Traditional Chinese Medicine for Regulating Reproductive Aging: Pharmacological Activities and Mechanisms

With the postponement of marriage and childbearing age, the reproductive demand of advanced-age couples is steadily increasing, and reproductive aging has become a significant public health challenge facing societal development. Reproductive aging refers to the progressive functional decline of the reproductive system during organismal aging, accompanied by hormonal dysregulation, decreased gamete quality, and degeneration of reproductive organs. Compared with conventional Western medical therapies, which are often associated with side effects, traditional Chinese medicine (TCM) offers a multi-target, low-cost alternative with favorable clinical safety and efficacy. This article systematically reviews the pathological mechanisms of reproductive aging and elucidates the anti-reproductive-aging mechanisms of four commonly used single-herb medicinals derived from natural products - Panax ginseng, Cistanche, Lycium barbarum, and Epimedium. The evidence indicates that these herbs improve reproductive function by modulating oxidative stress levels, exerting anti-inflammatory effects, inhibiting reproductive cell apoptosis, ameliorating mitochondrial function, and regulating reproductive hormone secretion. However, due to the absence of comparative studies evaluating the efficacy of certain herbal constituents within a single model and the insufficient depth of mechanistic validation, relevant clinical evidence for these herbs remains scarce. It is therefore imperative to conduct standardized multi-omics mechanistic exploration and large-sample, multicenter randomized controlled trials, and to strengthen the linkage between basic pharmacological research and clinical validation, thereby providing a more robust scientific basis for intervention strategies.