3Principle, P.S.G.V.P. Mandal’s College of Pharmacy, Shahada, India.
*Corresponding Author E-mail: sakshupatil291204@gmail.com
ABSTRACT:
Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal and metabolic disorders in women of reproductive age. It is mainly associated with insulin resistance, high androgen levels, and irregular ovulation. Standard treatments such as hormonal pills, anti-androgen medications, and insulin-sensitizing drugs can help manage symptoms but may cause side effects and do not always work for every patient. Because of this, there is growing interest in natural and integrative approaches for PCOS management, including Ayurvedic herbal therapies. This review highlights clinically studied Ayurvedic herbs, including cinnamon, fenugreek, spearmint, licorice, ashwagandha, and shatavari. Research suggests these herbs may help improve insulin sensitivity, lower androgen levels, support ovarian function, reduce inflammation and oxidative stress, and improve stress response through adaptogenic effects. Early clinical findings report benefits such as more regular menstrual cycles, improved ovulation, reduced symptoms like hirsutism, better blood sugar control, and enhanced overall well-being. Although results are promising, most available studies are small and short-term, and herbal dosages vary across trials. Therefore, while Ayurvedic herbs may serve as a complementary approach alongside lifestyle changes and medical care, larger and high-quality clinical studies are needed to confirm long-term safety and effectiveness.
KEYWORDS: PCOS, Ayurveda, Herbal therapy, Insulin resistance, Hormonal imbalance.
1. INTRODUCTION:
Polycystic Ovary Syndrome (PCOS) is a common and complex endocrine disorder that affects both reproductive and metabolic systems in women. Characterized by ovarian cysts, hormonal imbalances, and anovulation, it significantly impacts a woman’s health and overall quality of life1. The condition was first identified by Irving F. Stein Sr. and Michael Leventhal in 19352. According to World Health Organization, over 116 million women about 3.4% of the global female population are affected. Genetic studies have shown a strong hereditary component, particularly linked to hyperandrogenism, with the most promising gene candidate being part of the TGF-ß superfamily coding for fibrillin3. Elevated androgen levels often lead to symptoms like hirsutism, acne, obesity, and alopecia, along with increased risks of type 2 diabetes, hypertension, cardiovascular disease, dyslipidaemia, and endometrial cancer3,4. PCOS is closely tied to metabolic, biochemical, reproductive, and endocrine dysfunctions, and it can also influence mental well-being, leading to depression and other mood disorders. Many affected women are overweight or obese, which worsens hormonal and metabolic imbalances, thereby increasing the severity of the condition5. Conventional treatments such as anti-androgens, hormonal contraceptives, insulin sensitizers like metformin, and lifestyle modifications can relieve symptoms but often come with side effects and limited long-term success6. As a result, interest in herbal and traditional remedies has grown steadily in recent years. Herbal medicines are valued for their safety, fewer side effects, cost-effectiveness, and multiple active compounds that can offer holistic therapeutic benefits7. This study aims to explore the mechanisms and pharmacological actions of medicinal plants and polyherbal formulations that may provide safer, more sustainable, and effective management options for PCOS8.
Ayurveda takes a holistic approach that focuses on maintaining balance between the body, mind, and spirit. It provides personalized care, aims to treat the root cause of illness, and encourages overall well-being through natural and preventive methods9,10.
1.1. Types:
1. Phenotype Based:
Four types of observable characteristics have been found in patients in different studies:
1. Phenotype A: Classic PCOS (HA + OD + PCOM)
2. Phenotype B: Classic PCOS (HA + OD)
3. Phenotype C: Ovulatory PCOS (HA + PCOM)
4. Phenotype D:Non-Hyperandrogenic (OD + PCOM)11
2. Pathophysiology Based:
1. Insulin-resistant PCOS
2. Inflammatory PCOS
3. Post-pill PCOS
4. Hidden cause PCOS12
1.2. Causes of PCOS:
1. Genetic predisposition and Genetic polymorphisms.
2. Raised insulin levels.
3. Contraceptive pills.
4. Strong stimulation in adrenals in childhood.
5. Hormonal imbalance and chronic inflammation.
Figure 1: Pathophysiology of Polycystic Ovary Syndrome.
1.3. Sign and Symptoms of PCOS:
The principle sign and symptoms of PCOS are:
1. Menstrual Irregularities: Irregular or absent periods and pelvic pain
2. Hormonal Imbalance: Increased LH, reduced FSH, excess body hair (Hirsutism), acne
3. Metabolic Changes: Weight gain or difficulty losing weight
4. Reproductive Issue: Infertility or difficulty becoming pregnant
1.4. Histological features of PCOS:
1. Ovarian enlargement and Capsule thickness (>100 µ)
2. Subcapsular follicle cysts have increased.
3. Lack of albicantia or corporea lutea
4. Ovarian stromal hyperplasia and fibrosis7
1.5. Complications:
PCOS can cause irregular ovulation, infertility, and pregnancy issues; while long-term it raises the risk of diabetes, heart disease, and obesity. Early care and healthy habits can help prevent complications13.
Figure 2: Complications of PCOS.
2. Ayurvedic Herbal Remedies Available for PCOS:
2.1. Cinnamon:
6. Targeted PCOS Effects:
6.1. Insulin resistance and Hyperinsulinemia:
Cinnamon’s water-soluble polyphenols improve insulin sensitivity and glucose control in PCOS, unlike its oil. Dosage used- 500mg extract twice daily or 1–6g powder for 40 days17,18.
6.2. Menstrual irregularity/Oligo-amenorrhea:
Cinnamon supplementation (1.5g/day for 6 months) improved menstrual frequency in PCOS, increasing cycles by +0.23/month, is indicating its potential to help restore regular periods19.
6.3. Atherogenic lipids (↑TG/LDL; ↓HDL):
Cinnamon (1–6g/day, ~1.5g in PCOS) improves lipid profiles, lowers LDL, triglycerides, and insulin and raises HDL, helping manage dyslipidemia and metabolic issues in PCOS20.
6.4. Chronic low-grade inflammation:
Cinnamon (1–6g/day or ~500mg extract) shows strong antioxidant and anti-inflammatory effects, reducing oxidative stress, TNF-α, and NF-κB activity, aiding metabolic and reproductive issues in PCOS18,21.
· Scientific Evidence: Studies show that cinnamon can improve insulin sensitivity and regulate menstrual cycles in women with PCOS. A six-month trial using 1.5g/day of cinnamon powder improved menstrual regularity and insulin function and its polyphenols also lower inflammation and oxidative stress, supporting better hormonal balance22
2.2. Liquorice:
1. Synonym (s): Glycyrrhiza glabra, Jethi madh, Mulethi.
2. Biological Source: Dried root and rhizome of Glycyrrhiza glabra used in powdered form, extracts, teas.
3. Family: Leuminosae.
4. Forms: Powdered root, extracts (ethanolic, hydroalcoholic), capsules, infusions or teas8.
5. Phytochemical Constituents: Glycyrrhizin and 18-β-glycyrrhetinic acid, Glabridin, Amorfrutin, Glycycoumarin, Glabrene, Liquiritigenin23.
Figure4: Liquorice.
6. Targeted PCOS Effects:
6.1. Insulin Resistance and Metabolic Parameters:
An 8-week study found that 1.5g/day licorice extract with a low-calorie diet improved weight, insulin levels, and lipid profile in overweight PCOS women24.
6.2. Hormonal Balance, Ovarian Morphology and Ovulation:
In PCOS, GRR (300mg/kg) improved ovarian function, reduced cysts, and balanced hormones in rats, showing potential to restore ovulation and hormonal health25.
6.3. Anti-androgenic action:
A 2004 study found that daily licorice root intake lowered testosterone levels in women, which returned to normal after stopping; safe below 100mg glycyrrhizin/day26.
6.4. Anti-inflammatory / Antioxidant Actions:
Studies show licorice’s flavonoids and triterpenes have strong anti-inflammatory and antioxidant effects, helping reduce oxidative stress and inflammation linked to PCOS27,28
· Scientific Evidence: Studies show that licorice helps balance hormones by lowering testosterone and improving ovarian health. Animal studies found it reduced cysts and normalized cycles (Yousefi et al., 2017), while human trials showed decreased androgen levels after two cycles of use (Armanini et al., 2004)29.
· Safety and Precautions: High doses or prolonged use of licorice may elevate blood pressure or cause water retention due to its glycyrrhizin content. The recommended safe daily limit is below 100mg of glycyrrhizin30.
Ashwagandha (240–600mg/day) has taken for 6–12 weeks effectively lowers cortisol and stress levels, showing strong adaptogenic and calming benefits in clinical studies34.
6.2. Balances Reproductive Hormones:
An RCT found that ashwagandha (300 mg twice daily for 8 weeks) reduced androgens and balanced LH: FSH ratios, improving reproductive hormone health in PCOS 35.
6.3. Regulates Menstrual Cycles:
Ashwagandha (250–500mg/day) supports regular menstrual cycles and ovulation by reducing stress, balancing hormones, and improving ovarian function, as shown in Ayurvedic studies36.
Ashwagandha (300mg twice daily for 10 weeks) improves sleep quality and efficiency, which indirectly helps ease PCOS symptoms by supporting hormonal balance and rest37.
· Scientific Evidence: Ashwagandha is well known for its adaptogenic properties that reduce cortisol and balance reproductive hormones. Clinical trials show that 300mg of ashwagandha extract twice daily for eight weeks significantly improved LH: FSH ratios and lowered stress-related symptoms in women with hormonal imbalance.
· Safety and Precautions: Ashwagandha is generally safe at moderate doses (240–600mg/day). However, excessive intake may cause mild stomach upset or drowsiness; pregnant women should avoid it without medical supervision38.
2.4. Shatavari:
1. Synonym(s): Asparagus adscendens Roxb, A. persicus.
2. Biological Source: Dried root (Tuberous roots) are the principal medicinal part used in Ayurveda and research studies.
3. Family: Asparagaceae.
4. Forms: Dried root powder, aqueous or alcoholic extracts, standardized root extract capsules/tablets, decoctions, and herbal formulations.
5. Phytochemical Constituents: Shatavari contains steroidal saponins, glycosides, flavonoids, polyphenols, and alkaloids that support its hormone-balancing, antioxidant, and anti-inflammatory effects 39,40
Figure 6: Shatavari.
Shatavari (300–1000mg or 3–12g/day) improves menstrual regularity and hormone balance through its phytoestrogenic compounds, as shown in clinical and preclinical studies41,42.
6.2. Improves fertility and reproductive health:
Asparagus racemosus (6–12g/day or 300mg capsules) enhances ovarian function, supports follicle development, and improves menstrual symptoms, activating the HPG axis in studies43.
6.3. Manages stress and cortisol levels (Adaptogenic effect):
Shatavari (300mg capsules or gram-range root powder) reduces stress, modulates neuroendocrine function, and lowers cortisol, supporting reproductive hormone balance in women with PCOS44.
6.4. Improves gut and digestive health:
Shatavari’s mucilaginous compounds support gut health and digestion, which may indirectly aid PCOS by improving metabolism and hormones, though more clinical research is needed. (3–12g/day)45
· Clinical Findings: Shatavari’s phytoestrogenic compounds support female fertility and menstrual regularity. A 12-week clinical study showed significant improvement in ovulatory function and hormone balance in women treated with Shatavari extract. Its adaptogenic and antioxidant actions help regulate the hypothalamic-pituitary-gonadal (HPG) axis, promoting hormonal equilibrium 46.
2.5. Spearmint:
1. Synonyms: Mentha spicata L., Mentha viridis L.
2. Biological source: Aerial parts (leaves and flowering tops) of Mentha spicata L.
3. Family: Lamiaceae.
4. Forms: Dried herb tea, aqueous extracts, essential oil, capsules, and topical formulations.
5. Phytochemical Constituents: Monoterpenes (carvone, limonene), phenolic acids (rosmarinic acid, caffeic acid), flavonoids, and volatile oils47,48.
Figure 7: Spearmint.
Spearmint tea may balance hormones by improving the LH/FSH ratio and lowering testosterone, supporting ovulation and follicle growth. Evidence is promising. (2 cups daily, 30 days)49
6.3. Potential Aid in Ovulation and Fertility:
Spearmint may support ovarian health and follicle growth by lowering androgens and balancing hormones. Evidence in humans is limited, but animal studies show promise. (2cups/day)50
6.4. Anti-Inflammatory and Antioxidant Effects:
Spearmint’s flavonoids and rosmarinic acid offer strong antioxidant and anti-inflammatory effects, helping reduce oxidative stress in PCOS. (2 cups daily supply beneficial polyphenols)51
· Scientific Evidence: Spearmint tea is shown to significantly lower androgen levels and improve the LH/FSH ratio in women with PCOS. A human trial involving 42 participants demonstrated reduced free testosterone and enhanced subjective improvement in hirsutism after 30 days of daily tea intake 52.
2.6. Fenugreek:
1. Synonyms: Greek hayseed, Methi, Halba.
2. Biological source: Dried ripe seeds (leaves also used as vegetable/herb).
3. Family: Fabaceae (Leguminosae)
4. Forms: Seeds, seed powder, extracts, capsules, teas.
5. Phytochemical Constituents: Galactomannans (fiber), 4-Hydroxyisoleucine, steroidal saponins, trigonelline, flavonoids53,54.
Figure 8: Fenugreek.
6. Targeted PCOS Effects:
6.1. Improves Insulin Sensitivity and Glucose Control:
Fenugreek’s active compounds enhance insulin secretion and sensitivity by slowing carbohydrate absorption, helping lower blood glucose and insulin levels in PCOS. (5–10 g powder or 1 g extract daily)55
6.2. Supports Weight Management and Satiety:
Fenugreek’s soluble fibre promotes fullness and helps control appetite, leading to slight weight and BMI reductions in PCOS when paired with lifestyle changes. (5–10g/day)56
6.3. Improves Fertility and Ovulation:
Fenugreek supplements may help restore menstrual cycles, balance hormones, and promote ovulation, sometimes leading to pregnancy in women with PCOS. (1g standardized extract daily for 90 days)57
6.4. Anti-inflammatory and Antioxidant Effects:
Fenugreek’s flavonoids and saponins reduce inflammation and oxidative stress, key factors in PCOS, with benefits shown in both human and animal studies. (1g extract or 5–10g powder daily)57,58
· Scientific Evidence: Fenugreek seeds enhance insulin sensitivity and promote ovulation in PCOS. A clinical study using 1 g/day of standardized fenugreek extract for 90 days led to restoration of menstrual regularity and improved ovarian morphology.
· Summary Note: Fenugreek’s active compounds help balance insulin, support fertility, and ease inflammation, often used with other herbs in Ayurvedic PCOS treatments57.
3. CONCLUSION:
Polycystic Ovary Syndrome (PCOS) is a hormonal and metabolic disorder that needs a well-rounded treatment approach. Research shows that Ayurvedic herbal therapies may help manage important PCOS problems such as insulin resistance, hormonal imbalance, inflammation, and irregular periods. Herbs like cinnamon, fenugreek, licorice, spearmint, ashwagandha, and shatavari have shown potential to improve metabolism, lower excess male hormones, and support healthier ovarian function. Although early studies are encouraging, more large and high-quality research is needed to confirm these benefits and understand long-term effects. When combined with a healthy lifestyle and proper medical guidance, these Ayurvedic herbs can be used as a supportive option for women with PCOS, helping improve both metabolic health and hormonal balance in a natural way.
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Received on 08.04.2026 Revised on 27.04.2026 Accepted on 13.05.2026 Published on 08.07.2026 Available online from July 13, 2026 Res. J. Pharmacognosy and Phytochem. 2026; 18(3):309-314. DOI: 10.52711/0975-4385.2026.00044 ©AandV Publications All right reserved
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