Efficacy of myo-inositol and d-chiro-inositol combination on menstrual cycle regulation and improving insulin resistance in young woman with polycystic ovary syndrome

Lazareva, Ljupka and Jovevska, Svetlana and Baldzieva, Sanja (2023) Efficacy of myo-inositol and d-chiro-inositol combination on menstrual cycle regulation and improving insulin resistance in young woman with polycystic ovary syndrome. Knowledge-Internationa Journal, Vol.61 (4). pp. 773-775.

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Abstract

hyperandrogenemia (hirsutism, acne, alopecia) and ovaries that on ultrasound show the presence of multiple cysts,
characteristically distributed in the periphery of the ovary( known as the "string of pearls" sign.) The clinical
presentation of PCOS varies widely. To establish a diagnosis of polycystic ovary syndrome, it is necessary to have
at least two of the three so-called Rotterdam criteria, which include:
1.Irregularities of the menstrual cycle - oligomenorrhea, amenorrhea or prolonged menstrual bleeding.
2.Hyperandrogenemia (proven clinically or laboratory) - hirsutism is the most common clinical presentation of
hyperandrogenemia and occurs in up to 70% of women with this syndrome. Evaluation of hirsutism is with use of a
modified Ferriman-Gallwey score system. With this system we evaluate hair growth in seven regions: upper lip,
chin/face, chest, back, abdomen, arms and thighs. In about 90% of women that have normal menstrual cycle and
hirsutism, during an ultrasound exam, it can be found that they have polycystic ovaries.
3.Polycystic ovaries (presence of ≥ 12 follicles 2-9 mm in size and/or ovarian volume > 10 mL)
The most of the patients with PCOS have insulin resistance that leads to hyperinsulinemia. A paradox present in
PCOS patients is that the ovaries remain insulin sensitive despite the universal insulin resistance.
The increased androgen production is not so much due to remained insulin sensitivity of the ovaries as to
compensatory hyperinsulinemia. Compensatory hyperinsilinemia increases pulsatile secretion of GnRH which can
cause increased secretion of LH and lower the secretion of FSH.
Insulin resistance and compensatory hyperinsulinemia affect about 65-70% of women with PCOS, of which 70-80%
are obese and 20-25% are of normal body mass.
The most authors suggest that that insulin resistance is the primary defect in patients with PCOS and
hyperandrogenemia is secondary to that
Our purpose is to evaluate the efficacy of treatment with myo-inositol (MI) and D-chiro-inositol (DCI) in ratio 40:1 ,
in the therapy of polycystic ovary syndrome (PCOS).
Case study of 22 year-old female who presented to the clinic for irregular menstrual cycle , acne and hirsutism.
Transvaginal ultrasound showed anteverted uterus, proliferative endometrium d-7mm and more than 12 antral
follicles on right and left ovary.Hormonal investigations showed increase fasting insulin level and testosterone level.
She was advised to start treatment with combination of myo-inositol and D chiro-inositol (ratio 40:1) 2 g per day
during three months.
Hormonal investigation after 3 months treatment with myo-insoitol/D- chiroinsoitol showed a decrease in the values
of IRI 9.3 uU /ml , Testosteron 48,8ng/dl, Prolactine 19,3ng/ml. Also the treatment with combination od myo
insotiol/D- chiroinsotiol in ratio 40:1 contributed to regulation of menstrual cycle.
Myo-inositol and D-chiro-inositol in combination (40:1 ratio) are effective in regularizing menstrual cycles in PCOS
patients, improving insulin resistance and decreasing of hyperandrogenemia.
The combination of myo-insoitol/D- chiroinositol (40:1) ratio should be considered as first line treatment in women
with PCOS.
Keywords: PCOS, inositols, insulin resistance, hyperandrogenemia, anovulation

Item Type:	Article
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Sanja Baldzieva
Date Deposited:	03 Dec 2024 13:24
Last Modified:	03 Dec 2024 13:24
URI:	https://eprints.ugd.edu.mk/id/eprint/35148

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