PHYTOESTROGENS AND THE POLYCYSTIC OVARY SYNDROME:
A SYSTEMATIC REVIEW OF CLINICAL EVIDENCE AND
LABORATORY FINDINGS
MONA NAJAF NAJAFI 1, JAMAL KASAIAN 2, LEDA KOVATSI 3, GRIGORIOS LEON 4, ELNAZ KHANI SOLOUT 5, MAHMOUD HASHEMZAEI 6, RAMIN REZAEE 1, PARVANEH MODIRAMANI 7, MASUMEH GHAZANFARPOUR 8*
1Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2Natural Products and Medicinal Plants Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
3Laboratory of Forensic Medicine and Toxicology School of Medicine, Aristotle University of Thessaloniki, 54124, Greece
4Medicolegal office, Alexandras Ave. 120, Athens, Greece
5Department of Horticulture and Landscape Engineering, Faculty of Agriculture, Ferdowsi University of Mashhad, Mashhad,
Iran
6Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran
7Central Library, Scientific Resources Office. Mashhad University of Medical Sciences, Mashhad, Iran
8Evidence-Based Care Research Centre, Mashhad University of Medical Science, Mashhad, Iran
*corresponding author: Masoumeh.Ghazanfarpour@yahoo.com
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Abstract:
The aim of this review was to identify the effect of phytoestrogens on polycystic ovary syndrome (PCOS) (clinical evidence
and laboratory findings) in women of reproductive age. Major databases were systematically searched until 1st July 2017. The
Jadad scale was used for evaluating the quality of trials. Compared to placebo, there is a variable and inconclusive result
regarding the effect of soy on testosterone. The luteinizing hormone (LH), the follicular stimulating hormone (FSH), and
dehydroepiandrosterone sulphate (DHEAS) are not affected significantly either. No significant changes in the menstrual
cycle were observed following treatment with soy. Following the administration of flaxseed, testosterone and DHEAS levels
did not change significantly but 33.3% of patients had a normal menstrual cycle and 10% of patients become pregnant.
Cimicifuga racemosa alone, or in combination with clomiphene, had a beneficial effect on decreasing serum LH. Ninety-five
percent of patients reported irregular cycle at baseline, while 71.4% of patients receiving fenugreek seed extract (Trigonella
foenum-graecum) had a normal cycle at the end of the study. There is scientific evidence that phytoestrogens, such as
flaxseed and the fenugreek seed extract, may have effects on ovulation regulation. However, the currently available evidence
on the effect of phytoestrogens on PCOS endocrine disorder is inconclusive.

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