INOSITOLS AS A MULTIDIMENSIONAL THERAPEUTIC APPROACH TO PCOS/PMOS: EFFECTS ON METABOLIC, HORMONAL, AND REPRODUCTIVE OUTCOMES

Abstract

Background Polycystic ovary syndrome (PCOS), recently renamed Polyendocrine Metabolic Ovarian Syndrome (PMOS), is one of the most common endocrine disorders affecting women of reproductive age, characterized by metabolic, hormonal, and reproductive disturbances. Current therapies mainly address symptoms and may be associated with adverse effects, highlighting the need for better tolerated treatment strategies. Inositols may represent a promising adjunctive therapeutic approach. Aims This narrative review provides an updated overview of the role of myo-inositol (MYO) and D-chiro-inositol (DCI) in the management of PCOS, focusing on metabolic, hormonal, reproductive and safety outcomes, while highlighting the potential relevance of individualized therapeutic approaches. Methods A narrative literature review was conducted using the PubMed database. Clinical studies evaluating the effects of MYO and/or DCI in women with PCOS were identified using predefined keyword combinations. Results Available evidence suggests that MYO, alone or combined with DCI, may improve metabolic, hormonal, and reproductive outcomes in selected women with PCOS. Benefits include improvements in insulin sensitivity, hormonal profile, menstrual regularity, ovulatory function, and fertility outcomes, together with reductions in HOMA-IR and androgen levels. MYO and DCI were generally well tolerated. However, considerable heterogeneity among studies limits the strength of the available evidence. Conclusions MYO, alone or in combination with DCI, may be considered as an adjunctive therapeutic option for selected women with PCOS. Further large-scale randomized controlled trials are required to establish optimal treatment regimens and identify patients most likely to benefit.