Preclinical evaluation of kamal petals (Nelumbo nucifera) on letrozole-induced polycystic ovarian syndrome: An Ayurvedic and experimental correlation

Objective Polycystic Ovarian Syndrome (PCOS) is a complex endocrine and metabolic disorder that causes menstrual irregularities, anovulation, and infertility. In Ayurvedic terms, it is linked to Artavakshaya and Yonivyapad, caused by an imbalance of Kapha and Vata. Allopathic treatments provide short-term relief but often result in undesirable side effects. Therefore, herbal remedies offer a safer and holistic alternative. This study evaluates the therapeutic effectiveness of ethanol extract of petals of Nelumbo nucifera in managing letrozole-induced PCOS in female Wistar rats. Methods The ethanolic extract of Nelumbo nucifera petals was characterized through physicochemical analysis, preliminary phytochemical screening, and HPLC to identify major phytoconstituents. PCOS was induced by oral administration of letrozole (1 mg/kg) for 21 days, followed by treatment with a standard drug Clomiphene citrate (1 mg/kg) and Nelumbo nucifera ethanolic extract at doses of 200 and 400 mg/kg for 14 days. Results Treatment resulted in a significant (∗∗∗∗ P < 0.0001) decrease in serum testosterone [(60.20 ± 3.35) to (31.61 ± 2.80) ng/mL], total cholesterol [(115.10 ± 2.99) to (63.76 ± 3.05) mg/dL], triglycerides [(132.85 ± 2.52) to (74.16 ± 3.81) mg/dL], and low density lipoprotein levels [(78.01 ± 1.73) to (33.09 ± 1.68) mg/dL], along with increased levels of estradiol [(7.47 ± 0.87) to (27.63 ± 1.55) pg/mL], follicle stimulating hormone [(10.17 ± 1.99) to (23.36 ± 0.94) IU/L], and high density lipoprotein [(16.08 ± 1.88) to (36.41 ± 2.69) mg/dL]. Histopathological examination revealed the restoration of normal ovarian follicular structure with reduced cystic degeneration, especially in the high-dose group. Conclusion The Nelumbo nucifera ethanolic extract exhibits strong anti-androgenic and antioxidant properties, aiding in the hormonal and metabolic balance restoration in PCOS. Vaginal smear staging and Ovarian histopathology provided qualitative support for the functional endpoint. Phytoconstituents such as quercetin act by modulating ovarian function and lipid metabolism, supporting its use as part of a holistic phytotherapeutic approach for managing PCOS.