Medical Chronicle recently hosted a CPD-accredited webinar in conjunction with Lamelle Pharmaceuticals, presented by Dr Bradley Wagemaker. This was the first on this two-part series on polycystic ovarian syndrome (PCOS).and Bronwyn Bosch.
To watch a replay and still earn a CPD point, go to:
Myo-inositol (MI) and D-chiro-inositol (DCI) act as insulin mediators. As insulin second messengers, both these molecules are involved in increasing insulin sensitivity of different tissues to improve metabolic and ovulatory functions. MI stimulates FSH signalling and aromatase. DCI enhances insulin-mediated androgen production and is also an aromatase inhibitor.
Both MI and DCI enhance insulin sensitivity. MI enhances glucose uptake and reduces free fatty acids from adipocytes. DCI participates in glycogen storage.
POSITIONING INOSITOL ON PCOS INFERTILITY
All patients should look at dietary modification and exercise. The oral contraceptive pill regulates the menstrual cycle and reduces hyperandrogenic symptoms. The downsides are increased risk of metabolic syndrome. Metformin regulates the menstrual cycle, reduce hyperandrogenic symptoms and improves IR. However, there are side effects. Inositol regulates the menstrual cycle, reduce hyperandrogenic symptoms, improve IR and improve oocyte quality.
PCOS - INFERTILITY AND INOSITOL SUMMARY
- Can be used for extended periods of time (compared to clomiphene, which is six months, to maybe 12)
- Increase rates of ovulation and frequency of menstrual cycles (protective against endometrial over stimulation by E2)
- Consistently improves glycaemic parameters (fasting glucose, insulin levels and IR compared to placebo)
- Lowers total androgens, serum testosterone, and DHEA
- Increases levels of SHBG
- No differences observed between MI and DCI
- This supplement can be acquired in a primary care setting and does not require expensive specialist review and monitoring
- Significantly improves ovulation rate, metabolic and hormonal profiles in women with PCOS compared to placebo.