Influence of myoinositol on metabolic and endocrine problems of women with PCO. Polycystic ovary syndrome (PCO) is a fairly common hormonal disorder in women of childbearing age.
The primary cause is a genetic predisposition. It occurs more frequently in some families. The severity of PCO, however, depends on lifestyle. Increased body weight. a simple carbohydrate diet and too little exercise increase the severity of the disease,
Clinical signs are dominated by:
- menstrual disorders (amenorrhea or oligomenorrhea often with anovulation and consequent reduced fertility)
- signs of hyperandrogenism (increased hair growth, acne. hair loss),
- and increased body weight in about half of women with PCO.
In PCO, the hormonal state is disrupted, it is difficult to clearly explain what is the cause and what is the consequence. Insulin resistance is more or less pronounced and consequently an increased concentration of insulin in the blood. Hyperinsulinemia leads to increased secretion of ovarian androgens. Insulin also inhibits the synthesis of SHBG in the liver, which further increases the concentration of free androgens in the blood. Under the influence of aromatase (a lot of aromatase is secreted by adipose tissue in overweight women), they are also converted into estrogens, especially estrone. This lowers FSH production and accelerates LH production, so the LH: FSH ratio is usually elevated in favor of LH.
LH further increases the production of androgens in the ovary, while interfering with the normal development of the leading follicle in the ovary. Consequently, hyperinsulinemia also leads to the development of impaired glucose tolerance, due to increased vascular and endothelial reactivity to arterial hypertension and dyslipidemia. In the long run, this can lead to metabolic syndrome with arterial hypertension and diabetes.
Treatment in women with PCO depends on the severity of symptoms and, above all, on the desire to conceive. A healthy lifestyle with a lot of exercise is very important for everyone. In the diet, avoiding sugar and white flour is important for everyone, and for those who are overweight, slow weight loss of 5-10% is important.
It has been gaining ground around the world for the last ten years myoinositol therapy . It is a pseudovitamin from group B. Numerous studies confirm the positive effect of inositol on metabolism and hormonal balance. In a German study from 2016 (1), 3602 infertile women with PCO were followed. They received 4 g of myoinositol and 400 ug of folic acid and observed a decrease in insulin resistance, fasting blood sugar, a decrease in blood pressure, triglycerides, blood cholesterol. The skin improved, there were more ovulatory cycles and more women became pregnant.
An extensive meta-analysis (2) was performed in which 9 randomized controlled trials were collected to evaluate the effect of myoinositol and d-chiroinositol on endocrine and metabolic changes in women with PCO. For 12-24 weeks they received 1.1-4 g of myoinositol or d-chiro inositol. A decrease in fasting insulin, an improvement in the HOMA index (homeostsis model assessment index), and a decrease in testosterone levels were observed. Androstenedione concentration did not decrease significantly, and SHBG concentration increased only in studies where they received therapy for six months. They describe that myoinositol accelerates the conversion of glucose to glycogen in the liver and reduces the formation of androgens after exposure to insulin. Similar results were obtained in a number of other studies. (3)
Myoinositol therapy is an alternative for women with polycystic ovaries who want a natural and safe solution to regulate the cycle, lower androgen levels and improve metabolic parameters.
More on polycystic ovary syndrome
Endocrinologist's experience with myoinositol
I personally first heard of myoinositol in an education from the NaPro method of infertility treatment in Omaha, USA. An endocrinology specialist told me a personal story. Due to PCO and severe acne, she took OHK with antiandrogenic action for several years. She maintained regular cycles and relatively good skin. When she stopped taking OHK when she wanted to get pregnant, very severe acne appeared and menstruation was irregular. With myoinositol, her skin improved tremendously in a few months and her cycles settled down.
Milena Igličar, MD, spec. gynecology. and childbirth.
Abbreviations
FSH - follicle stimulating hormone
LH - luteinizing hormone
Sources
1. Regidor. PA in Schindler. AE Research Article. Myoinositol as a Safe and Alternative Approach in Treatment
of Infertile PCOS Women A German Observational Study International J of Endocrinology 2016
2. Unfer V in dr Myo inositol effects in women with PCOS a meta analysis of randomized controlled trials. Endocrine connection 2017 Nov 6 (8) 647 658
3. Constantino D in dr Metabolic and hormonal effects of myo inositol in women with polycystic ovary syndrome a double blind trial. Eur Rev Med Pharmacol Sci 2009 May Apr 13 (2) 105 10
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