Among the variety of factors that affect the female organism, obesity is of great importance in the formation, development and functioning of the reproductive system, the development of gynecological diseases in which metabolic syndrome plays an important pathogenetic role (polycystic ovary syndrome is diagnosed in 35-60% of obese women; menstrual dysfunction – in 6 times more often, primary infertility – 2 times more). The components of the metabolic syndrome have a significant effect on the body: insulin resistance, hyperinsulinemia, dyslipoproteinemia, elevated levels of thrombosis factors. This article reviews the current scientific literature on the role of sirtuins in the regulatory cellular processes and metabolic cascades, with special emphasis on the possibilities of their pharmacological activation by resveratrol. The role of resveratrol as a promoter of sirtuin activity at different levels of homeostasis disturbance was analyzed, and the properties of resveratrol, its effects and impact on the female body in the presence of metabolic pathology were analyzed in order to prescribe timely treatment and slow down the reproductive aging process.Literature data prove the importance of polyphenols (resveratrol) use as an effective and pathogenetically determined activator of sirtuins for the regulation of oxidative stress, inflammation, correction of dysbiosis and imbalance of the immune system in the concept of treatment of women with gynecological diseases and metabolic disorders. Resveratrol itself has a wide range of pharmacological effects with proven antilipogenic properties and a safe harmonizing estrogen-like effect on various regulatory levels. The natural plant composition and long history of use of resveratrol have repeatedly revealed its clinical achievements, including polycystic ovary syndrome treatment. The high clinical effectiveness and safety profile allow to recommend the inclusion of resveratrol in treatment regimens and to prevent the relapses of metabolically determined gynecological and somatic diseases in women of various age periods.