Natural Products for Polyendocrine Metabolic Ovarian Syndrome: Integrating Traditional Chinese and Western Medicine Perspectives.

Polyendocrine metabolic ovarian syndrome (PMOS), the new consensus nomenclature renamed from polycystic ovary syndrome (PCOS) in 2026 by The Lancet global expert consortium, is a prevalent multisystem endocrine-metabolic disorder affecting reproductive-age women worldwide. The traditional term PCOS is scientifically inaccurate as it misleadingly emphasizes pathological ovarian cysts while ignoring the complex polyendocrine, metabolic, and systemic pathological characteristics of the disease, which also leads to delayed diagnosis and fragmented clinical management. PMOS is characterized by the core pathological vicious cycles of insulin resistance, hyperandrogenism, chronic low-grade inflammation, and oxidative stress, substantially elevating the risk of type 2 diabetes, cardiovascular diseases, and endometrial carcinoma. Mitochondrial dysfunction and gut microbiota dysbiosis play key roles as emerging pathological factors in PMOS. Traditional Chinese medicine (TCM) interprets PMOS pathogenesis as dysfunction of the kidney-tiangui-chong-ren-baogong axis, with spleen deficiency, liver qi stagnation, phlegm-dampness and blood stasis as key syndrome patterns. Natural products, as the core material basis of TCM, possess multi-component and multi-target pharmacological properties, which perfectly fit the complex multisystem pathophysiological attributes of PMOS emphasized in the latest global consensus. This comprehensive review systematically elaborates the dual-pathogenesis of PMOS from Western medicine and TCM perspectives in line with the 2026 Lancet consensus. We further clarify the mechanism by which natural products exert therapeutic effects on PMOS via improving glucose metabolism, regulating lipid homeostasis, and ameliorating hyperandrogenism. This work aims to provide a standardized theoretical reference for basic precision research and clinical translational application of natural products in the management of PMOS.