Beyond Metformin: A Review of Non-pharmacological Treatments for Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) affects reproductive-aged women through hereditary, biological, environmental, and lifestyle factors including stress, poor diet, and oxidative stress. This narrative review aims to systematically synthesize evidence on non-pharmacological naturopathic treatments (yoga, hydrotherapy, diet, and acupuncture) for improving insulin sensitivity, reducing obesity, and alleviating PCOS symptoms. While conventional treatments like metformin increase insulin sensitivity and clomiphene promote ovulation, they fail to address underlying causes and carry side effects, necessitating complementary approaches. The objective of this review is to investigate databases, including Web of Science, PubMed/MEDLINE, and Scopus were searched from October 1, 1998, to January 16, 2025, using Boolean combinations of keywords such as "PCOS," "naturopathy," "complementary and alternative medicine," "chromotherapy," "metformin," "insulin sensitivity," "obesity," and "diabetes." Naturopathic interventions consistently demonstrated favorable effects on PCOS outcomes across reviewed studies. Yoga therapies improved insulin sensitivity, reduced inflammatory responses, and enhanced quality of life, with only minimal adverse effects reported. Hydrotherapy and dietary approaches effectively addressed obesity parameters and PCOS clinical symptoms. Combined non-pharmacological modalities showed synergistic benefits over pharmacological treatments alone, characterized by high patient adherence and excellent safety profiles. Complementary therapies provide safer ways to manage PCOS compared to using medication alone. Combining these methods needs clinical guidelines and randomized controlled trials.