The Role of Antioxidants in the Management of Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine-metabolic disorder characterized by endocrine disruption, insulin resistance, hyperandrogenism, and chronic low-grade inflammation, in which oxidative stress has been proposed as a mechanistic link between metabolic and reproductive dysfunction. This narrative review summarizes current evidence on redox-related mechanisms and evaluates dietary and supplemental antioxidants in PCOS. Clinical trials, systematic reviews, and mechanistic studies were examined to assess antioxidant classification, signaling pathways, and outcomes related to metabolic, endocrine, reproductive, and oxidative stress parameters. Antioxidant interventions frequently modify circulating redox biomarkers and may improve selected metabolic indices; however, consistent effects on hormonal regulation, ovulation, and long-term clinical outcomes remain limited and heterogeneous. Differences in study design, antioxidant formulation and dosage, baseline metabolic status, and outcome selection complicate interpretation, while emerging evidence suggests modulation by lifestyle factors and gut microbiota-related mechanisms. Overall, antioxidants appear to act primarily through modulation of endogenous redox regulation rather than direct reactive oxygen species scavenging and are best considered adjuncts to lifestyle-based management. Further phenotype-informed and longitudinal studies using clinically relevant endpoints are required to clarify therapeutic relevance in PCOS.