Evidence-Based Nutritional Supplementation in Polycystic Ovary Syndrome: A Comprehensive Review of Clinical Outcomes, Mechanisms, and Recommendations

Polycystic Ovary Syndrome (PCOS) is a prevalent and multifactorial endocrine-metabolic disorder among women of reproductive age. Recent research indicates that nutritional supplementation may play a valuable adjunctive role in PCOS management, particularly in addressing metabolic, hormonal, and inflammatory disturbances. This review synthesizes evidence from randomized controlled trials and meta-analyses published up to 2024, evaluating the efficacy and safety of commonly used supplements such as myo-inositol, vitamin D, omega-3 fatty acids, selenium, and coenzyme Q10. The analysis demonstrates that several supplements can improve insulin sensitivity, lipid profiles, hormonal balance, and oxidative stress markers in women with PCOS. Mechanistic insights suggest these effects are mediated through the modulation of metabolic and inflammatory pathways, including AMPK, NF-κB, PPAR-γ, and VDR. Nevertheless, the heterogeneity of study designs, sample sizes, and a paucity of long-term safety data highlight the need for standardized protocols and further high-quality trials. Overall, nutritional supplements offer a promising strategy for personalized PCOS management, especially for women with insulin resistance or those seeking alternatives to conventional pharmacotherapy. Continued research into optimal dosing, duration, and co-supplementation effects will be essential to refine clinical recommendations and maximize patient outcomes. This is the most comprehensive synthesis, combining clinical outcomes with mechanistic insights across 13 key nutritional supplements in PCOS management.