Quercetin as a noteworthy treatment for polycystic ovary syndrome: An evidence-based review from molecular basis mechanism to clinical perspective

Polycystic ovary syndrome (PCOS) is a complex endocrinopathy that often occurs in reproductive-age women and causes anovulatory infertility problems. Current management guidelines, including fertility medications, hormonal therapy, and glycemic control, have drawbacks due to their limited efficacy and undesirable outcomes. Therefore, this review intended to scrutinise the mechanism and potential benefits of a candidate herbal therapy for PCOS, quercetin, as an adjunctive medication to alleviate disease manifestations. Articles were searched in PubMed, EBSCOHost, ProQuest, and Scopus databases and screened based on their titles and abstracts. A critical appraisal was done using an Evidence-Based Medicine worksheet. Fourteen eligible articles were obtained, including one systematic review, four randomized clinical trials; eight experimental studies; and one systematic pharmacological strategy-based research. It was shown that quercetin alleviated insulin resistance via activating phosphatidylinositol 3-kinase (PI3–K) signalling, reduced testosterone, controlled luteinising hormone, and had anti-inflammatory effects on the ovaries. This antioxidant also altered catabolism and steroidogenesis, regulated AMP-activated protein kinase (AMPK), and decreased oocyte nucleation failure. Furthermore, the lipid profile was reduced by quercetin through the modulation of adiponectin receptors. Ultimately, quercetin successfully improved the pregnancy rate. Due to its potential to modulate several pathways involved in metabolic disease and infertility, quercetin is a promising candidate in clinical practice as adjunctive therapy for PCOS.