Objective:

To critically evaluate current evidence on lifestyle-based and adjunct therapeutic strategies in PCOS management, emphasizing their clinical significance and potential impact on patient outcomes.

Key Findings:

• Dietary approaches such as Mediterranean, low-glycemic index, ketogenic, and anti-inflammatory diets improve metabolic parameters and insulin sensitivity, as evidenced by various clinical trials.
• Structured physical activity, including aerobic exercise and mind-body practices, shows beneficial effects on metabolic and hormonal outcomes, supported by systematic reviews.
• Adjunct strategies like nutraceuticals and phytochemicals may modulate insulin signaling and inflammation, with some studies indicating positive outcomes.
• Psychological interventions, particularly mindfulness-based therapy and cognitive behavioral therapy, can alleviate psychosocial burden and improve treatment adherence.
• Cultural systems like Ayurveda and Traditional Chinese Medicine have been explored as supportive approaches, though evidence is still emerging.

Interpretation:

The evidence suggests that lifestyle and adjunct interventions can improve clinical outcomes in PCOS, but the heterogeneity in study design necessitates cautious interpretation and highlights the need for standardized protocols in future research.

Limitations:

• Heterogeneity in study design and quality, particularly among dietary and exercise interventions.
• Need for further high-quality clinical validation to establish the efficacy of adjunct therapies.

Conclusion:

Effective PCOS management requires a balanced, evidence-based approach integrating lifestyle strategies with pharmacological therapies and adjunct interventions, emphasizing the need for personalized treatment plans.