycystic ovary syndrome.

Further molecular docking studies were conducted, and carotenoids apocarotenoids were assessed for absorption, distribution, metabolism, excretion, and toxicity predictions. Elements like crocetin, picrocrocin, and safranal showed strong binding affinity for the identified targets. This analysis also revealed that these compounds had excellent bioavailability and could cross the blood-brain barrier without demonstrating toxicity.

In summary, the study demonstrated that these phytochemicals could act on the identified targets, thus pointing towards the potentiality of Crocus sativus extract in managing polycystic ovary syndrome.

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Acupuncture, when used in conjunction with medicine or alone, appears to improve certain PCOS outcomes such as ovulation rate and recovery of menstrual cycle.

2022 Journal of Integrative Medicine Efficacy and safety of acupuncture for polycystic ovary syndrome: An overview of systematic reviews Yang H, Xiao Z, Yin Z, Yu Z, Liu J, Xiao Y, et al.

Systematic Review PCOS

This overview consolidates existing systematic reviews (SRs) on the efficacy and safety of acupuncture for treating Polycystic Ovary Syndrome (PCOS). Methodological quality, risk of bias, and confidence in evidence were assessed from these SRs to guide clinical practice and future research directions. However, due to the inconsistency and low quality of evidence, a definitive conclusion regarding the benefits of acupuncture for PCOS remains elusive. Notably, though all included SRs suggest potential benefits, their conclusions are undermined by defects in individual SRs and the limited reliability of evidence. Acupuncture, when used in conjunction with medicine or alone, appears to improve certain PCOS outcomes such as ovulation rate and recovery of menstrual cycle. Adverse events are mild, and while some evidence points to favorable effects on various outcomes, confidence remains too low to draw firm conclusions. The review highlights methodological shortcomings in SRs' assessments and calls for robust future studies. These studies should feature pre-registered protocols, comprehensive literature retrieval, detailed statistical methods, thorough reporting of trial characteristics and funding sources, and strategies to address bias and heterogeneity. In spite of potential benefits, the current evidence's poor quality and inconsistencies necessitate further high-quality research to establish acupuncture's effectiveness and safety for PCOS definitively.

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PCOS patients suggests that combining acupuncture with metformin might enhance pregnancy and ovulation rates, as well as improve insulin resistance.

2022 Frontiers in Endocrinology Acupuncture combined with metformin versus metformin alone to improve pregnancy rate in polycystic ovary syndrome: A systematic review and meta-analysis Chen X, Lan Y, Yang L, Liu Y, Li H, Zhu X, et al.

Systematic Review PCOS Pregnancy

The study initially screened 330 relevant articles, eventually including nine randomized controlled trials (RCTs) that met the inclusion criteria. These trials encompassed 1,159 patients with PCOS who underwent acupuncture or acupuncture combined with metformin treatment. Using the GRADE method, a "Summary of Findings" table was employed to evaluate the quality of evidence for various outcome measures. The main results indicated that acupuncture combined with metformin exhibited superiority over metformin alone in terms of pregnancy rate, ovulation rate, and HOMA-IR (insulin resistance). Subgroup analysis highlighted that diagnostic criteria and random methods contributed to heterogeneity in results.

However, the evidence's quality was predominantly low or very low due to study limitations, inconsistencies, and imprecisions. The intervention measures, such as acupuncture methods and treatment parameters, varied substantially among studies. Challenges in contacting original authors and incomplete information posed further limitations. The study suggested potential improvements in pregnancy rate, ovulation rate, and HOMA-IR with acupuncture combined with metformin, but these findings were subject to uncertainties related to diagnostic criteria and overall evidence quality. Consequently, the conclusive efficacy of acupuncture combined with metformin for treating PCOS remains uncertain due to the dearth of high-quality research. The study called for well-designed and well-executed RCTs to address this question under standardized diagnostic criteria and treatment protocols for acupuncture and metformin.

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