Endocrine Disruption or Enhancement? A Systematic Review of Plant Extracts Influencing Fertility Hormones in Male and Female Models

Fertility regulation through natural agents has garnered significant interest in reproductive pharmacology and endocrinology. This systematic review evaluates the dual role of plant-derived extracts as either endocrine disruptors or enhancers, focusing on their influence on reproductive hormones in both male and female experimental models. Using PRISMA guidelines, we screened articles from PubMed, ScienceDirect, and Scopus databases, including studies published between 2000 and 2024. A total of 87 studies met the inclusion criteria. Results indicate that while some plant extracts such as Tribulus terrestris, Withania somnifera, and Fadogia agrestis enhance gonadotropin and testosterone levels in males, others like Glycyrrhiza glabra and Nigella sativa exhibit anti-androgenic effects. In females, extracts like Trigonella foenum-graecum and Asparagus racemosus stimulate folliculogenesis and elevate estrogen and LH levels, whereas Piper betle and Carica papaya leaf extracts may disrupt the hypothalamic-pituitary-ovarian axis. These findings underscore the complexity of phytoendocrine interactions, highlighting both therapeutic potentials and risks. Mechanistic insights, dosage variations, and species-specific responses warrant careful consideration in translating preclinical findings to clinical use.