Efficacy of Seed Cycling as an Integrative Therapy for Premenstrual Syndrome and Polycystic Ovary Syndrome in Reproductive-Aged Women: A Systematic Review
Abstract
Premenstrual syndrome (PMS) and polycystic ovary syndrome (PCOS) are common hormonal disorders in reproductive-aged women. Conventional treatments often have side effects, highlighting the need for natural alternatives such as seed cycling, a dietary strategy involving flax, pumpkin, sesame, and sunflower seeds consumed in specific phases of the menstrual cycle. This systematic review evaluated studies from 2015 to 2025 (PubMed, Scopus) on seed cycling or its components in women aged 15-49 years with PMS or PCOS diagnosed using standardized criteria. Eligible designs included randomized controlled trials, cohort, case-control, observational, quasi-experimental, and case series. Non-human studies, reviews, opinion pieces, conference abstracts, and studies outside the age range or before 2015 were excluded. The PRISMA 2020 guidelines were followed, and the Quality Assessment with Diverse Studies Tool assessed risk of bias. Primary outcomes included changes in hormonal markers (e.g., estrogen, progesterone, LH/FSH ratio, testosterone), symptom scores for PMS, and metabolic parameters (e.g., BMI, lipid profile, insulin resistance). Ten studies (n = 635) with low to medium risk of bias reported that seed cycling, particularly flax and sesame seeds, was associated with improved menstrual regularity, reduced PMS symptom severity, favorable modulation of sex hormone levels, and improvements in metabolic profiles. While findings suggest that seed cycling is a low-cost, safe, and…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 635 participants or records.
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