Management of Polycystic Ovarian Syndrome; A Metabolic Morbidity of Reproductive Age, Special Focus on the Role of Natural and Alternative Medicine

Abstract

Abstract: Polycystic ovarian syndrome (PCOS) is a complicated metabolic and endocrine disorder characterized by androgen excess and chronic anovulation. Depending upon the diagnostic criteria 2% to 26% of women of reproductive ages have been diagnosed with PCOS. The etiology of PCOS is still unclear, but some evidence-based data exhibited multiple causes including ovarian hyperandrogenism, adrenal hyperandrogenism, hypothalamic-pituitary-ovarian dysfunction, obesity, insulin resistance and neuroendocrine dysfunction. PCOS is associated with elevated oxidative stress and anti-Müllerian hormone (AMH) levels. The imbalance of Myo-inositol/D-chiro-inositol also played a pivotal role in its etiology. The diagnosis of PCOS mainly depends on a few disease characteristics such as., oligo-ovulation or anovulation, clinical and or biochemical signs of hyperandrogenism, and polycystic ovaries. Polycystic ovarian patients have multiple clinical abnormalities such as chronic menstrual irregularities, oligo-ovulation or anovulation, recurrent abortions, sleep apnea, obesity, reactive hypoglycemia, hypertension, hirsutism, and male-pattern alopecia. Additional complications of PCOS are infertility, acne, oligomenorrhea, obesity, endometrial cancer, glucose intolerance, hyperlipidemia, pre-eclampsia, acanthosis nigricans, depression and anxiety, etc. The management and treatment of PCOS are typically symptom-based. Allopathic treatments include anti-diabetic, ovulation induction agents, glucocorticoids, statins, oral contraceptive pills (OCPs), anti-androgens, and eflornithine, with a lot of adverse effects and complications. Most recently, there are a lot of natural and alternative medicines available that have the potential to manage the syndrome. Homeopathic medicines are also very safe and effective with fewer side effects for patients. The aims of the present review are to provide an in-depth understanding of the pathogenesis of PCOS along with the comprehensive review of natural and alternative medicines that have excellent potential to manage the disease.