I have PCOS symptoms: will myo-inositol help?

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If you are experiencing symptoms of polycystic ovary syndrome (PCOS), you may have spent hours scouring the internet for miracle cures. The nature of the condition means that all its symptoms, which include weight gain, acne, hirsutism (excess body hair growth), and irregular periods, are unpleasant, and can cause considerable psychological distress.

It is frustrating that there is still no ‘cure’ per se for a condition that affects one in five women.1 The symptoms are caused by a hormonal imbalance and a lot of evidence has also shown a strong link between insulin resistance and PCOS.2 Because of this link, one supplement you may have heard of when doing research around treatments is myo-inositol.

What is myo-inositol?

Inositol is a compound found in many plants and animals. It is produced in the human body from glucose, and some can be obtained through diet. It is crucial in humans as it mediates the passing of signals through cells and is particularly important in the brain, where it plays a crucial role in the functioning of some hormones and neurotransmitters.

There are lots of different types of inositol, but myo-inositol (MI), a B vitamin, looks particularly promising as a treatment for PCOS. It is also used to treat metabolic syndrome and certain mental health conditions.

The link between insulin, myo-inositol, and PCOS

Insulin is produced in the pancreas to help move glucose from blood into cells, thus controlling blood sugar levels. A link between insulin resistance (IR) and PCOS has been established, with up to 70% of women with the condition showing signs of IR.3

If you are resistant to insulin, your cells can’t uptake as much sugar, meaning more remains in your bloodstream. Your body produces extra insulin as it registers the lack of sugar in cells, and one side effect of this excess insulin is that it contributes to the ovaries producing more androgens (male hormones) than usual, leading to more testosterone in the body.4

Myo-inositol has been shown to have a number of positive effects in women with PCOS. At its most simple, it works by reducing insulin resistance (IR), increasing levels of sex hormone binding globulin (SHBG) and improving egg quality.

IR also lowers levels of sex hormone-binding globulin (SHBG), which normally acts to prevent testosterone from causing problems.5 Excess testosterone, aside from causing lots of other symptoms, interferes with the development of follicles in the ovaries, which, when combined with other hormonal changes caused by PCOS, can lead to anovulation (when ovulation does not take place). Finally, IR can cause weight gain, which brings about a vicious cycle, as excess fat causes you to produce even more insulin.

Myo-inositol has been shown to have a number of positive effects in women with PCOS. At its most simple, it works by reducing insulin resistance (IR), increasing levels of sex hormone binding globulin (SHBG)6 and improving egg quality.7 On top of this, problems with the ratio of different inositols in the body have been found in people with PCOS,8 suggesting inositol treatment could be beneficial.

By tackling IR and other issues, myo-inositol can reduce symptoms of PCOS. But how does it work to combat each symptom specifically?

Myo-inositol and weight gain

Weight gain is a common symptom of PCOS due to the cycle of IR causing weight gain and weight gain increasing IR. Furthermore, as increased insulin in the body causes testosterone levels to rise, scientists believe that chronic exposure to higher testosterone levels in PCOS may modify body fat distribution, leading to increased upper body fat.9

Finally, ghrelin (a hormone implicated in appetite regulation) is supposed to go down after you have eaten, but women with PCOS have less reduction of this hormone after meals, which can interfere with meal termination and lead to weight gain.10

Few studies have been carried out to show whether or not myo-inositol treatment is successful in lowering the weight of overweight people with PCOS. However, as myo-inositol reduces insulin resistance and lowers resting testosterone levels, high levels of which can contribute to obesity, it may prove useful in helping women with PCOS lose weight.11

Myo-inositol and hirsutism

The prevalence of hirsutism in women with PCOS ranges from 70-80%, compared to 4-11% of women in the general population.12 This is caused by high levels of androgens and/or increased sensitivity of the hair follicles to circulating testosterone. In the body, free testosterone is converted to dihydrotestosterone (DHT) by an enzyme present in hair follicles, and which is predominant in the follicles of beard and genital hair.

When it comes to treating hirsutism with myo-inositol, the results are promising. In one study hirsutism decreased after six months of therapy with myo-inositol.

There, DHT prolongs the anagen (growth) phase of hair growth, resulting in longer, thicker hairs. As women with PCOS experience high levels of free testosterone in their bodies, they are at high risk of hirsutism.13

When it comes to treating hirsutism with myo-inositol, the results are promising. In one study hirsutism decreased after six months of therapy with myo-inositol, as the vitamin reduces total androgens in the body, meaning less can be converted to DHT.14

Myo-inositol and acne with PCOS

Acne in women with PCOS is caused by high circulating levels of androgens, producing more oily skin. DHT, again, is the particular hormone at fault for causing acne, and it starts being produced at puberty to develop and activate sebaceous glands, hence why many women who don’t have PCOS also get acne around puberty.

DHT is the most important product of metabolism involved in the stimulation of secretion from the sebaceous glands. As myo-inositol works to decrease insulin resistance, therefore decreasing free-running testosterone, it has been said to control the metabolic alterations linked to acne. Studies have proven its effect on reducing acne in women with PCOS, reducing serum concentrations of testosterone.15

Myo-inositol and irregular periods

Women with PCOS have irregular periods as they don’t ovulate regularly: egg follicles start maturing in the ovaries, but don’t mature enough to release an egg due to hormonal irregularities, meaning that the hormonal changes in your reproductive system that arise after the egg has been released don’t occur. Without ovulation, therefore, you are unlikely to have a period.

Studies have confirmed the efficacy of myo-inositol in reinstating periods in women with PCOS. In one study, 88% of patients had at least one spontaneous menstrual cycle during treatment.16

Studies have confirmed the efficacy of myo-inositol in reinstating periods in women with PCOS. In one study, 88% of patients had at least one spontaneous menstrual cycle during treatment.

As PCOS causes excess testosterone, which prevents follicles in the ovaries from developing properly, this may be why a treatment such as myo-inositol, which brings down testosterone levels and increases SHBG levels, may help to restore your menstrual cycle.

Myo-inositol has also been shown to have a positive effect on oocyte (cells in the ovaries which form eggs) quality.17 On top of this, studies have shown insulin to affect the ratio of luteinising hormone (LH) and follicle-stimulating hormone (FSH) in the body, a set ratio of which is needed for ovulation,18 and myo-inositol improves insulin resistance, which may help to restore correct levels of these hormones.

How to take myo-inositol

You don’t need a prescription for myo-inositol, and it can be bought from a pharmacy or nutritional supplement stores. Nonetheless, talk to your doctor before taking it, especially if you are already receiving alternative treatment, to ensure it won’t interfere with any other medication you are already taking.

It is important to persevere if you are taking myo-inositol, as the benefits can take several months to really show.19 Side effects are rare with myo-inositol taken at the usual dosage of 4g/day, but in extremely high doses (12g/day or more, which is not recommended) it can cause mild effects such as nausea and flatulence.20

If you do decide to begin taking myo-inositol it is important to continue with any other lifestyle changes you have made to tackle your PCOS, such as increasing exercise, and eating a healthy diet, to ensure you optimise your chances of reducing your symptoms.

If you are experiencing symptoms of polycystic ovary syndrome (PCOS), you may have spent hours scouring the internet for miracle cures. The nature of the condition means that all its symptoms, which include weight gain, acne, hirsutism (excess body hair growth), and irregular periods, are unpleasant, and can cause considerable psychological distress.

It is frustrating that there is still no ‘cure’ per se for a condition that affects one in five women.1 The symptoms are caused by a hormonal imbalance and a lot of evidence has also shown a strong link between insulin resistance and PCOS.2 Because of this link, one supplement you may have heard of when doing research around treatments is myo-inositol.

What is myo-inositol?

Inositol is a compound found in many plants and animals. It is produced in the human body from glucose, and some can be obtained through diet. It is crucial in humans as it mediates the passing of signals through cells and is particularly important in the brain, where it plays a crucial role in the functioning of some hormones and neurotransmitters.

There are lots of different types of inositol, but myo-inositol (MI), a B vitamin, looks particularly promising as a treatment for PCOS. It is also used to treat metabolic syndrome and certain mental health conditions.

The link between insulin, myo-inositol, and PCOS

Insulin is produced in the pancreas to help move glucose from blood into cells, thus controlling blood sugar levels. A link between insulin resistance (IR) and PCOS has been established, with up to 70% of women with the condition showing signs of IR.3

If you are resistant to insulin, your cells can’t uptake as much sugar, meaning more remains in your bloodstream. Your body produces extra insulin as it registers the lack of sugar in cells, and one side effect of this excess insulin is that it contributes to the ovaries producing more androgens (male hormones) than usual, leading to more testosterone in the body.4

Myo-inositol has been shown to have a number of positive effects in women with PCOS. At its most simple, it works by reducing insulin resistance (IR), increasing levels of sex hormone binding globulin (SHBG) and improving egg quality.

IR also lowers levels of sex hormone-binding globulin (SHBG), which normally acts to prevent testosterone from causing problems.5 Excess testosterone, aside from causing lots of other symptoms, interferes with the development of follicles in the ovaries, which, when combined with other hormonal changes caused by PCOS, can lead to anovulation (when ovulation does not take place). Finally, IR can cause weight gain, which brings about a vicious cycle, as excess fat causes you to produce even more insulin.

Myo-inositol has been shown to have a number of positive effects in women with PCOS. At its most simple, it works by reducing insulin resistance (IR), increasing levels of sex hormone binding globulin (SHBG)6 and improving egg quality.7 On top of this, problems with the ratio of different inositols in the body have been found in people with PCOS,8 suggesting inositol treatment could be beneficial.

By tackling IR and other issues, myo-inositol can reduce symptoms of PCOS. But how does it work to combat each symptom specifically?

Myo-inositol and weight gain

Weight gain is a common symptom of PCOS due to the cycle of IR causing weight gain and weight gain increasing IR. Furthermore, as increased insulin in the body causes testosterone levels to rise, scientists believe that chronic exposure to higher testosterone levels in PCOS may modify body fat distribution, leading to increased upper body fat.9

Finally, ghrelin (a hormone implicated in appetite regulation) is supposed to go down after you have eaten, but women with PCOS have less reduction of this hormone after meals, which can interfere with meal termination and lead to weight gain.10

Few studies have been carried out to show whether or not myo-inositol treatment is successful in lowering the weight of overweight people with PCOS. However, as myo-inositol reduces insulin resistance and lowers resting testosterone levels, high levels of which can contribute to obesity, it may prove useful in helping women with PCOS lose weight.11

Myo-inositol and hirsutism

The prevalence of hirsutism in women with PCOS ranges from 70-80%, compared to 4-11% of women in the general population.12 This is caused by high levels of androgens and/or increased sensitivity of the hair follicles to circulating testosterone. In the body, free testosterone is converted to dihydrotestosterone (DHT) by an enzyme present in hair follicles, and which is predominant in the follicles of beard and genital hair.

When it comes to treating hirsutism with myo-inositol, the results are promising. In one study hirsutism decreased after six months of therapy with myo-inositol.

There, DHT prolongs the anagen (growth) phase of hair growth, resulting in longer, thicker hairs. As women with PCOS experience high levels of free testosterone in their bodies, they are at high risk of hirsutism.13

When it comes to treating hirsutism with myo-inositol, the results are promising. In one study hirsutism decreased after six months of therapy with myo-inositol, as the vitamin reduces total androgens in the body, meaning less can be converted to DHT.14

Myo-inositol and acne with PCOS

Acne in women with PCOS is caused by high circulating levels of androgens, producing more oily skin. DHT, again, is the particular hormone at fault for causing acne, and it starts being produced at puberty to develop and activate sebaceous glands, hence why many women who don’t have PCOS also get acne around puberty.

DHT is the most important product of metabolism involved in the stimulation of secretion from the sebaceous glands. As myo-inositol works to decrease insulin resistance, therefore decreasing free-running testosterone, it has been said to control the metabolic alterations linked to acne. Studies have proven its effect on reducing acne in women with PCOS, reducing serum concentrations of testosterone.15

Myo-inositol and irregular periods

Women with PCOS have irregular periods as they don’t ovulate regularly: egg follicles start maturing in the ovaries, but don’t mature enough to release an egg due to hormonal irregularities, meaning that the hormonal changes in your reproductive system that arise after the egg has been released don’t occur. Without ovulation, therefore, you are unlikely to have a period.

Studies have confirmed the efficacy of myo-inositol in reinstating periods in women with PCOS. In one study, 88% of patients had at least one spontaneous menstrual cycle during treatment.16

Studies have confirmed the efficacy of myo-inositol in reinstating periods in women with PCOS. In one study, 88% of patients had at least one spontaneous menstrual cycle during treatment.

As PCOS causes excess testosterone, which prevents follicles in the ovaries from developing properly, this may be why a treatment such as myo-inositol, which brings down testosterone levels and increases SHBG levels, may help to restore your menstrual cycle.

Myo-inositol has also been shown to have a positive effect on oocyte (cells in the ovaries which form eggs) quality.17 On top of this, studies have shown insulin to affect the ratio of luteinising hormone (LH) and follicle-stimulating hormone (FSH) in the body, a set ratio of which is needed for ovulation,18 and myo-inositol improves insulin resistance, which may help to restore correct levels of these hormones.

How to take myo-inositol

You don’t need a prescription for myo-inositol, and it can be bought from a pharmacy or nutritional supplement stores. Nonetheless, talk to your doctor before taking it, especially if you are already receiving alternative treatment, to ensure it won’t interfere with any other medication you are already taking.

It is important to persevere if you are taking myo-inositol, as the benefits can take several months to really show.19 Side effects are rare with myo-inositol taken at the usual dosage of 4g/day, but in extremely high doses (12g/day or more, which is not recommended) it can cause mild effects such as nausea and flatulence.20

If you do decide to begin taking myo-inositol it is important to continue with any other lifestyle changes you have made to tackle your PCOS, such as increasing exercise, and eating a healthy diet, to ensure you optimise your chances of reducing your symptoms.

Nature’s Best

Nature’s Best have over 35 years’ experience in the nutritional supplement industry. With high potency products backed by science and consumers they have more than just an interest in health and wellbeing, they live and breathe it. From their extensive knowledge they have developed unique formulas to help support specific health problems, and as a result have researched the causes, symptoms and treatments. They hope that sharing this valuable knowledge with the public will help raise awareness and hopefully empower readers to live happy, healthy lives.

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References

  1. NHS Choices Health A-Z, ‘Polycystic ovary syndrome’, [website], 2016,https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/, (accessed 14 August 2018).
  2. J. C. Marshall and A. Dunaif, ‘All Women With PCOS Should Be Treated For Insulin Resistance’, Fertil Steril., Vol. 97, No. 1, 2012, pp. 18-22.
  3. M. L. Traub, ‘Assessing and treating insulin resistance in women with polycystic ovarian syndrome’, World J Diabetes, Vol. 2, No. 3, 2011, pp. 33-40.
  4. Center for Young Women’s Health, ‘PCOS (Polycystic Ovary Syndrome): General Information’, [website], 2016, https://youngwomenshealth.org/2014/02/25/polycystic-ovary-syndrome/, (accessed 14 August 2018).
  5. R. Deswal et al., ‘Sex hormone binding globulin – an important biomarker for predicting PCOS risk: A systematic review and meta-analysis’, Syst Biol Reprod Med, Vol. 64, No. 1, 2018, pp. 12-24.
  6. V. Unfer et al., ‘Myo-inositol effects in women with PCOS: a meta-analysis of randomised controlled trials’, Endocr Connect., Vol. 6, No. 8, 2017, p. 647-658.
  7. B. Kalra et al., ‘The inositols and polycystic ovary syndrome’, Indian J Endocrinol Metab, Vol. 20, No. 5, 2016, pp. 720-724.
  8. V. Unfer et al., ‘Myo-inositol effects in women with PCOS: a meta-analysis of randomised controlled trials’, 2017, p. 647-658.
  9. S. Sam, ‘Obesity and Polycystic Ovary Syndrome’, Obes Manag., Vol. 3, No. 2, 2007, pp. 69-73.
  10. Ibid.
  11. V. Unfer et al., ‘Myo-inositol effects in women with PCOS: a meta-analysis of randomised controlled trials’, 2017, p. 647-658.
  12. P. M. Spritzer et al., ‘Hirsutism in Polycystic Ovary Syndrome: Pathophysiology and Management’, Curr Pharm Des., Vol. 22, No. 36, 2016, pp. 5603-5613.
  13. S. Sachdeva, ‘Hirsutism: Evaluation and Treatment’, Indian J Dermatol., Vol. 55, No. 1, 2010, pp. 3-7.
  14. M. Minozzi et al., ‘Treatment of hirsutism with myo-inositol: a prospective clinical study’, Reproductive BioMedicine Online, Vol. 17, No. 4, 2008, pp. 579-582.
  15. M. Pezza and V. Carlomagno, ‘Inositol in women suffering from acne and PCOS: a randomized study’, Global Dermatol., Vol. 4, No. 1, 2017, pp. 1-4.
  16. E. Papaleo et al., ‘Myo-inositol in patients with polycystic ovary syndrome: a novel method for ovulation induction’, Gynecol Endocrinol., Vol. 23, No. 12, 2007, pp. 700-3.
  17. B. Kalra et al., ‘The inositols and polycystic ovary syndrome’, 2016, pp. 720-724.
  18. Ibid.
  19. V. Unfer et al., ‘Myo-inositol effects in women with PCOS: a meta-analysis of randomised controlled trials’, 2017, p. 647-658.
  20. G. Carlomagno and V. Unfer, ‘Inositol safety: clinical evidences’, Eur Rev Med Pharmacol Sci., Vol. 15, No.8, 2011, pp. 931-6.