Reproductive Endocrinology Ovarian Hormones
RRM Academy Synopsis
Myo-inositol raised ovulation and lowered testosterone in PCOS
A 2009 double-blind trial in 42 women with polycystic ovary syndrome (PCOS) reports that women given myo-inositol ovulated far more often than women given a placebo: about 7 out of 10 against about 2 out of 10. Treated women also showed lower testosterone.
Key Findings
- Ovulation occurred in 16 of 23 women taking myo-inositol and in 4 of 19 women taking folic acid alone as the placebo.
- After a glucose drink, insulin exposure fell with myo-inositol (P = 0.03), and a composite measure of whole body insulin sensitivity (ISI comp) rose (P < 0.002).
- Triglycerides, systolic blood pressure and diastolic blood pressure also fell with myo-inositol (P = 0.001, P = 0.002 and P = 0.001).
- Total and free testosterone in the blood fell with myo-inositol (P = 0.003 and P = 0.01 against the placebo group).
Interpretation
This synopsis rests on the published abstract alone. The trial assigned 42 women with PCOS to myo-inositol with folic acid or to folic acid only, and the abstract lists outcomes for each group. The authors summarize that myo-inositol lowered circulating insulin and total testosterone and improved metabolic factors. The findings apply to women with PCOS as enrolled in this trial.
RRM Context
RRM treats PCOS, also named PMOS (Polyendocrine Metabolic Ovarian Syndrome), as a hormone and metabolic problem with causes to find. Ovulation is a central outcome. This trial reports insulin response, androgens and ovulation in one group of women.
Abstract
To investigate the effects of treatment with Myo-inositol (an insulin sensitizing drug), on circulating insulin, glucose tolerance, ovulation and serum androgens concentrations in women with the Polycystic Ovary Syndrome (PCOS). Forty-two women with PCOS were treated in a double-blind trial with Myo-inositol plus folic acid or folic acid alone as placebo. In the group treated with Myo-inositol the serum total testosterone decreased from 99.5 +/- 7 to 34.8 +/- 4.3 ng/dl (placebo group: from 116.8 +/- 15 to 109 +/- 7.5 ng/dl; P = 0.003), and serum free testosterone from 0.85 +/- 0.1 to 0.24 +/- 0.33 ng/dl (placebo group: from 0.89 +/- 0.12 to 0.85 +/- 0.13 ng/dl; P = 0.01). Plasma triglycerides decreased from 195 +/- 20 to 95 +/- 17 mg/dl (placebo group: from 166 +/- 21 to 148 +/- 19 mg/dl; P = 0.001). Systolic blood pressure decreased from 131 +/- 2 to 127 +/- 2 mmHg (placebo group: from 128 +/- 1 to 130 +/-1 mmHg; P = 0.002). Diastolic blood pressure decreased from 88 +/- 1 to 82 +/- 3 mmHg (placebo group: from 86 +/- 1 to 90 +/- 1 mmHg; P = 0.001). The area under the plasma insulin curve after oral administration of glucose decreased from 8.54 +/- 1.149 to 5.535 +/- 1.792 microU/ml/min (placebo group: from 8.903 +/- 1.276 to 9.1 +/- 1.162 microU/ml/min; P = 0.03). The index of composite whole body insulin sensitivity (ISI comp) increased from 2.80 +/- 0.35 to 5.05 +/- 0.59 mg(-2)/dl(-2) (placebo group: from 3.23 +/- 0.48 to 2.81 +/- 0.54 mg(-2)/dl(-2); P < 0.002). 16 out of 23 women of Myo-inositol group ovulated (4 out of 19 in placebo group). Treatment of PCOS patients with Myo-inositol provided a decreasing of circulating insulin and serum total testosterone as well as an improvement in metabolic factors.
