Pre Clinical and Clinical Evaluation of Vitamin E Add on Therapy with Fourth Generation Combined Oral Contraceptive Pill against Polycystic Ovarian Syndrome

Abstract

Polycystic ovarian syndrome (PCOS) is a multifaceted endocrine disorder newlinethat affects women of reproductive age with manifestations extending beyond the newlinereproductive system. This exhibits a wide array of complex pathophysiology and newlinediagnostic complexities posing significant challenges and sparking extensive scientific newlinediscussions. PCOS impacts a significant proportion of women ranging from 5% to 18% newlineand represents a condition affecting reproductive, metabolic and psychological aspects newlinethroughout a women s life. newlineElevated androgen levels, insulin resistance (IR), and adiposity-related newlinemechanisms contribute to its development with a wide cluster of symptoms including newlinemenstrual cycles without ovulation, excessive hair growth (hirsutism), acne, and weight newlinegain, which increase their susceptibility to a range of health concerns like lipid newlineabnormalities, hypertension, sleep disorders, diabetes, mood disorders, and metabolic newlinesyndrome. PCOS is widely considered a multifaceted condition affected by various newlinegenetic factors, epigenetic alterations, and environmental elements such as dietary newlinepatterns, physical activity, and lifestyle choices. The aim of this study is to assess the newlineeffect of fourth generation combined oral contraceptive (COC), drospirenone and newlinevitamin E and exploring its possible mechanisms by network pharmacology, in-silico newlinemolecular docking, preclinical studies (hormonal model and circadian model) and newlineclinical study in PCOS women and adolescent newline