This article explores how myo-inositol and D-chiro-inositol can ease PCOS symptoms and support your fertility goals.
Key Facts
- Myo-inositol and D-chiro-inositol regulate hormones and metabolism, addressing key PCOS symptoms.
- Inositols improve insulin sensitivity, reducing weight gain and hyperinsulinemia.
- Combined inositols (40:1 ratio) help restore regular cycles and ovulation.
- Inositols enhance ovarian function, egg quality and embryo development.
- Myo-inositol is well-tolerated, with minimal side effects compared to metformin.
Introduction
Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects about 5-20% of women who are of childbearing age. In recent years, various treatment approaches for PCOS have been investigated, including the use of myo-inositol and D-chiro-inositol. These two forms of inositol can help women with PCOS improve their fertility by regulating their endocrine system and metabolism.
If you have PCOS and are looking for a way to manage your symptoms and improve your fertility, myo-inositol and D-chiro-inositol may be a promising option. In this article, you'll learn more about how inositols work, their benefits for treating PCOS, and how to use them.
What is Inositol?
Inositol is a natural substance found in cell membranes. It plays an important role in essential bodily processes, such as fat metabolism and cell growth. Inositols are present in some foods and act as secondary messengers, which means they help with communication within your cells. They used to be classified as B vitamins, but now they're considered vitamin-like substances because your body can actually produce some of them on its own.
Research has shown that PCOS women often have lower levels of myo-inositol and D-chiro-inositol in their blood. This suggests that taking inositol supplements could offer many health benefits, including treating metabolic disorders, insulin resistance, PCOS, and mental health conditions, potentially reducing the risk of developing heart disease and gestational diabetes later in life.
There are nine different types of inositol, also known as inositol isomers. Myo-inositol and D-chiro-inositol are the two types used in the treatment of PCOS.
Typical Symptoms of PCOS
Polycystic ovary syndrome often presents with a cluster of symptoms, including hyperandrogenism (high levels of male hormones), which can cause excess hair growth (hirsutism), acne, hair loss, infertility, and irregular or absent ovulation (caused by polycystic ovaries).
Women with polycystic ovarian syndrome often suffer from insulin resistance. Insulin resistance often leads to weight gain and makes it significantly harder to lose weight. Women with obesity are more likely to be affected by insulin resistance, which can lead to difficulties with weight loss.
Elevated insulin levels in the blood are referred to as hyperinsulinemia. This causes an increased release of luteinising hormone (LH) in the ovaries, which can manifest as menstrual cycle irregularities, among other things.
Myo-inositol and D-chiro-inositol have a number of positive effects that have been shown to help women with PCOS regulate their cycles, ovulate regularly, and ultimately conceive naturally. In addition, it helps alleviate typical symptoms of PCOS.
Positive Effects of Inositol Treatment
According to a study published in 2021, myo-inositol and D-chiro-inositol have the best effects when combined. When the two isomers are administered together – in the natural 40:1 ratio found in the body – patients could benefit from increased FSH and estrogen reactivity of myo-inositol and, at the same time, from the insulin-sensitizing effect of D-chiro-inositol.
Improved Insulin Sensitivity
A 2020 study found that myo-inositol supplementation led to a significant improvement in insulin sensitivity in women with PCOS. This is important because insulin resistance is a common feature of PCOS and is linked to the development of type 2 diabetes. By improving insulin signaling, myo-inositol may help regulate blood sugar levels (glucose) and reduce the risk of long-term complications.
Menstrual Cycle Regulation
A 2021 study showed that the combination of myo-inositol and D-chiro-inositol led to better regulation of menstrual cycles in women with PCOS. This is an important factor for fertility in affected women.
Reduction of Androgen Levels
A 2019 study showed that inositols can also help lower androgens (male hormones) in women with PCOS. This can have a positive effect on skin problems and excess body hair.
Improved Egg and Embryo Quality
A 2021 analysis suggests that myo-inositol and D-chiro-inositol can improve ovarian function, oocyte quality, and embryo quality by supporting follicle maturation and ovulation induction.
In another study of 29 patients, half received 4000 mg myo-inositol and 400 µg folic acid per day for 2 months prior to in vitro fertilsiation (IVF). While the number of eggs was higher in the placebo group (300 vs. 233), the ratio of fertilised eggs to the number of eggs retrieved was better in the test group (136 vs. 128 eggs were fertilised). The test group also showed higher egg and embryo quality.
Improvement of Metabolic Syndrome Symptoms
According to a meta-analysis, young women are twice as likely to suffer from metabolic syndrome if they have PCOS than women who do not have PCOS. Metabolic syndrome is characterised by severe overweight (especially around the abdomen), high cholesterol, high blood pressure, increased body mass index and high blood sugar.
Reduction of Inflammation
Research published in 2021 shows that myo-inositol and D-chiro-inositol have anti-inflammatory properties and can decrease inflammation associated with PCOS.
Improved Sperm Quality
A 2019 study investigated the effect of myo-inositol on sperm and pregnancy rates before fertility treatment (IUI). According to the study, sperm in the group that received myo-inositol showed higher motility than in the group that received a placebo. In the subsequent intrauterine insemination, the pregnancy rate was twice as high (18%) in couples where the men were treated with myo-inositol.
Use and Dosage of Inositol
Inositol is available as a dietary supplement in powder or capsule form. The individual dose for myo-inositol is 2 grams, which can be taken once in the morning and once in the evening (in combination with 2 x 200 µg folic acid). Myo-inositol and D-chiro-inositol are available over the counter. If you are considering buying inositol, it is best to schedule an appointment with your gynecologist beforehand to discuss the optimal dosage.
Taking Myo-Inositol
In a randomised controlled trial of 50 obese women with PCOS, 2 grams of myo-inositol (with 200 µg folic acid) in the morning led to a significant reduction in the hormones prolactin, testosterone, insulin, and LH compared to follicle-stimulating hormone (FSH) and an improvement in insulin sensitivity. The chances of conception also improved significantly with myo-inositol. There were no changes in the menstrual cycle in the patients treated with folic acid alone. In addition, it was found that 2 grams of myo-inositol per day improved ovulation, which led to higher pregnancy and delivery rates.
Taking D-Chiro-Inositol
While the dosage of myo-inositol is relatively well researched, it is still unclear how much D-chiro-inositol can be recommended. Although D-chiro-inositol contributes to several positive effects, the negative effects of an overdose should not be ignored. According to a review published in 2023, too high a dosage (1200 mg per day) of D-chiro-inositol over a period of 6 months can lead to increased testosterone levels and cycle fluctuations. This can consequently have a negative effect on PCOS symptoms and a woman's fertility.
Side Effects
Studies have found that inositol and the diabetes drug metformin are equally effective, but inositol is better tolerated than metformin. While metformin can cause side effects such as nausea, diarrhea, vomiting, or flatulence, there are practically no side effects with a daily intake of up to 4 grams of myo-inositol. However, with an increased intake of 12 grams or more per day, mild side effects such as nausea, sleep disturbances, headaches, dizziness, and fatigue may occur.
Combination with Other Supplements
Myo-inositol can be combined with other dietary supplements, which may even improve the treatment of certain conditions. For example, a 2022 study showed that the combination of myo-inositol with omega-3 fatty acids had a better antidepressant effect than treatment with omega-3 fatty acids or inositol alone. However, you should be aware that inositol can interact with medications taken for insulin resistance, diabetes, and cholesterol reduction. In this case, you should always consult your healthcare provider.
Takeaway
Studies in recent years suggest that myo-inositol and D-chiro-inositol are promising options for treating patients with PCOS. These natural inositols have the potential to improve insulin resistance, regulate the menstrual cycle, lower androgen levels, improve hormonal balance and support ovarian function. However, it is important to note that the optimal dosage and composition of inositols may vary depending on individual needs. Women with PCOS should discuss the use of inositols with their doctor to determine if they are an appropriate treatment option.
Research in this area is promising, but further studies are needed to better understand the long-term effects and optimal use of myo-inositol and D-chiro-inositol in PCOS patients. Nevertheless, these inositols offer a promising addition to combined therapy approaches for women suffering from PCOS.
