Role of Functional Foods and Nutraceutical Compounds in Alleviating Polycystic Ovary Syndrome: A Narrative Review

Polycystic ovary syndrome (PCOS) represents one of the most common endocrine disorders among women of reproductive age. It is often associated with hormonal imbalance, metabolic disturbances, and reproductive complications, which together contribute to an elevated risk of long-term cardiometabolic disorders. Limitations and side effects of conventional pharmacotherapies have prompted growing interest in nutrition-based adjunct strategies targeting core PCOS pathophysiology. To narratively synthesize mechanistic rationale and human clinical evidence on dietary seeds and selected nutraceuticals relevant to PCOS, with emphasis on metabolic and reproductive endpoints of interest to nutrition and obstetrics/gynecology practice. A targeted literature search was conducted in PubMed, Scopus, ScienceDirect, Wiley Online Library, Google Scholar, and ACS Publications for studies published up to December 2025. Search terms combined "polycystic ovary syndrome/PCOS" with seed-related terms (flaxseed, sesame, pumpkin, sunflower, chia, fenugreek, seed cycling) and nutraceuticals (myo‑inositol, D‑chiro‑inositol, omega‑3 fatty acids, curcumin, N‑acetylcysteine, coenzyme Q10, selenium, vitamin D, alpha‑lipoic acid). Among seeds, flaxseed trials and mixed-seed interventions (pumpkin/sunflower/sesame/flaxseed) have the most direct clinical data in PCOS and have been associated with improvements in insulin resistance indices (e.g., homeostatic model assessment of insulin resistance (HOMA-IR)), inflammatory markers, lipid profiles, and selected reproductive parameters (e.g., luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratio, ovarian morphology). However, heterogeneity in dosage, duration, and comparators limits firm conclusions. Pumpkin, sunflower, and sesame seeds may have potential mechanistic roles that are supported by human studies in related metabolic conditions, but PCOS-specific trials of individual seeds are still limited. Proposed "seed cycling" protocols have received attention, yet most clinical data are derived from mixed-seed supplementation studies or low-level evidence, such as case reports, and should be considered hypothesis-generating. Among nutraceuticals, inositols, omega‑3 fatty acids, curcumin, and N‑acetylcysteine show comparatively stronger clinical signals in PCOS, primarily for insulin sensitivity and selected endocrine or reproductive outcomes, whereas evidence for micronutrients such as selenium is more context-dependent. Dietary seeds and selected nutraceuticals represent promising adjuncts for PCOS management, especially for cardiometabolic risk modification, but the evidence base is limited by heterogeneity in PCOS phenotyping, interventions, and outcomes. Future trials should standardize diagnostic criteria, dosing, and clinically meaningful endpoints and explore which PCOS phenotypes benefit most from specific seed-based and nutraceutical strategies.