Herbal Strategies in Reproductive Health: Evidence-Based Insights into PCOS and Infertility Management

Polycystic ovary syndrome (PCOS) and infertility are among the most prevalent endocrine and reproductive disorders affecting women of reproductive age worldwide.Conventional therapies, including clomiphene citrate, metformin, and oral contraceptives, are often associated with limited efficacy, recurrence, and undesirable adverse effects, highlighting the need for safer and more holistic treatment options.Herbal medicines, rich in bioactive phytoconstituents, have gained increasing attention for their potential to modulate hormonal balance, improve insulin sensitivity, and enhance reproductive outcomes.This review provides an evidencebased synthesis of key medicinal plants traditionally used in the management of PCOS and infertility, including Trigonella foenumgraecum (fenugreek), Vitex agnus-castus (chasteberry), Withania somnifera (ashwagandha), Glycyrrhiza glabra (licorice), and Cimicifuga racemosa (black cohosh).These botanicals exert diverse pharmacological effects through mechanisms such as dopaminergic modulation, anti-androgenic activity, insulin signaling regulation, and antioxidative protection.Integrative approaches combining phytotherapy with lifestyle modification and conventional treatment have demonstrated synergistic benefits in improving ovulation, menstrual regularity, and fertility outcomes.Despite encouraging preclinical and clinical evidence, challenges related to standardization, bioavailability, and quality control remain barriers to clinical translation.Future research should emphasize well-designed, multicentric randomized controlled trials and biomarker-based standardization to validate the therapeutic role of herbal strategies in reproductive health.Overall, evidence-based phytotherapy represents a promising, accessible, and culturally acceptable approach for the long-term management of PCOS and infertility.