Abstract
Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly known as polycystic ovary syndrome, is a common endocrine and metabolic disorder affecting women of reproductive age, characterized by hyperandrogenism, ovulatory dysfunction, and insulin resistance. Despite its high prevalence, its pathophysiology remains incompletely understood, and current therapies are largely symptomatic. Increasing evidence implicates mitochondrial dysfunction, oxidative stress, and chronic low-grade inflammation in disease development. In this context, L-carnitine, a key regulator of mitochondrial fatty acid transport and energy metabolism, has emerged as a potential adjunctive therapeutic agent.
This narrative review summarizes current evidence on the role of L-carnitine and its derivatives in PMOS, integrating findings from randomized controlled trials, observational studies, systematic reviews, and preclinical models. Available data suggest that L-carnitine supplementation may improve metabolic parameters, including insulin resistance and lipid profiles, while exerting antioxidant and anti-inflammatory effects in ovarian tissue. However, evidence regarding endocrine and fertility outcomes remains inconsistent.
Although preclinical studies strongly support biological plausibility, clinical evidence is limited by heterogeneity in study design, small sample sizes, and reliance on surrogate endpoints. L-carnitine should therefore be considered a promising adjunct rather than a standard treatment for PMOS. Further large-scale randomized controlled trials are required to define optimal dosing, formulation, and patient subgroups most likely to benefit.