Introduction: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among reproductive-aged women with various prevalence from 5-21%. This syndrome is associated with wide spectrum complications in different aspects of health, including reproductive (hyperandrogenism, hirsutism, anovulation, infertility, and menstrual disturbance), metabolic (obesity and diabetes mellitus as well as cardiovascular risk), and psychological features (mood disorders and decreased quality of life). Some characteristics of PCOS such as obesity and abdominal adiposity, androgen excess, and insulin resistance can develop oxidative stress in these patients. Nowadays, the use of antioxidants in management of women with PCOS has attracted lots of interests. Indeed, PCOS is a condition with significant decrease in serum antioxidant and vitamins levels and these women are in an increased risk of oxidative status (OS). OS occurs from the imbalance between reactive oxygen spices production and antioxidant defenses. The present study was conducted to review the extent of antioxidant treatment and PCOS.
Methods: A comprehensive literature search was carried out to assess if antioxidant Google scholar data base. Epidemiological studies, experimental studies, inquiries or editorials on the mentioned theme published from 2015 until 2022 were included. specific keywords including “Polycystic ovary syndrome”, “PCOS”, “antioxidant” and “antioxidant treatment” have been used.
Results: Studies reported significantly increased concentrations of oxidative stress biomarkers including plasma thiobarbituric acid reactive substances (TBARS) and malondialdehyde (MDA) and significantly lowered levels of superoxide dismutase (SOD), catalase (CAT), vitamin C and vitamin E in PCOS patients. Antioxidant supplementation has been shown to improve insulin sensitivity and other health threating conditions in women with PCOS. One study revealed that calcium and vitamin D supplementation had a significant effect on follicle growth and response to main PCOS treatment. NAC (N-acetyl-cysteine) is an antioxidant that derivative from the amino acid L-cysteine. NAC can have effects on insulin receptor activity as well as insulin secretion and subsequently increase glucose utility. Previous studies showed NAC can have effect on levels of circulated insulin and insulin sensitivity in PCOS women with hyperinsulinemia. Although some studies didn’t find any significant differences between women with and without PCOS regarding to serum Zn levels, a research team believes zinc supplementation for PCOS women has some beneficial effects on cardio metabolic risk factors.
Conclusion: Despite the important role of alternative medicine especially antioxidants in management of PCOS women, there are not many well-designed papers or detailed literature reviews report in this field, especially in Iran. In the other hand, the available studies addressing antioxidant use in PCOS women yielded controversial results. For overcoming these limitations, updating our knowledge on this field and a critical appraisal of all available studies might be helpful to guide clinical practice. Collectively the results of all reviewed studies in this paper showed that antioxidants and vitamins have positive effects in management of PCOS and its' complications, although it seems more studies is necessary in this field because evidence are not enough to identify an optimum antioxidant management in women with PCOS.