Myoinositol combination with Metformin benefits women with PCOS

Polycystic ovary syndrome (PCOS) has gained more attention as it's a condition in which the ovaries produce an abnormal amount of androgens, male sex hormones that are usually present in women in small amounts. Insulin resistance and hyperinsulinemia is known to play an important role in pathogenesis of PCOS.

Myoinositol (MI) and D-chiro-inositol (DCI) act as second messengers for insulin signalling and exerts a beneficial effect in PCOS as an insulin sensitizers. The researchers aimed to compare the effect of metformin monotherapy versus a combination of metformin with Myoinositol and d-chiro-inositol in PCOS.

A randomized controlled trial conducted over a period of 6 months and published in Clinical Endocrinology journal revealed that addition of myoinositol to metformin was beneficial and exerts additional benefits in improving menstrual cycle regularity, and quality of life in women with PCOS.

The study was a randomized controlled trial conducted over a period of 6 months.All overweight and obese women with PCOS with the age group between 18 and 35 were included and randomized into two groups, 27 in the metformin monotherapy arm and 26 in the myoinositol combination arm. The variables assessed were duration of menstrual cycle, anthropometric parameters, modified Ferriman Gallwey score, global acne score, Fasting insulin, HOMA-IR, fasting lipid profile, serum testosterone, sex hormone binding globulin, luteinizing hormone, follicle stimulating hormone, anti-Mullerian hormone, and pelvic ultrasound to assess ovarian volume, PCOS Questionnaire score. Changes in the parameters from baseline at the end of 6 months of treatment were assessed and compared between the groups.

The key findings of the study are

• Menstrual cycle regularity improved in both groups with significantly greater improvement in the group receiving myoinositol-based therapy (p < .001).

• Pregnancy rate was equal in both the arms. There was a significant improvement in PCOSQ score in myoinositol-based therapy group (p < .001).

• However, there was no statistically significant difference in other hormonal, metabolic parameters between two groups in spite of symptomatic benefits.

Researchers concluded that “The addition of myoinositol to metformin exerts additional benefits in improving menstrual cycle regularity, and quality of life in women with PCOS.”

Reference: Nazirudeen R, Sridhar S, Priyanka R, Sumathi B, Natarajan V, Subbiah E, Raghavan KS, Sangumani J. A randomized controlled trial comparing myoinositol with metformin versus metformin monotherapy in polycystic ovary syndrome. Clin Endocrinol (Oxf). 2023 Aug;99(2):198-205. doi: 10.1111/cen.14931. Epub 2023 Jun 2. PMID: 37265016.