Authors:
Saghar Salehpour, Sedigheh Hosseini and Zahra Zarisfi
Abstract
Polycystic ovary syndrome (PCOS) is a prevalent and complex endocrine disorder that affects women of reproductive age. It is primarily characterized by metabolic disturbances, notably insulin resistance (IR), hyperandrogenism, and ovulatory dysfunction, often leading to menstrual irregularities and fertility challenges.
Myoinositol (MI), a naturally occurring carbocyclic sugar alcohol, has gained significant attention as a promising therapeutic agent for PCOS due to its crucial role as a second messenger in insulin signal transduction. This chapter reviews the current understanding of PCOS pathophysiology and explores the multifaceted applications
of myoinositol in its management. Evidence from numerous randomized controlled trials and meta-analyses suggests that MI supplementation can improve insulin sensitivity, reduce hyperinsulinemia, ameliorate hormonal imbalances by lowering androgen levels and normalizing the luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratio, restore menstrual regularity, and enhance oocyte quality and reproductive outcomes. Comparisons with metformin indicate comparable efficacy for several parameters, often with a superior tolerability profile for MI. Furthermore,
combination therapies, particularly MI with D-chiro-inositol in a physiological ratio (e.g., 40:1), and MI with other agents like alpha-lactalbumin or folic acid, are discussed for their potential synergistic effects. While clinical guidelines are increasingly recognizing MI as a viable option, particularly for improving menstrual cycles
and as an alternative to metformin, a clear understanding of the evidence, patient preferences, and the need for further high-quality research remains paramount for individualized patient care.
