Written by Chrystal Moulton. Exploration of the causes and treatment of PCOS.

Polycystic ovarian syndrome is a common endocrine disorder affecting 5% – 20% of women of reproductive age worldwide.^1,2 It is a multifaceted disease requiring a strategic approach to diagnosis and treatment. In this paper, we will explore diagnosis, treatment, and alternative approaches to managing PCOS.

What is PCOS?

As the name suggests, polycystic ovarian syndrome means “many cysts on the ovaries”. In normal functioning ovaries, the cycle of luteinizing hormone (LH), follicle stimulating hormone (FSH), progesterone, estrogen, and anti-mullerian hormone (AMH) produces the natural cycle of ovulation and menses.^3-5 As a recap, day 1 of the menstrual cycle is the beginning of menstruation. The creation of a mature egg resulting from the normal hormone cycle takes months to develop. Once the egg is mature, ovulation occurs on day 14, as part of the menstrual cycle. The mature egg or ovum travels through the fallopian tube into the uterus where it attaches to the uterine wall. The uterine wall thickens and the body is prepared for fertilization of the ovum. If fertilization of the egg doesn’t occur between day 14-28, the uterine wall is shed and the process begins again.^3,5 However, in women diagnosed with PCOS, LH is overproduced and stimulates thecal cells [endocrine cells located in the ovaries] to create androstenedione and testosterone.⁴ This change in hormone produces the hyperandrogenic features commonly associated with PCOS, including unwanted hair on the chin and/or chest, alopecia, acne, and weight gain usually around the midsection.^3-5 Furthermore, the increase in testosterone due to overproduction of LH delays the development of mature eggs, creating multiple follicles within the ovaries that do not develop into mature eggs (or ovum) and thus, ovulation does not take place according to the normal menstrual cycle. The multiple follicles visible in the ovaries are characteristic of PCOS and also where the name for this disorder is derived.⁵ The lack of or delay in ovulation causes menstrual irregularities such as no periods or periods lasting longer than usual (more than 30 days). The menstrual irregularities common to PCOS causes infertility in roughly 40% of women.³

However, PCOS does not present the same in all women who are diagnosed. Per established Rotterdam Consensus, if a patient presents with 2 out of 3 identifiable features of PCOS then they are diagnosed with PCOS. The 3 criteria currently used as a basis for diagnosis are^3-6:

• Anovulation (delayed ovulation)
• Hyperandrogenism (increased testosterone, DHEA, and other androgenic features)
• Polycystic ovaries (identified through ultrasound)

Given the complex nature of this syndrome, researchers in this field acknowledge that as more is learned about the physiological mechanisms related to PCOS, the criteria for diagnosis will evolve. Nonetheless, the criterion for diagnosis establishes 4 phenotypical presentations of PCOS ⁵:

• Phenotype A: patients presenting all 3 criteria for diagnosis
• Phenotype B: patients presenting hyperandrogenism and anovulation
• Phenotype C: patients presenting hyperandrogenism and polycystic ovaries
• Phenotype D: patients presenting anovulation and polycystic ovaries

Phenotype D could be caused by other disorders such as hypothyroidism, hypothalamic amenorrhea, congenital adrenal hyperplasia, and high prolactin levels. Diagnosis of PCOS patients presenting with phenotype D must rule out other causes before confirming PCOS diagnosis.⁵ Other factors that could influence symptom severity in PCOS include age, genetics, environment, weight, and stress. Any approach to treatment must consider these factors as well.^{1,3 5}

Comorbidities & Conventional Approaches

PCOS is characterized by low-grade inflammation.⁵ Chronic low grade inflammation is linked to insulin resistance which leads to type II diabetes. Furthermore, continued low grade inflammation acts on the ovaries by promoting the creation of androgens, creating a vicious cycle.^4,5,7 PCOS is also linked to dyslipidemia, cardiovascular disease, obesity, endometrial cancer, hyperinsulinemia, infertility, and adverse outcomes related to pregnancy.^5,7 Women with PCOS also experience a low quality of life due to the syndrome and are prone to depression and anxiety.^1,3-5

Conventional treatment is focused on symptom management, along with lifestyle and dietary modifications.^1-8 PCOS patients with insulin resistance could be prescribed metformin, spironolactone for hair loss, along with oral contraceptive medicines.^5,8,9 They may also be prescribed medicine to manage dyslipidemia, cardiovascular disease, depression, and anxiety. Longterm use of conventional drugs are linked to other unfavorable side effects. Thus, conventional medicine and lifestyle/diet modifications alone may not be as efficacious in managing PCOS symptoms.^1-7

Alternative Approach to Treatment of PCOS

As stated previously, PCOS presentation is unique for each individual and can transform overtime. Therefore, treatment approaches must identify immediate issues faced by the patient in order to develop a comprehensive plan and goal. That being said, chronic low-grade inflammation, reduced insulin sensitivity, and suboptimal levels of reproductive hormones (i.e. FSH, LH, AMH, progesterone, and estradiol) are consistent in all phenotypes of PCOS. Let’s take a look at various natural products that can help improve the underlying issues specific to PCOS.

Vitamin D

Vitamin D deficiency is common among women diagnosed with PCOS. Depending on region and population, rates of vitamin D deficiency in women with PCOS range from 30-80%.²  In fact, vitamin D deficiency is correlated with PCOS diagnosis.^2-5 However, supplementing with vitamin D is linked to significant health benefits in PCOS. ^2,3,5,10 A meta-analysis of studies focused on inflammatory and metabolic changes following vitamin D supplementation in women with PCOS revealed that vitamin D supplementation⁶:

1. Significantly lowered HOMA-IR index (P=0.00001), fasting serum insulin (P=0.04), and hs-CRP levels (P=0.01)
2. Significantly reduced total testosterone levels (P=0.009)
3. Significantly improved serum 25(OH)-D levels (P≤0.05)

Dosing ranged from 4000 IU – 12000 IU daily and 3200 IU – 50000 IU weekly in the study.⁶  No statistically significant effect was observed in lipids or androgenic hormones within the study. Nonetheless, other studies have demonstrated vitamin D supplementation significantly reduces LDL-C, triglycerides, and total cholesterol in women with PCOS.^10,11 Furthermore, vitamin D supplementation as low as 4000 IU daily for 3 months is associated with improvement in sex-hormone binding globulin, free testosterone, and free androgen index.¹² Also, vitamin D receptors are present on the ovaries and directly plays a role in follicular development and steroidogenesis.² Vitamin D supplementation is significantly correlated with menstrual regularity in PCOS women.^10,13

Current guidelines recommend daily intake between 1000 – 3200 IU daily, with target serum vitamin D between 30-50 ng/mL. However, the optimal therapeutic dose for PCOS is not established and some experts suggest a higher target for individuals with PCOS diagnosis.¹⁴ Monitoring vitamin D levels is strongly recommended per Endocrine Society guidelines every 6 to 12 months. Monitoring is especially key to preventing toxicity and hypercalcemia. The use of assessments and individualized plans are also recommended when using vitamin D as an adjunctive therapy in treatment.²

Inositol

Inositol is crucial to insulin production and ovarian function. Myo-inositol and D-chiro inositol are biological isomers required for human health. Women with PCOS excrete excessive amounts of D-chiro inositol compared to women without PCOS.⁵ This significant decrease in D-chiro inositol is linked to reduced insulin sensitivity in PCOS patients. Biologically, D-chiro inositol is not found in food and serves as a regulator of inositiol-3-kinase which affects insulin sensitivity and ovarian function.^2,5 Therefore, supplementation with D-chiro inositol is required to improve overall health related to PCOS.

Several studies have demonstrated the effectiveness of D-chiro inositol supplementation on improving BMI, insulin sensitivity, as well as endocrine parameters such as LH/FSH ratio, androstenedione, and LH levels.¹⁵ Another study reported improvement in PCOS women attaining regular menstrual cycles after 6 months (24%) and 15 months (51%) of treatment with D-chiro inositol. These women also saw a significant decrease in anti-mullerian hormone (a major contributor to androgenic features of PCOS) and insulin resistance.¹⁶

Myo-inositol can be found in food and acts as a second messenger for insulin signal transduction.^2,5 Like D-chiro inositol, myo-inositol is essential to improving insulin sensitivity and ovarian function.^2,4,5 Studies focused on the effects of myo-inositol have demonstrated significant improvement in insulin resistance, along with a significant decrease in BMI, fasting insulin levels, glucose levels, free testosterone, total testosterone, and androstenedione levels.^4,17,18 In a meta-analysis, researchers also noted that the effect of inositol supplementation on total testosterone levels could be linked to BMI. They noted within a sub-analysis that women with normal BMI (<25 kg/m2) saw a significant reduction in total testosterone even if they had low insulin sensitivity.⁴

Optimal dosing for both myo-inositol and D-chiro inositol has not been established. Some research suggests a 40:1 ratio of myo-inositol to D-chiro inositol, while others suggest a 2:1 ratio.² Typical dosing for D-chiro inositol ranges from 100 – 600 mg daily. Myo-inositol dosing ranges from 2,000 – 4000 mg daily.⁵ Mild side effects such as bloating, diarrhea, and nausea have been associated with inositol intake. Otherwise, both inositols are well-tolerated.²

Omega-3 fatty acids

EPA and DHA are very potent anti-inflammatory compounds that inhibit production of IL-6 and TNF-alpha and promote the creation of anti-inflammatory molecules such as resolvins and protectins.^5,19 Given that low-grade chronic inflammation is a pervasive issue with PCOS, the anti-inflammatory effects of EPA and DHA could result in resolution of the chronic inflammatory nature of PCOS, as well as the cascade of symptoms resulting from chronic inflammation.^2,5 Clinical studies in PCOS patients have shown that supplementation with omega-3 fatty acids can²:

1. Significantly reduce hs-CRP levels
2. Improve HOMA-IR index and modulate gene expression related to insulin signaling
3. Reduce total testosterone levels
4. Increase menstrual regularity and frequency of ovulation
5. Improve symptoms of anxiety and depression⁵

No established dose is set for EPA or DHA as it relates to PCOS treatment. However, various experts recommend the EPA target dose set at 1000 mg when taking omega-3 supplements.⁵

Curcumin

Curcumin is the active compound found in turmeric which inhibits pro-inflammatory enzymes (cyclooxygenase-2 [COX-2] and 5-lipoxygenase-2 [5-LOX]) and modulates inflammatory signaling pathways.^2,20 This is particularly useful in the treatment of PCOS which is characterized by low grade chronic inflammation. Studies utilizing curcumin as the treatment in PCOS patients showed significant reduction in inflammatory markers like CRP and IL-6 compared to placebo.²¹ Researchers in several studies also observed improvements in menstrual regularity and frequency of ovulation.²² As with the aforementioned supplements, no standard therapeutic dose is established. However, typical dosing ranges from 50 – 500 mg daily. Furthermore, curcumin is not easily absorbed by the body. Pairing curcumin with piperine or consuming bioavailable versions of curcumin such as curcumin phytosomes with phosphatidylcholine or water-soluble forms of curcumin are recommended.⁵

N-Acetyl Cysteine/Glutathione

N-acetyl cysteine is a precursor to glutathione. Therefore, taking N-acetyl cysteine could upregulate production of glutathione.⁵ Both serve as an antioxidant and has been shown to reduce oxidative stress, improve insulin resistance and ovulation, while also reducing androgens in women with PCOS.^2,5 Typical dosing of N-acetyl cysteine is 600 mg three times daily. Glutathione, unlike N-acetyl cysteine, is not bioavailable, however, other forms of glutathione such as liposomal glutathione and N-acetyl glutathione have been shown to increase glutathione. Additional research is needed to establish a therapeutic dose for N-acetyl cysteine and glutathione.^2,5

Minerals (Zn, Mg, Se, Chromium)

Minerals such as zinc, magnesium, selenium, and chromium are essential to multiple physiological pathways in the body. In women with PCOS, supplementation with zinc, magnesium, selenium, and chromium is significantly shown to:

1. Reduce cholesterol and triglyceride levels (P<0.001)¹
2. Reduce HOMA-IR index, fasting blood glucose and fasting insulin levels (P<0.001)¹ and
3. Improve menstrual regularity and ovulatory function²

Zinc can also tighten cell junction and diminish symptoms of leaky gut. Typical dosing for zinc ranges from 5 – 30 mg daily. It is suggested to combine zinc supplementation with copper to prevent copper deficiency.⁵ Chromium dosing generally ranges from 200 – 400 mcg/d and 200 mcg of selenium has shown benefits to women with PCOS.⁵ Magnesium has also demonstrated improvement in mood and promotes sleep.^3,5 Typical dosing for magnesium ranges between 200 – 600 mg/day.⁵

B-vitamins (B6, B2, B12)

B-vitamins are essential to cardiovascular health, various metabolic processes, and hormone modulation.^2,5 High stress is correlated with lower levels of folate and B-12, while B6 has demonstrated benefits with PMS, hormone regulation, and improving progesterone levels.⁵ B-5 increases co-enzyme A which, if deficient, could cause adrenal insufficiency and B-vitamins, overall, can attenuate inflammatory markers and enhance insulin sensitivity.^2,5 No dose is established for B-vitamins, however, it is recommended that PCOS patients take a B-complex supplement.^3,5

Probiotics, Prebiotics, Symbiotic

Various studies have demonstrated the importance of gut health in overall health and well-being. This is especially true for women with PCOS.^5,8 One meta-analysis⁸ showed that in women with PCOS supplementation with prebiotics and symbiotics was significantly associated with:

1. Reduction in body weight, BMI, waist circumference, and weight-to-height ratio
2. Reduction in LDL-C, total cholesterol, triglycerides, and an increase in HDL-C
3. Reduction in insulin, HOMA-IR, and fasting glucose
4. Reduction in testosterone with no significant changes in DHEA and sex-hormone binding globulin

Results from the same meta-analysis did not show improvement in oxidative stress. However, researchers concluded that supplementation with pre-, pro-, and symbiotics for 8 weeks or longer was associated with significant improvement in metabolic markers.⁸ Both lactobacillus and bifidus strains have demonstrated benefits in women with PCOS.^5,8 Strains such as L. plantarum, L. rhamnosus, and B. infantis has proven anti-inflammatory benefits.⁵ Probiotics are also associated with significant improvement in symptoms of anxiety and depression.⁷

Berberine

Berberine is an active component extracted from goldenseal and barberry which has been used in Chinese medicine to treat diabetes.^2,3,5 Berberine has been shown to increase insulin sensitivity, decrease markers of inflammation, improve menstrual cycle regulation, and promote ovulation in women with PCOS.^2,5 Although the mechanism of action is unknown, some studies have demonstrated that supplementation with berberine at 500 mg three times a day outperformed metformin in improving metabolic markers of insulin resistance.²³ Berberine is well tolerated, however, drug interaction with antibiotics such as azithromycin and clarithromycin has been observed.⁵

Other Herbs and Supplements

Phytoestrogenic herbs such as black cohosh and anti-androgenic herbs such as saw palmetto are also useful in the treatment of PCOS. In fact, both black cohosh and saw palmetto have been found to inhibit 5-alpha reductase, an enzyme involved in expression of androgenic symptoms commonly associated with PCOS.⁵ Besides the aforementioned herbs and supplements, there are plenty of herbs available with anti-inflammatory, phytoestrogenic, anti-depressive, anti-diabetic, and anti-androgenic features to choose from (See Table 1). Although research is still ongoing in the field of alternative treatments for PCOS, much is already known about the benefits of effective natural remedies such as omega-3’s, vitamin D, and inositol. These benefits include improving inflammation, insulin resistance, and hormonal balance, which directly translate to the needs of PCOS patients.

Table 1. List of Herbs and Supplements Suggested for PCOS⁵
* = Adjuncts

** = Highest-confidence PCOS-specific items

Improves Androgenic symptoms (hirsutism/alopecia/ hormone imbalance)	Anti-inflammatory	Improves insulin resistance	Improves mood & anxiety	Improves Acne
*Black cohosh: 20–40 mg – 2x daily standardized extract	*Cordyceps (C. militaris): 500–1,000 mg/day extract	**Fenugreek: 500 mg – 2x daily standardized extract	*Golden Root (Rhodiola rosea): 200 mg twice daily or 400 mg/day standardized extract.	*Licorice: 250 mg/day
*Licorice: 250 mg/day	*Bioflavonoids (adjunct) -pine bark extract: 20–360 mg/day -EGCG: 300–500 mg/day -grape seed extract: 100–300 mg/day	*Cinnamon: 1.5 g/day	*St. John’s wort: 300 mg – 1-3x daily standardized extract	*Tea tree oil: 5% topical gel or dilution, applied daily
	**Resveratrol: 800–1,500 mg/day	**Alpha-Lipoic Acid: 600–1,800 mg/day	*Cordyceps (C. militaris): 500–1,500 mg/day extract
*Vitex (if high prolactin levels are suspected): 20–100 mg/day standardized extract	*Enzymes (enzyme activity dependent) -papain: 500–1,500 mg/day -serrapeptase: 20,000–120,000 SPU/day   bromelain: 200–400 mg/day	*Glucomannan: 1 g before meals, 2–3 times/day	*Holy Basil: 125 mg twice daily standardized extract	*Glycolic and alpha-hydroxy acid: 5–10% (OTC products); 20–70% (prescribed under supervision
*White peony: 500–1,500 mg/day extract	*N-acetyl glucosamine [leaky gut]: 500–1,000 mg/day	*Grape seed extract: 100–300 mg/day	*Siberian ginseng: 300–1,200 mg/day extract.	*Salicylic acid: 0.5–2% topical once daily
*Reishi mushrooms: 500–1,000 mg	*L-glutamine [leaky gut]: 5–30 g/day	**Resveratrol: 800–1,500 mg/day	**Melatonin: Melatonin: 3–10 mg/day
*Saw palmetto: 160 mg twice daily or 320 mg/day standardized extract		*Cordyceps (C. militaris): 500–1,500 mg/day extract	*Vitex: 20–100 mg/day standardized extract
			*Phosphatidylserine: 100–300 mg/day
*Kudzu root: 500–1,500 mg/day extract
*Dong quai: 500–1,500 mg/day

*Additional herbs not previously discussed. This list does not represent all herbs used to treat PCOS

The above only represents some natural treatments that can be used in treating symptoms of PCOS. Use of any of the above treatments must be done with consultation from a licensed healthcare provider. In some cases, these treatments may be used adjunctively or in place of conventional medicine. However, in either case, attention must be taken to prevent contraindication or potentiation with medicines already in use due to existing comorbidities.

Diet

Lifestyle modification is an important part of the treatment for PCOS. In particular, dietary changes are necessary to ensure long-term benefits of any treatments used. In a book entitled “The PCOS Plan” by Dr. Fung and Dr. Pateguana, they highlight several important modifications that support the treatment of PCOS. Their recommendations are as follows³:

1. Eliminate added sugars: wherever possible do not add sugar to drinks or foods and avoid artificial sweeteners. Choose unprocessed whole foods like fruits and dark chocolate. Choose low-carb wine & spirits.
2. Decrease consumption of refined carbs: consume root vegetables, legumes, unrefined whole grains like spelt and farro. Consume fiber rich foods.
3. Moderate protein intake: consume the daily recommended protein preferably from salmon, sardines, chicken thighs, egg, chia seeds, mushrooms, almonds, dark green leafy vegetables, and broccoli. These foods produce a lower insulin response when consumed. Dairy products that are full-fat are also recommended, specifically, kefir and yogurt for the same reason.
4. Consume natural fats: fat produces the least spike in insulin response. Thus, consuming full-fat products that contain fat soluble vitamins are recommended. Foods like egg and beef liver provide an almost complete spectrum of protein, fat, and vitamins. Pairing vegetables with olive oil or other healthy fats is also useful. Avoid refined fats such as margarine, seed oils, and vegetable oils as they increase inflammation.

Conclusion

PCOS is a multifaceted and complex disorder which requires an individual approach to treatment and management over time. Since the symptoms may change with age and overall health status, constant monitoring is required to achieve consistent improvement and maintenance of good quality of life. Understanding of the physiological mechanisms associated with symptoms is still underway. However, the current body of research demonstrates significant improvement in the application of natural solutions that effectively support quality of life for women afflicted with this syndrome. Future research could only provide clarity in individualized treatment application for PCOS patients.

Posted June 17, 2026.

Chrystal is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Chicago.

References:

1. Ye J, Cen S, Qi Q, et al. Effectiveness of mineral supplements (magnesium, chromium, zinc, selenium, chromium picolinate) in reducing insulin resistance in polycystic ovary syndrome: a meta-analysis of randomized controlled trials. BMC Endocr Disord. Jan 24 2026;26(1)doi:10.1186/s12902-025-02158-x
2. Iván SCH, Iván SCH. Nutritional Supplements in Polycystic Ovary Syndrome: A State-of-the-Art Review.
3. Fung NBPaJ. The PCOS Plan: Prevent and Reverse Polycystic Ovary Syndrome Through Diet and Fasting. Greystone Books Ltd; 2020.
4. Tienforti D, Puocci G, Venditti C, et al. Metabolic Phenotype Predicts Biochemical Response to Inositol Supplementation in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Clin Endocrinol (Oxf). Apr 7 2026;doi:10.1111/cen.70140
5. McCulloch F. 8 Steps to Reverse Your PCOS: A Proven Program to Reset Your Hormones, Repair Your Metabolism, and Restore Your Fertility. Greenleaf Book Group; 2016.
6. Wu B, Yao J. A meta-analysis of the effects of vitamin D supplementation on endocrine metabolic and inflammatory markers in patients with polycystic ovarian syndrome. Medicine (Baltimore). Jan 2 2026;105(1):e46892. doi:10.1097/md.0000000000046892
7. Łagowska K, Ptaszyńska D. Effects of Probiotic Supplementation on Mental Health and the Risk of Depression in Women with Polycystic Ovary Syndrome: A Systematic Review of Randomized Controlled Trials. Nutrients. Jan 19 2026;18(2)doi:10.3390/nu18020307
8. Yin T, Lai L, Lin X, et al. Gut microbiota, a new approach to management of polycystic ovary syndrome: a systematic review, meta-analysis and meta-evidence of 26 randomized controlled trials. J Ovarian Res. Mar 3 2026;19(1)doi:10.1186/s13048-025-01959-x
9. Plus M. Spironolactone. Accessed 5/26/2026, 2026. https://medlineplus.gov/druginfo/meds/a682627.html
10. Jaafar B, Chami N, Tlais M, et al. The Association Between Vitamin D and Polycystic Ovary Syndrome (PCOS) in Women: A Systematic Review. Nutrients. Mar 19 2026;18(6)doi:10.3390/nu18060968
11. Gao H, Li Y, Yan W, Gao F. The Effect of Vitamin D Supplementation on Blood Lipids in Patients with Polycystic Ovary Syndrome: A Meta-Analysis of Randomized Controlled Trials. Int J Endocrinol. 2021;2021:8849688. doi:10.1155/2021/8849688
12. Menichini D, Facchinetti F. Effects of vitamin D supplementation in women with polycystic ovary syndrome: a review. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. Jan 2020;36(1):1–5. doi:10.1080/09513590.2019.1625881
13. Han Y, Cao Q, Qiao X, Huang W. Effect of vitamin D supplementation on hormones and menstrual cycle regularization in polycystic ovary syndrome women: A systemic review and meta-analysis. J Obstet Gynaecol Res. Sep 2023;49(9):2232–2244. doi:10.1111/jog.15727
14. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism. 2011;96(7):1911–1930.
15. Genazzani AD, Santagni S, Rattighieri E, et al. Modulatory role of D-chiro-inositol (DCI) on LH and insulin secretion in obese PCOS patients. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. Jun 2014;30(6):438–43. doi:10.3109/09513590.2014.897321
16. La Marca A, Grisendi V, Dondi G, Sighinolfi G, Cianci A. The menstrual cycle regularization following D-chiro-inositol treatment in PCOS women: a retrospective study. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. Jan 2015;31(1):52–6. doi:10.3109/09513590.2014.964201
17. Greff D, Juhász AE, Váncsa S, et al. Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Reprod Biol Endocrinol. Jan 26 2023;21(1):10. doi:10.1186/s12958-023-01055-z
18. Facchinetti F, Orrù B, Grandi G, Unfer V. Short-term effects of metformin and myo-inositol in women with polycystic ovarian syndrome (PCOS): a meta-analysis of randomized clinical trials. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. Mar 2019;35(3):198–206. doi:10.1080/09513590.2018.1540578
19. Rudnicka E, Suchta K, Grymowicz M, et al. Chronic Low Grade Inflammation in Pathogenesis of PCOS. Int J Mol Sci. Apr 6 2021;22(7)doi:10.3390/ijms22073789
20. Dehzad MJ, Ghalandari H, Nouri M, Askarpour M. Antioxidant and anti-inflammatory effects of curcumin/turmeric supplementation in adults: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials. Cytokine. Apr 2023;164:156144. doi:10.1016/j.cyto.2023.156144
21. Shen W, Qu Y, Jiang H, et al. Therapeutic effect and safety of curcumin in women with PCOS: A systematic review and meta-analysis. Front Endocrinol (Lausanne). 2022;13:1051111. doi:10.3389/fendo.2022.1051111
22. Kamal DAM, Salamt N, Yusuf ANM, Kashim M, Mokhtar MH. Potential Health Benefits of Curcumin on Female Reproductive Disorders: A Review. Nutrients. Sep 7 2021;13(9)doi:10.3390/nu13093126
23. Wei W, Zhao H, Wang A, et al. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. Eur J Endocrinol. Jan 2012;166(1):99–105. doi:10.1530/eje-11-0616