Role of oral inositol supplementation in women with polycystic ovarian syndrome
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20214648Keywords:
Inositol, Insulin resistance, Myoinositol, PCOSAbstract
Background: PCOS is one of the most common endocrine disorder in women of reproductive age, it affects about 5-10% of women of reproductive age. It is characterized by chronic anovulation, hyperandrogenism, and insulin resistance. 30-40% of PCOS women have impaired glucose tolerance.
Methods: This was prospective observational study carried out on 100 patients of PCOS visiting outpatient Department of Obstetrics and Gynecology, BRD Medical College, Gorakhpur from 1st July 2018 to 30th June 2019. Patients were diagnosed as PCOS on basis of Rotterdam criteria. In these 100 patients, oral inositol 2 gm twice daily was given for 3 months to 6 months depending upon the response of the patient and patients were examined every 4 week for menstrual regularity, acne improvement, hirsutism, spontaneous ovulation and pregnancy.
Results: With inositol supplementation, menstrual abnormality corrected in 80% cases, 45% cases having acne improved. Ovulation occurred in 75.5% cases and 66.6% cases conceived with inositol supplementation.
Conclusions: Insulin resistance is the basic pathophysiology for PCOS hence inositol supplementation is supposed to be very good medicine for management of PCOS to improve insulin sensitivity. Inositol leads to improvement in regularity of menstrual cycle, insulin resistance, hyperandrogenic features like hirsutism, acne, restores ovulation and improves oocyte quality.
References
The Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1):41-7.
Ciampelli M, Fulghesu AM, Cucinelli F, Pavone V, Ronsisvalle E, Guido M, et al. Impact of insulin and body mass index on metabolic and endocrine variables in polycystic ovary syndrome. Metabolism. 1999;48(2):167-72.
Baillargeon JP, Nestler JE. Commentry: polycystic ovary syndrome; a syndrome of ovarian hypersensitivity to insulin ? J Clin Endocrinol Metab. 2006;91:22-4.
Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev. 1997;18.
Kennington AS, Hill CR, Craig J, Bogardusc, Raz I, Ortyer HK, et al. Low urinary chiro-inositol excretion in non-insulin dependent diabetes mellitus. N Engl J Med. 1990;323;373-8.
Asplin I, Galasko G, Larner J. Chiro-inositol deficiency and insulin deficiency .a comparison of the chiro-inositol and the myo-inositol containing insulin mediators isolated from urine, hemodialysate, and muscles of control and type II diabetes subjects. Proc Nat Acad Sci USA. 1993;90:5924-8.
Baillargeon JP, Diamanti-Kandarakis E, Ostlund RE, Apridonidze T, Iuorno MJ, Nestler JE. Altered D-chiro-inositol urinary clearance in women with polycystic ovary syndrome. Diabetes Care. 2006;29(2):300-5.
Croze MI, Soulage CO. Practical role and therapeutic interest of myoinositol in metabolic diseases. Biochimie, 2013;95(10):1811-27.
Bizzarri M, Carlomagno G. Inositol: history of an effective therapy for polycystic ovary syndrome. Eur Rev Med Pharmacol Sci. 2014;18:1896-903.
Carlomagno G, Unfer V. Inositol safety: clinical evidences. Eur Rev Med Pharmacol Sci. 2011;15(8):931-6.
Murlidhara KD, Adhikari PM, Murlidhara DV. Overweight/obesity and metabolic syndrome in women with polycystic ovary syndrome. Indian J Basic Applied Med Res. 2015;4(3):227-36.
Ranwa M, Nagaria T, Jaiswal , Arya A. Study of effect of myoinositol on menstrual irregularities and skin problems in polycystic ovarian syndrome cases. Int J Reprod Contracept Obstet Gynecol l2017;6(6):2310-7.
Spandana JC. A study on the clinical, biochemical and hormonal profile of polycystic ovary syndrome patients attending tertiary care hospital. Int J Reprod Contraception, Obstet Gynecol. 2017;6(5):1987.
Hanna R, Wehbe T, Abou Jaoude E. Metabolic effects of D-chiro-inositol and myo-inositol in polycystic ovary syndrome. Int J Clin Endocrinol Metab. 2017;3(1):029-33.
Genazzani F, Jassoni VN. Myoinositol administration positively affects hyperinsulinemia and hormonal parameters in overweight patients with polycystic ovary syndrome. Gynecol Endocrinol. 2008:24;139-44.
Venturella R, Mocciaro R, De Trana E, D'Alessandro P, Morelli M, Zullo F. Assessment of the modification of the clinical, endocrinal and metabolical profile of patients with PCOS syndrome treated with myo-inositol. Minerva Ginecol. 2012;64(3):239-43.
Le Donne M, Alibrandi A, Giarrusso R, Lo Monaco, Muraca U. Diet, metformin and inositol in overweight and obese women with polycystic ovary syndrome: effects on body composition. Minerva Ginecol. 2012;64(1):23-9.
Minozzi M, Costantino D, Guaraldi C, Unfer V. The effect of a combination therapy with myoinositol and a combined oral contraceptive pill versus a combined oral contraceptive pill alone on metabolic, endocrine and clinical parameters in PCOS. Gynecol Endocrinol. 2011;27(11):920-4.
Zacche MM, Caputo L, Fillipis S, Zacche G, Dindelli M, Ferrari A. Efficacy of myoinositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome. Gynecol Endocrinol. 2009;25:508-13.
Raffone E, Rizzo P, Benedetto V. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. Gynecol Endocrinol. 2010;26(4):275-80.
Regidor PA, Schindler AE. Myoinositol as a safe and alternative approach in the treatment of infertile PCOS women: a German observational study. Int J Endocrinol. 2016;2016.
Papaleo E, Unfer V, Baillargeon JP, De Santis L, Fusi F, Brigante C, et al. Myo-inositol in patients with polycystic ovary syndrome: a novel method for ovulation induction. Gynecol Endocrinol. 2007;23(12):700-3.
Angik R, Jajoo SS, Hariharan C, Chimote A. A comparative study of metabolic and hormonal effects of myoinositol versus metformin in women with polycystic ovary syndrome: a randomised controlled trial. Int J Reprod Contracept Obstet Gynecol. 2015;4(1):189-95.
