Objective: Polycystic ovary syndrome (PCOS) is a common endocrine disorder. Fenugreek (Trigonella foenum-graecum) is an herbal supplement investigated for managing PCOS symptoms, but its efficacy remains unclear. This systematic review assessed the impact of fenugreek supplementation on PCOS outcomes in human and animal studies.
Materials and Methods: A search was conducted in PubMed, Scopus, and Web of Science up to December 2024. Eligible studies included clinical trials involving women with PCOS and animal models utilizing rodent PCOS models that assessed fenugreek supplementation (any form or dose) against a control group. Outcomes of interest included insulin resistance, hormonal parameters, and ovarian morphology.
Results: Thirteen studies (8 human and 5 animal) were included. In human studies, fenugreek supplementation (doses ranging from 333 mg/day to 2000 mg/day) significantly improved ovarian morphology and lipid profiles in a majority of studies investigating these outcomes. Effects on insulin resistance (HOMA-IR), fasting blood glucose, and testosterone levels were significant in some, but not all, clinical trials. Menstrual regularity improved in half of the relevant studies. In animal studies, fenugreek (0.5 to 100 mg/kg) consistently reduced ovarian cyst formation and improved estrous cyclicity. No significant adverse effects were reported.
Conclusion: Fenugreek supplementation demonstrates promise in improving ovarian morphology and lipid metabolism in PCOS. Its effects on hormonal and glycemic outcomes are inconsistent. The evidence suggests benefits may be dependent on the specific extract and patient population. Further high-quality, standardized trials are required to confirm these findings and establish optimal clinical protocols.