Therapeutic efficacy in polycystic ovary syndrome: A comprehensive review comparing pharmaceutical and phytotherapeutic interventions from RCT evidence

Abstract

Background: Five to ten percent of women of reproductive age suffer from polycystic ovarian syndrome (PCOS), which necessitates a variety of treatment modalities that address its intricate hormonal, metabolic, and reproductive symptoms. Objective: This thorough analysis uses data from randomised controlled trials to compare pharmacological and phototherapeutic approaches for the treatment of PCOS. Methods: Systematic analysis of RCTs examining herbal treatments (traditional Chinese medicine, Ayurvedic preparations, botanical supplements) and synthetic drugs (metformin, combined oral contraceptives, clomiphene citrate combinations) for the treatment of PCOS. Results: Drug treatments showed strong effectiveness. Ferriman-Gallwey scores and menstrual regularity were considerably enhanced by combined oral contraceptives (EE+DRSP, EE+CA). Metformin continuously improved cardiovascular indicators, lipid profiles, insulin resistance, and glucose tolerance. While combined treatments boosted ovulation in resistant situations, better clomiphene regimens raised pregnancy rates. Ayurvedic Satapushpa Churnam significantly decreased ovarian volume (p<0.001), cinnamon enhanced menstrual cyclicity (p=0.0085), and traditional Chinese medicine decreased the incidence of Type 2 diabetes (HR: 0.31, p=0.0014). Garlic, lavender, and quercetin were among the other herbal therapies that showed benefits in metabolic parameters, inflammation, and hormonal balance. Conclusions: In the management of PCOS, pharmacological and phytotherapeutic approaches offer complementing therapeutic potential. Herbal medicines offer special mechanisms and long-term protective effects, whereas synthetic pharmaceuticals have proven efficacy for symptom control and metabolic advantages. Because PCOS is varied, customised, multimodal approaches are supported. To improve inclusion into evidence-based PCOS procedures and bolster the evidence for herbal therapy, larger, more thorough RCTs are required.

Keywords: Polycystic ovary syndrome, Combined Oral Contraceptives, Phytotherapy, Randomized Controlled Trials, Metabolic Syndrome, Insulin Resistance.