Inositols in PCOS

Many females don’t know this but: “As per the World Health Organisation (WHO) 8–13% of women worldwide who are of reproductive age are diagnosed with Polycystic Ovarian Syndrome (PCOS), and up to 70% of these women go undiagnosed.” Isn’t it concerning? Do you have PCOS or do you know someone who has PCOS? If yes, this blog is for you!

In this article, we’ll discuss the role of inositol supplementation in PCOS management. We understand and respect the sensitivity of the topic, therefore we have used scientific research studies to showcase its influence for the reader.

Introduction to PCOS

PCOS is a hormonal disorder in women which is characterized by:

Insulin resistance,
Irregular periods,
Excess levels of male hormones and
Ovarian cysts.

What exactly happens in PCOS?

Even today, the root cause of this health condition is unclear. Insulin resistance is the key problem of PCOS. We all know that insulin is a type of hormone which helps in managing blood glucose levels. In PCOS, the body struggles with using insulin effectively as the body cells don’t respond to insulin leading insulin resistance. As a result, the body produces more insulin to manage the blood glucose levels. But despite the increased levels of insulin, due to insulin resistance the blood glucose keeps building up in the blood, leading to various metabolic health issues over time, for example, type 2 diabetes.

On the other hand, the increased levels of insulin stimulates the ovaries to produce more male hormones i.e., androgens, leading to a condition known as hyperandrogenism. It causes problems like hirsutism (excessive hair growth on face, back, and chest), acne, male pattern hair loss, irregular menstrual cycles and the failure to ovulate, which are common in PCOS.

PCOS also involves complex changes in brain hormones that affect the ovaries which leads to higher levels of another hormone, LH (Luteinizing Hormone). This alters the balance between (LH) and Follicular Stimulating Hormone (FSH). This imbalance is another key feature of PCOS.

Moreover, many times there are also some psychological indications like depression and anxiety that go unnoticed. Obesity makes insulin resistance and other related metabolic problems worse in PCOS patients. Ultimately, PCOS is an incurable chronic condition. However, its symptoms can be controlled with the right medication, lifestyle modifications, and some fertility treatments.

The patients can try personalized fitness and nutrition coaching to treat their PCOS symptoms. It can improve the overall health and reduce the PCOS signs.

What is Inositol?

Inositols, particularly myo-inositol (MI) and D-chiroinositol (DCI), are the substances which are naturally synthesized in the body. They can also be obtained easily from various foods such as beans, grains, fruits, vegetables and nuts. MI and DCI are essential for ovaries where the eggs develop.

They help manage insulin sensitivity, which is crucial for managing the glucose levels in the body. They are also important for the functioning of various hormones such as Follicle Stimulating Hormone (FSH), estrogen, androgen, etc.

The balance between MI and DCI is crucial for normal ovarian function. However, in women with PCOS, this balance can be off due to too much insulin, which leads to more DCI compared to MI. This imbalance can lead to more male hormones and fewer female hormones, which isn’t ideal for ovarian health and can affect egg quality. Restoring the right balance of MI and DCI might help improve ovarian function, hormone levels, and the body’s use of sugar, which is especially beneficial in PCOS.

Research has shown that supplementing with inositols, either individually or combined, can be really helpful for improving both metabolic and reproductive health with minimal side effects. This is why inositols are considered promising treatments for PCOS. Now let us understand in detail about how inositol helps in PCOS.

How does Inositol help in PCOS?

Now let us see how MI and DCI help in managing the various aspects of PCOS in detail.

Inositol and insulin resistance:

Myoinositol and D-chiro-inositol help the body use insulin better. This means they can lower insulin resistance, which is a common problem in PCOS. Several studies have shown that these supplements can make insulin work better and decrease high blood sugar levels after eating.
Better insulin sensitivity leads to a lesser amount of insulin levels. Hence this prevents the ovaries from producing too much of androgens leading to reducing the symptoms of PCOS like excessive hair growth, acne, male pattern hair loss, etc.
As the androgen production gets lowered, it leads to better ovarian function, including improving the frequency of ovulation, which can be beneficial for fertility.
By improving the insulin sensitivity, MI and DCI help in managing the blood sugar levels, eventually reducing risks associated with heart health, like high blood pressure and high cholesterol levels.
Metformin is the most common drug used in diabetes management which is also used in PCOS for managing the insulin resistance. Studies have found that in comparison to metformin, myoinositol and D-chiro-inositol can be just as effective in managing insulin and blood sugar levels but with fewer side effects. Some studies suggest that combining these inositols with metformin could be even more effective, especially for those who have trouble tolerating high doses of metformin alone.

Inositols and Other Metabolic Abnormalities in PCOS

Studies have shown that adding MI and DCI to the diet of overweight and obese PCOS patients leads to significant reductions in weight, BMI, waist, and hip measurements. Other research finds no significant change in BMI despite improvements in other PCOS-related symptoms.
Combining MI with oral contraceptives (birth control pills) leads to better improvements in hormonal, metabolic, and overall health profiles in PCOS patients than using birth control pills alone. In contrast, using only birth control pills may result in weight gain and no metabolic health improvement.
Combining MI and DCI, especially in a 40:1 ratio, is more effective than using MI alone for reducing LDL cholesterol (bad cholesterol), triglycerides, and improving insulin resistance.

Inositols and Menstrual Disturbances/Ovulation in PCOS

Multiple studies have shown that different combinations of MI and DCI help in PCOS by lowering the levels of androgens, LH and LH: FSH ratio. These effects help in improving menstrual cycle and ovulation rate leading to higher pregnancy rates.
The 40:1 MI to DCI ratio is most effective in managing PCOS symptoms and restoring ovulation.
Several studies were done to compare the effectiveness of MI with other drugs like metformin and clomiphene citrate. It was found that MI is beneficial in restoring ovulation more effectively than metformin and with fewer side effects.
Compared to clomiphene citrate, MI may lead to higher pregnancy rates and significantly lower rates of multiple pregnancies. However, combining MI with clomiphene citrate was found to improve the outcomes for those resistant to MI alone.

Inositol and Gestational Diabetes in PCOS

Pregnancy in PCOS is related to the high risk of gestational diabetes (GDM). It is a diabetes type that can start to develop during pregnancy in women who otherwise do not have diabetes. It is because, during pregnancy, your body makes more hormones and experiences other changes like weight gain. These transformations lead your body’s cells to make less use of insulin leading to insulin resistance. Effectively controlling gestational diabetes ensures that the women have a healthy pregnancy and baby.

Studies have proven that the use of MI inositol can decrease the risk of gestational diabetes by 50-67% in women with a family history of type 2 diabetes and who are overweight and obese. Besides, after using MI treatment on PCOS patients diagnosed already with gestational diabetes, there was an improvement in glucose homeostasis measurements. Thus, you can see that inositols effectively manage insulin using the appropriate dosage of MI in PCOS patients.

Inositol and Hyperandrogenism

Inositol helps in hyperandrogenism by improving the insulin sensitivity which in turn prevents the ovaries from producing excessive amounts of androgens. Multiple studies have shown that inositol helps in decreasing the levels of androgens, FSH, LH, prolactin by improving the insulin sensitivity after 12 weeks of MI treatment. The latest studies reinforce these findings, showing substantial decreases in testosterone and significant increases in progesterone levels, enhancing overall hormonal balance and health in patients with PCOS.

Resistance to Myoinositol in PCOS

We can see that inositol MI positively affects PCOS patients in terms of managing hormonal, metabolic, and reproductive parameters. However, about 25% to 75% of patients still could be resistant to the treatment. The reason behind it is unclear. But, it could be associated with insulin resistance, obesity, and hyperandrogenemia. This might also be possible due to differences in its rate of absorption and from the digestive tract and level of availability in the blood after consumption

In different studies of responders and non-responders to MI, the reason for resistance to Myoinositol in PCOS patients is still not identifiable. However,it is noticed that PCOS patients with comparatively high testosterone might be resistant to MI treatment. Besides, obesity is also a significant factor according to different results. There is also a recommendation to add different agents to improve the ovulation and pregnancy rate in PCOS patients who failed to ovulate on monotherapy.

Moreover, PCOS patients who are resistant to MI can be treated by combining clomiphene citrate with MI. Clomiphene citrate is an FDA-approved drug that has a use in inducing ovulation for patients who want to conceive. PCOS patients can use the combination of MI and clomiphene citrate with no ovulation or pregnancy. After using over three cycles, there is a possibility of seeing an improvement in ovulation and chances of becoming pregnant.

Therefore, you can see that many PCOS patients can be resistant to MI treatment and notice no improvement in their bodies. However, there is still a possibility of managing the situation by combining MI with other elements as prescribed by the professionals. So, don’t worry; even MI-resistant patients can see the potential of controlling their symptoms.

Conclusion

In conclusion, understanding the role of inositols in managing PCOS offers hope and insight into addressing its complex symptoms. You may see the importance of looking into helpful treatment alternatives, considering that, as we previously stated, up to 70% of afflicted women globally do not receive medical care. Inositols have the potential to improve PCOS-related metabolic, hormonal, and reproductive problems. In particular, myoinositol (MI) and D-chiro inositol (DCI) exhibit promise. Their promise as an effective and risk-free treatment is highlighted by their effects on ovulation, menstrual irregularities, insulin resistance, and metabolic abnormalities.

If you or someone suffering from PCOS, and want to get an in-depth knowledge regarding its lifestyle management you can connect with Muscle Layman for one time consultation. And if you want to start working towards the lifestyle to manage PCOS you can join us through fitness and nutrition coaching.