Abstract
BACKGROUND: PCOS is a complex endocrine-metabolic disorder that is closely associated with oxidative stress. GEN, a naturally occurring isoflavone, has demonstrated beneficial effects in addressing hormonal imbalances and metabolic disturbances, primarily due to its potent antioxidant properties. While accumulating evidence supports its potential in managing PCOS, the full extent of GEN's therapeutic efficacy in alleviating PCOS-related symptoms remains inadequately defined, warranting further detailed investigation. PURPOSE: This study aims to systematically evaluate the pharmacological efficacy of GEN in the management of PCOS through a meta-analytic synthesis of preclinical data. METHODS: A comprehensive literature search was conducted across six major databases-CNKI, Wanfang Data, VIP, PubMed, and Web of Science-covering publications from database inception until May 2025. The methodological quality of eligible studies was assessed using SYRCLE's risk of bias tool. Data synthesis and meta-analysis were performed using Rev Man 5.3 and Stata 17 software to ensure statistical analysis of the pooled outcomes. RESULTS: A total of ten studies were included in the meta-analysis. Compared to the control group, GEN exhibited significant therapeutic effects in the treatment of PCOS, including a reduction in body weight (P < 0.00001) and ovarian weight (P < 0.00001) in PCOS rats, as well as a reversal of elevated serum levels of T (P = 0.003) and LH (P < 0.00001). GEN also significantly reduced FBG (P = 0.007), INS (P = 0.0006), and HOMA-IR indices (P = 0.01), decreased MDA content (P = 0.0002) in ovarian tissue, and enhanced antioxidant activity, as indicated by increases in TAC (P < 0.00001), SOD (P < 0.00001), and GPx (P = 0.02). Furthermore, GEN lowered serum levels of LDL-C (P < 0.00001). CONCLUSION: GEN demonstrates considerable therapeutic potential in managing PCOS through multiple mechanisms. These include modulation of body and ovarian weight, restoration of endocrine balance by reducing hyperandrogenism and normalizing reproductive hormone profiles, improvement of metabolic parameters through enhanced insulin sensitivity and glycemic control, and attenuation of oxidative stress via increased antioxidant enzyme activity and reduction of lipid peroxidation markers. These findings emphasize GEN's promise as a multifaceted intervention for PCOS, underscoring the need for further translational research to confirm its clinical efficacy.