Holistic approaches to polycystic ovary syndrome: a narrative review of non-pharmacological management
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20262154Keywords:
Acupuncture, Acupressure, Ayurveda, Diet, Alternative and complementary therapy, HomoeopathyAbstract
Polycystic ovary syndrome (PCOS) is the most common condition-affecting women of reproductive age, with range of reproductive, metabolic, and psychological issues. Available treatments include both pharmacological and non-pharmacological treatments. While pharmacological treatments are effective but having adverse effects. whereas non-pharmacological safer and free from such risks. The aim of this study is to explore the role of non-pharmacological treatments in PCOS. A comprehensive literature search was conducted across PubMed, CINAHL, Web of Science, and Google scholar to identify relevant studies published between 2012 and 2025. The search included peer-reviewed articles in the English language with full-text.200 articles were screened, and data extracted based on study objectives, methodology, and key findings. Following the application of inclusion and exclusion criteria, 21 articles were retained for the review. This narrative review synthesizes evidence on Ayurveda, Yoga, Homoeopathy, diet, physical activity, acupuncture, and acupressure for PCOS management. Ayurveda formulations such as Rajahpravartini Vati, Ashokarishta, Kumaryasava, etc. regulate cycles and support fertility; Yoga improves insulin sensitivity, reduces stress, and enhances hormonal balance; Homoeopathy improve menstrual regularity and quality of life. Dietary modifications and exercise contribute to weight reduction and metabolic outcomes; while acupuncture and acupressure beneficiary for restoring menstrual cycles, lowering testosterone and LH levels. Non-pharmacological treatment is safe, holistic, and enhance reproductive, metabolic, and psychological outcomes, contributing to quality overall health in women with PCOS.
References
WHO. Polycystic ovary syndrome. 2023. Available at: https://www.who.int/news room/fact sheets/detail/polycystic-ovary syndrome. Accessed on 07 April 2026.
Bharali MD, Rajendran R, Goswami J, Singal K, Rajendran V. Prevalence of Polycystic Ovarian Syndrome in India: A Systematic Review and Meta-Analysis. Cureus. 2022;14(12):e32351.
Djedjibegovic J, Marjanovic A, Kobilica I, Turalic A, Lugusic A, Sober M. Lifestyle management of polycystic ovary syndrome: A single-center study in Bosnia and Herzegovina. AIMS Public Health. 2020;7(3):504-20.
Oliveira FR, Azevedo RC, Silva VA, Peres TM, Candido AL, Gomes KB, et al. Recent advances in the understanding and management of polycystic ovary syndrome. F1000Res. 2019;8:F1000.
Speelman DL. Nonpharmacologic management of symptoms in females with polycystic ovary syndrome: A narrative review. J Am Osteopath Assoc. 2019;119(1):25-39.
Singh S, Pal N, Shubham S, Sarma DK, Verma V, Marotta F, et al. Polycystic Ovary Syndrome: Etiology, Current Management, and Future Therapeutics. J Clin Med. 2023;12(4):1454.
Harada M. Pathophysiology of polycystic ovary syndrome revisited: Current understanding and perspectives regarding future research. Reprod Med Biol. 2022;21(1):e12487.
Smet ME, McLennan A. Rotterdam criteria, the end. Australas J Ultrasound Med. 2018;21(2):59-60.
Lentscher JA, Decherney AH. Clinical Presentation and Diagnosis of Polycystic Ovarian Syndrome. Clin Obstet Gynecol. 2021;64(1):3-11.
Yang H, Xiao YQ, Liu JJ, Xu GX, Li J, Xiao ZY, et al. Effect of non-pharmacological interventions for overweight/obese women with polycystic ovary syndrome on ovulation and pregnancy outcomes: A protocol for a systematic review and network meta-analysis. BMJ Open. 2022;12(6):e059090.
Greenwell S, Jones A, Smith YR, Marriott D, Aikens JE, Padmanabhan V, et al. Protocol for a randomized comparative effectiveness trial comparing a very low-carbohydrate diet to DASH diet for polycystic ovary syndrome: the SUPER (Supporting Understanding of PCOS Education and Research) trial. Trials. 2024;25:750.
Gautam R, Maan P, Jyoti A, Kumar A, Malhotra N, Arora T. The Role of Lifestyle Interventions in PCOS Management: A Systematic Review. Nutrients. 2025;17(2):310.
Khalid K, Apparow S, Mushaddik IL, Anuar A, Rizvi SAA, Habib A. Effects of Ketogenic Diet on Reproductive Hormones in Women with Polycystic Ovary Syndrome. J Endocr Soc. 2023;7(10):bvad112.
Paoli A, Mancin L, Giacona MC, Bianco A, Caprio M. Effects of a ketogenic diet in overweight women with polycystic ovary syndrome. J Transl Med. 2020;18(1):104.
Barrea L, Verde L, Camajani E, Cernea S, Frias-Toral E, Lamabadusuriya D, et al. Ketogenic Diet as Medical Prescription in Women with Polycystic Ovary Syndrome (PCOS). Curr Nutr Rep. 2023;12(1):56-64.
Juhász AE, Stubnya MP, Teutsch B, Szűcs Z, Várbíró S, Takács I, et al. Ranking the dietary interventions by their effectiveness in the management of polycystic ovary syndrome: a systematic review and network meta-analysis. Reprod Health. 2024;21(1):28.
Kim CH, Lee SH. Effectiveness of Lifestyle Modification in Polycystic Ovary Syndrome Patients with Obesity: A Systematic Review and Meta-Analysis. Life (Basel). 2022;12(2):308.
Patten RK, Boyle RA, Moholdt T, Kiel I, Hopkins WG, Harrison CL, et al. Exercise Interventions in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Front Physiol. 2020;11:606.
The Federation of Obstetric and Gynaecological Societies of India (FOGSI). FOGSI Focus: PCOS Practice Points - PCOS and Lifestyle Modification. Mumbai: FOGSI, 2024. Available at: https://www.fogsi.org/wpcontent/uploads/2024/11/Fogsi-Focus-PCOS-Practice-Points_PCOS-and-Lifestyle-Modification.pdf. Accessed on 07 April 2026.
Samadi Z, Bambaeichi E, Valiani M, Shahshahan Z. Evaluation of Changes in Levels of Hyperandrogenism, Hirsutism and Menstrual Regulation After a Period of Aquatic High Intensity Interval Training in Women with Polycystic Ovary Syndrome. Int J Prev Med. 2019;10:187.
Abdolahian S, Tehrani FR, Amiri M, Ghodsi D, Yarandi RB, Jafari M, et al. Effect of Lifestyle Modifications on Anthropometric, Clinical, and Biochemical Parameters in Adolescent Girls with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. BMC Endocr Disord. 2020;20(1):71.
Stener-Victorin E, Holm G, Janson PO, Gustafson D, Waern M. Acupuncture and physical exercise for affective symptoms and health-related quality of life in polycystic ovary syndrome: secondary analysis from a randomized controlled trial. BMC Complement Altern Med. 2013;13:131.
Kumari D, Kumar M, Tiwari P, Mahey R, Malhotra N, Mishra R, et al. Impact of Yoga in Polycystic Ovary Syndrome. Int J Ayurveda Res. 2023;4(3):132-6.
Shrivastava R, Mishra S, Singh R, Shrivastava P. Effect of integrated approach of yoga and naturopathy on polycystic ovarian syndrome: A case study. J Family Med Prim Care. 2022;11(4):1525-7.
Bhingardive KB, Sarvade DD, Bhatted S. Clinical efficacy of Vamana Karma with Ikshwaaku Beeja Yoga followed by Shatapushpadi Ghanavati in PCOS. Ayu. 2017;38(4):127-32.
Anitha S, Babu G, Prasad KMVD, Prasad PVNR. Role of Ayurveda and Yoga in the management of PCOS. J Ayurveda Integr Med Sci. 2025;10(3):117-23.
Gupta G, Gupta N, Gupta M, Gupta A, Gupta S. Homoeopathic treatment of women with PCOS: A prospective observational study. Indian J Res Homoeopathy. 2021;15(1):12-20.
Dewan D, Sharma R, Nim P, Singh S. Homoeopathy as a holistic system in PCOS – A review. Int J High Dilution Res. 2021;20(4):43-59.
Maan P, Gautam R, Vasudevan S, Menon GR, Arora A, Nair A, et al. Pharmacological and Non-Pharmacological Interventions for Polycystic Ovary Syndrome (PCOS) in Indian Women: A Systematic Review and Meta-Analysis. Pharmaceuticals (Basel). 2025;18(5):680.
Jia LY, Feng JX, Li JL, Liu FY, Xie LZ, Luo SJ, et al. The Complementary and Alternative Medicine for Polycystic Ovary Syndrome: A Review of Clinical Application and Mechanism. Evid Based Complement Alternat Med. 2021;2021:5555315.
Moran LJ, Hutchison SK, Norman RJ, Teede HJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2011;(2):CD007506.
Marsh KA, Steinbeck KS, Atkinson FS, Petocz P, Brand-Miller JC. Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome. Am J Clin Nutr. 2010;92(1):83-92.
Harrison CL, Lombard CB, Moran LJ, Teede HJ. Exercise therapy in polycystic ovary syndrome: a systematic review. Hum Reprod Update. 2011;17(2):171-83.
Santos IK, Pichini GS, Daniel D Ferreira C, Dantas PB, Browne RAV, De Queiros V, et al. Effects of high-intensity interval training in combination with detraining on mental health in women with polycystic ovary syndrome: A randomized controlled trial. Front Physiol. 2022;13:948414.
Lim CED, Ng RWC, Cheng NCL, Zhang GS, Chen H. Acupuncture for polycystic ovarian syndrome. Cochrane Database Syst Rev. 2019;7(7):CD007689.
Arentz S, Smith CA, Abbott JA, Bensoussan A. A survey of the use of complementary medicine by a self-selected community group of Australian women with polycystic ovary syndrome. BMC Complement Altern Med. 2014;14:472.
Dayani Siriwardene SA, Karunathilaka LP, Kodituwakku ND, Karunarathne YA. Clinical efficacy of Ayurveda treatment regimen on Subfertility with Poly Cystic Ovarian Syndrome (PCOS). Ayu. 2010;31(1):24-7.
Thakur D, Singh SS, Tripathi M, Lufang D. Effect of yoga on polycystic ovarian syndrome: A systematic review. J Bodyw Mov Ther. 2021;27:281-6.
Rekha. A Clinical Study to Evaluate the Efficacy of Homoeopathic Medicine in the Management of Polycystic Ovarian Disease (PCOD). Delhi: Nehru Homoeopathic Medical College; 2024.
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