Effects of Inositol(s) in Women with PCOS: A Systematic Review of Randomized Controlled Trials

Abstract

Polycystic ovary syndrome (PCOS) is a common endocrine disorder, with complex etiology and pathophysiology, which remains poorly understood. It affects about 5–10% of women of reproductive age who typically suffer from obesity, hyperandrogenism, ovarian dysfunction, and menstrual irregularity. Indeed, PCOS is the most common cause of anovulatory infertility in industrialized nations, and it is associated with insulin resistance, type 2 diabetes mellitus, and increased cardiovascular risk. Although insulin resistance is not included as a criterion for diagnosis, it is a critical pathological condition of PCOS. The purpose of this systematic review is the analysis of recent randomized clinical trials of inositol(s) in PCOS, in particular myo- and D-chiro-inositol, in order to better elucidate their physiological involvement in PCOS and potential therapeutic use, alone and in conjunction with assisted reproductive technologies, in the clinical treatment of women with PCOS.

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“…The improvement in the lipid profile observed at the end of 24 weeks was as follows; with myo-inositol, triglycerides decreased by 15. 14,15 In about 50% of patients with PCOS, insulin receptor phosphorylation is impaired. Several trials showed that insulin sensitizer agents, such as metformin and MI, are the first-line treatment to restore normal menstrual cycles in women suffering from PCOS [16][17][18] suggesting that an endocellular defect of the precursor of IPG such as MI and/or DCI might trigger the compensatory hyperinsulinemia in most PCOS subjects.…”

Pre-treatment effect of myo-inositol and l-5, methyltetrahydrofolate in ovulation induction oocyte quality and pregnancy outcome in clomiphene resistance polycystic ovarian disease

“…19,20 In about 50% of patients with PCOS, insulin receptor phosphorylation is impaired. Several trials showed that insulin sensitizer agents, such as metformin and Myoinositol, are the first-line treatment to restore normal menstrual cycles in women suffering from PCOS.…”

Polycystic Ovary Syndrome: Features, Diagnostic Criteria and Treatments

“…The hypothesis of the presence of a defect in the transduction signal of insulin has focused attention on the function of the second messengers of insulin signals, such as IPG (inositol fosfo glycans). In particular, studies show that a deficiency of myo-inositol can underlie, besides a non-insulin response, also a reduced answer to ovarian FSH, being the myo-inositol the second hormone messenger predisposed to follicular growth [89,90]. Insulin acts as a real gonadotropic hormone in the ovary.…”