Genistein in polycystic ovary syndrome: mechanisms, preclinical evidence, and translational potential.

Polycystic ovary syndrome (PCOS) is a prevalent reproductive-endocrine disorder in reproductive-aged women. Due to the lack of radical cure, multi-target therapeutic strategies are urgently needed. Genistein, a soy-derived phytoestrogen, exhibits pleiotropic biological activities and is a promising adjuvant candidate for PCOS. Accumulating studies suggests that genistein may improves insulin sensitivity, regulates reproductive hormones, promotes follicular development, and alleviates oxidative stress and chronic inflammation, thereby ameliorating PCOS symptoms. This review summarizes the therapeutic effects, molecular mechanisms, preclinical evidence, and clinical translation prospects of genistein in PCOS, providing a theoretical basis for its clinical application. However, significant challenges remain in translating this research into clinical practice. These include the limited availability of data from human clinical trials, the lack of a clearly defined optimal dosage and administration regimen, insufficient evidence regarding long-term safety, and the potential for variations in bioavailability and individual metabolism to impact efficacy. Addressing these limitations is critical for advancing genistein toward future clinical application.