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Presl), rich in terpenoids and glycosides, improves insulin sensitivity, regulates menstrual cycles, and modulates glucose metabolism ( Berberis aristata Lindl.) provides berberine, which lowers leptin levels, improves insulin resistance, reduces oxidative stress, and supports lipid metabolism ( Vitex agnus-castus L.) contains agnuside and flavonoids that restore menstrual regularity and enhance fertility outcomes by modulating prolactin and estrogen balance ( Curcuma longa L.), which contains curcumin, luteolin, and apigenin, lowers androgen levels, increases estrogen, and provides strong antioxidant and anti-inflammatory effects ( Urtica dioica L.) supplies flavonoids, polyphenols, and sterols that reduce hirsutism, regulate inflammatory markers, and exert antioxidant activity ( Mentha sp icata L.), fenugreek ( Trigonella foenum-graecum L.), parsley ( Petroselinum crispum (Mill.) Nym.), green tea ( Camellia sinensis (L.) Kuntze), ginger ( Zingiber officinale Roscoe), licorice ( Glycyrrhiza glabra L.), black seed ( Nigella sativa L.), pomegranate ( Punica granatum L.), and raspberry ( Rubus idaeus L.) have also been documented to exert diverse benefits including anti-androgenic effects, improved ovarian function, enhanced insulin sensitivity, reduced ovarian volume, lipid metabolism regulation, and restoration of endocrine balance ( Table 2 Herbs/botanicals, natural bio-actives, and their pharmacodynamic action in PCOS management
The analgesic effect of BTX-A has been investigated through a series of open-labeled studies as well as a few randomized controlled trials (RCTs), with an increasingly strong evidence that botulinum toxin injections are efficacious, thus placing it as a treatment option either before surgery or for those with intractable trigeminal neuralgia and unwilling to undergo surgery, however, a more placebo-controlled clinical trials are still needed to confirm these findings
