Nutraceutical Intervention of Seeds in the Treatment of Poly Cystic Ovarian Syndrome; A Systematic Review: Nutraceutical Intervention; Seed Cycling

Abstract

In poly cystic ovary syndrome multiple cysts formation occurs in female ovaries. It is highly prevalent in developing countries like Pakistan and India. Its symptoms include irregular menstrual cycle, abnormal hair growth pattern, acne and mood swings. This disease is also associated with imbalance in androgen levels (which include testosterone and estrogen) and high insulin levels also called hyperinsulinemia. It also contributes in the development of type 2 diabetes, heart disease and cancers. Seed cycling is a modern method used in alternate medicine of treating PCOS by using different seeds in the different stages of menstrual cycle. In this review article we will find out how seed cycling is effective in the treatment of PCOS. Flax, sesame, pumpkin and sunflower seed combinations are being used at different stages of female menstrual cycle. Flaxseeds contain lignans, omega 3 fatty acids and fibre which help in relieving the symptoms of polycystic ovaries. Sesame and sunflower seeds contain high number of fatty acids and lignans which helps in balancing hormonal disturbances in female. Losing weight by having diet rich in fibre improve the level of cholesterol and it is also beneficial decreasing the level of insulin resistance, which if not treated can progressed into type 2 diabetes mellitus and its complications. Herbal medicine in Ayurveda has shown promising effects in relieving pre- menstrual symptoms, hormonal fluctuations and the co-morbidities.

Full text

A B S T R A C T
1. Poly Cystic Ovarian Syndrome (PCOS) is characterized by multiple cysts formation in female
ovaries. It is highly prevalent in developing countries like Pakistan and India. Its symptoms
include irregular menstrual cycle, abnormal hair growth pattern, acne and mood swings. This
disease is also associated with imbalance in androgen levels (which include testosterone
and estrogen) and high insulin levels also called hyperinsulinemia. It also contributes in the
development of type 2 diabetes, heart disease and cancers. Seed cycling is a modern
method used in alternate medicine of treating PCOS by using different seeds in the different
stages of menstrual cycle. Objective: In this review article we will nd out how seed cycling is
effective in the treatment of PCOS. Flax, sesame, pumpkin and sunower seed combinations
are being used at different stages of female menstrual cycle. Methods: Literature was
searched t hrough online da tabase s such as P ubMed, Goo glesch olar, Sci-Hub and
others.Results: Flaxseeds contain lignans, omega 3 fatty acids and bre which help in
relieving the symptoms of polycystic ovaries. Sesame and sunower seeds contain high
number of fatty acids and lignans which helps in balancing hormonal disturbances in female.
Losing weight by having diet rich in bre improve the level of cholesterol and it is also
benecial decreasing the level of insulin resistance, which if not treated can progressed into
type 2 diabetes mellitus and its complications. Conclusions: Herbal medicine in Ayurveda
has shown promising effects in relieving pre- menstrual symptoms, hormonal uctuations
Polycystic ovarian syndrome (PCOS) is most common in
women of childbearing age [1]. 52% Pakistani women are
suffering from PCOS that is comparatively higher than UK
percentage of women i.e. 20 -25%. Environmental, genetic
factors and inter marriages are the underlying causes [2,3].
In women PCOS is a reproductive disorder associated with
high androgen levels, hypersensitivity and chronic ovarian
di sea se [1]. The herbal name of axse ed seeds is
Linumusitatissimum [4,5] and Family is Linaceae. It is
benecial in decreasing BMI, insulin levels, total serum
testosterone level, [3,6] best herb for treating PCOS. These
are additionally called linseeds, and are thought of the most
useful thick seeds [6]. Because of the presence of
antioxidants like lignans and omega-3 unsaturated fats,
axseeds help in bringing down cholesterol levels in the body
viably [5]. As a result, the danger of getting heat infections
goes down to a least. Flaxseeds additionally end up
lessening circulatory strain while additionally forestalling
the development of harmful tumors in the body [5,7].
Sesame seeds, also called Sesamum indicum, contain
supplements valuable for PCOS patients. Its solid fats help to
balance blood glucose levels [7]. It additionally contains
minerals like calcium, magnesium, and zinc. They have
numerous medical advantages, for example, forestalling
diabetes, lessening danger of malignant growth, shielding
DNA from radiation harm, lessening indications of maturing,
encouraging digestion, boosting oral wellbeing, and bringing
down the danger of cardiovascular illness [6]. Seed cycling is
natural and newly trending way that aims to improve the
production and levels of hormones like estrogen and
progesterone by eating ax and pumpkin seeds into rst half
of the menstrual cycle and sunower and sesame seeds in
the second half [8].
The lignan present in ax seed [5] and pumpkin seed helps in
detoxify the excess estrogen in follicular phase. And the zinc
and selenium present in sesame seeds and sunower seeds
I N T R O D U C T I O N
https://www.pakistanbmj.com/journal/index.php/pbmj/index
Volume 4, Issue 2 (July-Dec 2021)
Aslam M et al.,
D O I: h  p s :/ / d o i. o rg / 1 0 . 5 4 3 9 3 /p b m j .v 4 i2 . 9 9DOI: https://doi.org/10.54393/pbmj.v4i2.100
*Corresponding Author:
Maria Aslam, University Institute of Diet and
Nutritional Sciences, The University of
Lahore , Lahore, Pakistan.
maria.aslam@ahs.uol.edu.pk
Systematic Review
Nutraceutical Intervention of Seeds in the Treatment of Poly Cystic Ovarian Syndrome
1*, 1 1 1
Maria Aslam Rameesha Shauket, Zoha Yousaf and Kinza Tehzeeb
1University Institute of Diet and Nutritional Sciences, The University of Lahore , Lahore, Pakistan.
PBMJ VOL.5 Issue 1 Jan-Jun 2022PBMJ VOL.4 Issue 2 July-Dec 2021
Nutraceutical Intervention; Seed Cycling
Keywords:
Poly cystic ovarian syndrome, seed therapy, holistic
medicine, axseed, sesame seed, pumpkin seed
and sunower seed
How to Cite:
Aslam, M., Shauket, R ., Yousaf, Z., & Tehzeeb, K. .
(2021). Nutraceutical Intervention of Seeds in the
Treatment of Poly Cystic Ovarian Syndrome; A
Systematic Review: Nutraceutical Intervention;
Seed Cycling. Pakistan BioMedical Journal, 4(2).
https://doi.org/10.54393/pbmj.v4i2.100

PBMJ VOL.5 Issue 1 Jan-Jun 2022PBMJ VOL.4 Issue 2 July-Dec 2021
help in increase the production of progesterone in luteal
phase [9]. Follicular phase and luteal phase both are the
phases [10] of menstruation. In follicular phase eat 1-2
tablespoons each of raw, fresh ground axseeds and
pumpkin seeds till ovulation (Day 1-15) [11]. Now from
ovulation till luteal phase (Days 15-28) eat 1-2 tablespoons
each of raw, fresh ground sunower and sesame seeds. On
the off chance that you ovulate at an alternate time in your
cycle, at that point switch the seeds in like manner. In the
event that your period comes consistently at an alternate
time (e.g., 26 days rather than 28) at that point switch the
seeds in like manner [12].
The hormone estrogen is considered to be the causal factor
of PCOS [13]. Flaxseed extract in the amount of 500mg per
day increase the level of serum estradiol in immature female
rats [14]. In breast cancer lignans of axseed showed ant
estrogenic effect. In breast cancer, the hormones are
uctuated as in the condition of oligo menorrhea [15].
Secoisolariciresinoldi glycoside (SDG) is the main lignan in
axseed which will be converted into weaker form of
estrogen by the action of gut bacteria and have ant
estrogenic effect [16]. Pharmacological interventions
include anti -and rogens (spironolactone, utamide),
hypoglycemic agents (metformin and thiazolidinedione) and
estrogen-progestogen conversion (oral contraceptives).
The effects of the most useful parts of these ingredients
differ from the irregular men strual syste m and are
associated with various gastrointestinal symptoms, but
weight gain increases insulin resistance [17]. Women
studies have shown that overweight women with PCOS are
obese especially in the lower abdomen. 100 women with
infertile PCOS who received a combination of 100,000 IU of
vitamins and 1,500 mg of metformin per day for 6 months
signicantly reduced their body mass index (BMI) [18].
Nutraceutical Intervention of Seeds:
Flax Seeds:
Flax plants are ancient plants of the world. Flaxseed is a
deliciou s foo d [ 13]. I t is m ainl y grown i n west o f
Mediterranean to India [19]. Seeds and oils were used in
herbal medicine for treating inammation, cold, respiratory
diseases, muscle pain, abdominal pain by masses. 7
They are also used as supplement in hormone replacement
therapy. Hence ax seeds, oils and bers are very benecial
for the humans [20]. Flax seeds are rich in ber [13]. This is
especially true if the soil is rich in nutrients especially
nitrogenous matter. The seeds are also rich source of
phytoestrogens called lignano [7]. A diet rich in ber and
lignins is also recommended for patients [21]. Addition of
axseed in the diet will help to get rid of toxins present in the
body [22]. A new clinical study from Duke University showed
that daily axseed supplementation (30g powder per day)
could lower testosterone levels by up to 80% of PCOS
patients [23].
And axseed help is to tenderness in breasts (premenstrual
syndrome is a symptom) that can occur after ovulation.
Flaxseed lignan affects the activity of enzymes responsible
for estrogen production (such as aromatase), allowing the
heart to be controlled by circulating sex hormones and
metabolites [24]. Phytoestrogens bind to their receptors
especially 17-β estradiol receptors and then shows there
main anti-diabetic and hypoglycemic effects [19]. Linolenic
acid works by effecting protein kinase A and cyclic
monophosphate adenosine functions which in turn maintain
beta pancreatic cells and insulin secretion [25]. Nowadays
main cause of infertility is PCOS. Flax seeds help in reducing
weight by delaying gastric emptying, creating feeling of
fullness [26]. AL A works by suppressing appetite and
promoting apoptosis of adipocyte. It mainly helps in
reducing BMI and weight [27]. On the other hand, lignans are
suggested to have chemo preventive properties in cancer
For this systematic review, articles were being collected
from Nov 2020, to March 2021. In this rigorous process we
made library of 140 articles out of which we selected 111.
Various keywords were used to make browsing ecient and
wholesome like poly cystic ovary syndrome, axseed,
sesame seed, sunower seed, pumpkin seed and oligo
menorrhea etc. The researches from the last decade i.e.,
from the year 2010 to 2020 were included (Table 1, Figure 1).
Included keywords were (axseeds, sunower seeds, PCOS,
Seed Cycling, phases of Menstrual cycle, Follicular phase
and Luteal Phase) for the researches. The focus was
minimum on review articles and maximum on clinical trials in
inclusion criteria. Valid research engines for the collection
of data were used. The researches before 2010 were not
included. Irrelevant researches were excluded.
M E T H O D S
Identication
Records identied from*:
Databases (n = 253)
Other Sources (n= 0)
Records removed before
screening:
Duplicate records
removed (n =133)
Screening
Records screened
(n = 133)
Records excluded(non-
systematic review)
(n =10)
Reports assessed for
eligibility
(n =123)
Reports excluded:
Reason (Duplicates, n =3)
Reason (Non-Systematic
review, n =3)
Studies included in
Quantitative synthesis
(n =112)
Included
Studies included in
quantitative synthesis
(meta-analysis)
(n =112)
Figure 1: Consort Diagram
Aslam M et al.,
D O I: h  p s :/ / d o i. o rg / 1 0 . 5 4 3 9 3 /p b m j .v 4 i2 . 9 9DOI: https://doi.org/10.54393/pbmj.v4i2.100
Nutraceutical Intervention; Seed Cycling

PBMJ VOL.5 Issue 1 Jan-Jun 2022PBMJ VOL.4 Issue 2 July-Dec 2021
C O N C L U S I O N S
R E F E R E N C E S
Nasiadek M, Stragierowicz J, Klimczak M, Kilanowicz
A. The Role of Zinc in Selected Female Reproductive
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Physicians Surg Pak 6, 2015. (accessed 2015, Jan).
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[21]. SDG is emerging as a potential ant carcinogenic agent.
SDG is thought to be possibly effective in reducing breast
tumor [28].
Pumpkin Seeds:
Pumpkin (Cucurbita) belongs to the family Cucurbitaceae
generally grown in the different regions of the globe as a fruit
vegetable [29]. Pumpkin is the one of the most famous plant
which is used as the cure of many disorders due to the
presence of many components and phytochemicals [30].
Pumpkin seeds oil accommodates rich vitamin E such as -α
tocopherol and -tocopherol that shows the positive health γ
effects [31]. Its oil has demonstrated to suppress high
percentage of the phytoestrogens and sterols such as
secoisolariciresinol and lariciresinol [32]. Pumpkin seeds
contain the healthy omega-3 fatty acids that can help out to
manage the high cholesterol and high insulin levels seen in
PCOS treatment. They also contain beta-sitosterol that can
remove unwanted androgens and treat the hirsutism, acne
and weight gain symptoms of PCOS [33]. They help your body
to waste the extra estrogen that can be out of the balance
during follicular phase of your cycle. The lignans in these
seeds, bind to excess estrogen in your body and help to
eliminate it [34]. Additionally, high levels of zinc in the
pumpkin seeds prevent the excess of estrogen from
converting to the harmful forms of testosterone, as well as
prime your body for progesterone production in the luteal
phas e o f yo ur c ycle [3 5]. So me w ome n m ay fee l
symptomatic relief and notice hormone levels balancing
within the rst month, while others may take 3 to 4 months
before they observe any improvements. The therapy is
based on slow and steady strategy [36].
Sesame Seeds:
Sesame seeds are wealthy in dietary ber, protein, nutrient
B, copper, manganese, calcium, and magnesium [6]. They
hav e numerous m edical ad vantage s , fo r example,
forestalling diabetes, shielding DNA from radiation harm,
diminishin g indic a t ions of m aturin g , encou raging
processing, boosting oral wellbeing, and bringing down the
danger of cardiovascular infection [37]. Nutrients A, D, E, C,
B6 and minerals like zinc, selenium are the supplement
proles which are vital for creating insusceptibility in human
body [6]. Dark sesame has been shown to play a role in the
inhibition of myocardial remodeling and prevent the
occurrence and development of atherosclerosis, total
cholesterol (TC), low density lipoprotein (LDL) levels, and
blood lipids [26]. It also helps in lowering the antioxidant
stress that damage healthy cells and cause inammation
[38]. Lipid imbalance, CVDs and bone resorption are some of
the late complications of PCOS that can potentially
beneted from sesame [39]. Sesame seeds are low in
carbohydrates. Therefore, these seeds are very easy to
manage insulin levels and hormonal disorders [40]. Sesame
seed also help in relieves constipation. Sesame seeds
improve the clearing time every week [41]. Likewise, sesame
seeds may incorporate a lot of laments and the ber may be
encouraging the quantity of stool [37]. In a 2020 study, fty-
four albino rats were fed on 10 percent axseed oil and 10
percent sesame oil in their diet collectively. The results
concluded marked improvements in decreasing rats' weight,
improving lipid prole and decreasing subcutaneous fat
[42]. Sesame seeds are stacked with lignans that encourage
cell reinforcement action in our body and help in better
ingestion of lipolysis. Sesame seeds help in curing PCOS
[43]. The herbal extract of sesame helped in regulating the
blood glucose level and also help in weight loss [7].
Seed Name
Flax seed [44-46]
Flaxseed oil [47,48]
Flaxseed Oil [49,50]
Flaxseed and spearmint
combination extract [51]
Sesame seed [52-54]
Sesame seed oil [55]
Pumpkin and axseed
mixture [56]
Pumpkin seed [57-59]
Pumpkin seed oil [60]
Sunower and sesame
seeds [61]
Mixture of pumpkin,
sunower and chia [42]
Decreases menopausal symptoms, Increased
quality of life
Increase in the level of estrogen, progesterone
and calcium. May alter the level of these
endogenous sex hormones.
60 mg per day of 7-hydroxymatarezinol balance
the level of estrogen. Improves levels of sex
hormones, insulin, dylipidimia and BMI
Improved levels of dehydroepiandrosterone,
estrogen, progesterone and testosterone
Effective alternative to initiate menses and
control heavy bleeding cycles, dysmonnorhea,
lowers BMI
Inhibition of testosterone and restoration of folli
cular development in ovarian tissue. Decreases
hirsutism
Boost in MUFA and PUFA, anti-atherosclerotic
activity
Reduce hot ashes, joint pain and headaches,
improve HDL cholesterol levels, anti- oxidative
Hypoglycemic effect
Balance the progesterone and estrogen in the
body
Decreased levels of testosterone, LDL,
triglycerides, insulin and body mass
Research Finding
Table 1: Literature Review of Included Studies.
The studies reinforce that the dietary intervention of seeds
at different stages of menstrual cycle can play a pivotal role
in diminishing the symptoms of polycystic ovary syndrome.
The nutraceutical elements present in the seeds can greatly
balance the levels of hormones and reduce weight. Further
researches on it will help to strengthen the current
knowledge.
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D O I: h  p s :/ / d o i. o rg / 1 0 . 5 4 3 9 3 /p b m j .v 4 i2 . 9 9DOI: https://doi.org/10.54393/pbmj.v4i2.100
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Nutraceutical Intervention; Seed Cycling

Work HDSC. Seed Cycling for Hormonal Balance We
may not realize it, but our bodies , minds , and
emotional states are incredibly sensitive to the
elements around us, and our hormone levels tend to
uctuate and change in response. Using seed cycling
to balance hormones is a natural and inexpensive
alternative to using drugs, supplements, or herbal
remedies, which can result in more balanced hormone
levels and boost fertility in women. What is seed
cycling?
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