# Soy Isoflavones and PCOS: Role in Hormonal and Metabolic Mechanisms
## 5 Limitations and Future Research
\begin{table}
\begin{tabular}{c c c c c c} \hline
**Authors, Year** & **Study Design, Duration** & **Characteristics of the Study Group** & **Intervention/Aim of the Study** & **Main Results** & **Conclusions** \\ \hline \multirow{8}{*}{[PERSON] et al., 2022 [185]} & & 36 female Sprague & & Co-administration of soy isoflav and \(B\). & _Bacillus coagulans_ \\  & & Dawley rats divided & & _coagulants_ improved hormonal balance (\(\downarrow\) & enhanced the bioavailability and \\  & & into 6 groups & & & \\  & & (\(n=6\)/each): & To evaluate the & LH, \(\downarrow\) testosterone, \(\uparrow\) & isoflav in the \\  & & (1) Control group & effect of _Bacillus_ & FSH, \(\uparrow\) progesterone), & treatment of PCOS \\  & & (2) Letrozole & _coagulants_ on the reduced oxidative & in rats. Combined \\  & & (1 mg/kg) & bioavailability and stress (\(\downarrow\) MDA), and & therapy improved ovarian & hormonal balance, \\  & Experimental & (3) Letrozole + soy & bioactivity of soy & improved ovarian & metabolic \\  & animal study, & isoflavones & isoflavones & morphology and & parameters \\  & 14-day treatment & (100 mg/kg) & (genistein and & & \\  & after 21-day & (4) Letrozole + soy & daídazie) and their & Additionally: \(\downarrow\) BMI, \(\downarrow\) & (glucose and lipid \\  & PCOS induction. & _coagulants_ = \(B\). & therapeutic & fasting glucose, \(\downarrow\) total & profile), and \\  & & _coagulants_ (0.65 mg/kg) & potential in & cholesterol, \(\downarrow\) & ovarian function, \\  & & (5) Letrozole + soy & treating PCOS & triglycerides, \(\downarrow\) LDL, & suggesting \\  & & isoflavones + \(B\). & induced by & and \(\uparrow\) HDL. The & potential for use in \\  & & _coagulans_ (3.25 mg/kg) & letrozole in rats. & highest dose & managing \\  & & (6) Letrozole + soy & & (6.5 mg/kg) of \(B\). & PCOS-related \\  & & isoflavones + \(B\). & _coagulants_ showed the & symptoms and \\  & _coagulans_ (6.5 mg/kg). & most pronounced & metabolic \\  & & & effects. & disturbances. \\ \hline \end{tabular}
\end{table} 
Table 6: _Cont._significantly stronger when isoflavnes were administered alongside resistant starch or a probiotic (Bacillus coagulants) [184; 185]. The results of the scientific studies conducted to date demonstrate the complex and individualised mechanisms of action of soy isoflav in PCOS. In addition, the ability of the organism to convert daidzein to equal is an individual issue that may significantly affect clinical efficacy. Further well-designed studies involving women with PCOS that take into account the role of the gut microbiota are needed in order to formulate specific clinical and nutritional recommendations (which are currently lacking in the context of PCOS), indicating the necessary duration of intervention, form of administration, and dose. In particular, the limited size of clinical trials, their often short duration, and the predominance of preclinical studies, especially in animal models, significantly limit the ability to formulate clear conclusions and apply them in clinical practice. In addition, animal studies are based on pharmacologically induced models of PCOS, which do not fully reflect the complex and heterogeneous nature of this disease in women. In fact, the course of PCOS can vary considerably depending on the individual predisposition and the still incompletely understood aetiology of the condition. Another major limitation is the wide variety of isoflavne preparations used, in terms of composition, dose, form, and route of administration. The lack of standardisation of preparations makes direct comparison of study results difficult. In addition, the heterogeneity of the pathophysiological mechanisms of PCOS, which are related to the diversity of clinical phenotypes among other things, may significantly affect the differential response to soy isoflavne supplementation. This highlights the importance of tailoring the therapeutic approach.