Polycystic Ovary Syndrome: Classical Unani Perspectives, Contemporary Understanding, and Therapeutic Approaches: A Narrative Review

Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine and metabolic disorders affecting women of reproductive age and is characterized by menstrual irregularities, hyperandrogenism, anovulation, infertility, obesity, and insulin resistance. Despite its high prevalence and significant impact on reproductive and metabolic health, the etiopathogenesis of PCOS remains complex and multifactorial. Although PCOS is not explicitly described in classical Unani literature, several of its clinical manifestations, including amenorrhoea, oligomenorrhoea, obesity, hirsutism, infertility, and acne, have been documented by eminent Unani physicians such as Rāzī, Ibn Sīnā, and Jurjānī. Unani scholars attributed these manifestations to disturbances in temperament (Su’-i-Mizāj), particularly the predominance of Barid wa Ratab (cold and moist) qualities and derangements of Balghamī humour. This review aims to explore the understanding of PCOS from both contemporary and Unani perspectives and to highlight the therapeutic potential of Unani medicine in its management. Relevant classical Unani texts and contemporary scientific literature were reviewed to examine the epidemiology, pathophysiology, clinical features, complications, and treatment approaches of PCOS. The review describes the role of Ilāj bi’l-Tadbīr (regimenal therapy), Ilāj bi’l-Ghidhā’ (dietotherapy), and Ilāj bi’l-Dawā’ (pharmacotherapy) in restoring humoral balance and improving reproductive and metabolic functions. Several medicinal plants, including ginger, liquorice, cinnamon, fenugreek, flaxseed, Nigella sativa, Tribulus terrestris, and Asparagus racemosus, have demonstrated beneficial effects on insulin resistance, hyperandrogenism, menstrual irregularities, and fertility. Classical compound formulations such as Majūn Suparī Pāk, Ḥabb-i-Mudīr, Majūn Dabīd al-Ward, and Itrīfal Shāhtra may further support the management of PCOS through their emmenagogue, uterine tonic, anti-inflammatory, and blood-purifying actions. The available evidence suggests that Unani medicine offers a holistic and individualized approach to the management of PCOS by addressing both its metabolic and reproductive dimensions. Further well-designed clinical studies are warranted to validate the efficacy and safety of these traditional interventions and to facilitate their integration into evidence-based healthcare practices.