The Effects of Metformin and Myo-Inositol on Hyperandrogenism, Insulin Sensitivity, and Fertility in Polycystic Ovary Syndrome: A Literature Review

Introduction: Polycystic ovary syndrome (PCOS) is an endocrine-metabolic disorder that occurs due to a hormone imbalance in the ovaries. It can cause the development of fluid-filled cysts on the follicles, causing infertility. Further, PCOS can cause insulin resistance and hyperandrogenism, increasing the amount of glucose and testosterone levels in the body. As a result, PCOS symptoms could include irregular or absent periods, weight gain, hirsutism, and more. PCOS patients are also at higher risk of developing type 2 diabetes, depression, and high blood pressure. Currently, there are no cures for PCOS, but it can be managed with lifestyle changes, contraceptive pills for irregular periods, and fertility treatments. Two of these treatments include inositol and metformin. The objective of the study is to ascertain how these therapies affect PCOS symptoms such as hyperandrogenism, insulin sensitivity, and infertility. Methods: Primary articles were found through the PubMed and OVID-Medline databases to investigate the effect of inositol or metformin on PCOS. Keywords such as PCOS, inositol, metformin, myo-inositol, insulin sensitivity, androgens, and fertility were used. Research published before 2010 was excluded. Results: The results found that metformin and inositol decreased the amounts of free testosterone and glucose in women with PCOS. Further, oocyte quality and production were improved in women taking metformin and inositol. These results were seen in women of all ages and of all BMIs. Discussion: Both metformin and MI are shown to significantly improve PCOS symptoms of hyperandrogenism, insulin sensitivity, and fertility issues. Although some limitations were present within the review and the studies examined due to exclusions, the review presents a comprehensive outlook on the impact of the interventions mentioned. Establishing a foundation for clinical trials would allow for the integration of these interventions into healthcare settings. Conclusion: A combination of both metformin and inositol, as well as diet and lifestyle changes can significantly improve the symptoms and life quality of individuals with PCOS. Future research would benefit from further studies done into investigating the combined effects of metformin and MI, as well as further assessment of secondary symptoms, as well as regarding the dosage of myo-inositol and metformin.