Polycystic Ovary Syndrome

To understand what Hormistol (myo-inositol and D-chiro-insoitol) is, we first need to understand polycystic ovary syndrome (PCOS). PCOS is a complex condition that affects women of childbearing age, and presents itself in different ways, however, the condition is predominantly characterised by an increase in androgen levels, which are male sex hormones such as testosterone, irregularities in the menstrual cycle, and/or the presence of small cysts on one or both ovaries.

The exact cause of PCOS is unknown but research suggests that it is linked to high levels of insulin which, in turn, can cause obesity and insulin resistance, and cause the ovaries to produce androgens, which can lead to unwanted hair growth, acne, hair loss, deepening of the voice and something called anovulation, which means the ovaries do not release an egg, causing infertility, or if an egg is released it may be of poor quality. Individuals with PCOS may only experience some of these symptoms depending on the severity.

Myo-inositol and D-chiro-inositol

Now let's take a look at the two inositols and the role they play in ovarian function. These two inositols are known as myo-inositol and D-chiro-inositol. Myo-inositol is converted to D-chiro-inositol by an enzyme called epimerase.

In the ovaries, myo-inositol and D-chiro-inositol have specific duties and allow for the maintenance of normal hormone levels and ovary function². In PCOS, insulin resistance causes the epimerase activity to be heightened, which creates an imbalance in the myo-inositol-D-chiro-inositol ratio². With the epimerase enzyme being more active, your body produces more D-chiro-inositol when in fact ovaries should have a higher concentration of myo-inositol as this is required to ensure a healthy egg³.

A number of studies suggest that myo-inositol and D-chiro-inositol may have therapeutic benefit in that they can reduce insulin resistance, improve ovarian function, and reduce androgen levels in women with PCOS². According to a meta-analysis (results from multiple scientific studies) conducted by Unfer, V. et al. (2017), in 247 patients who received myo-inositol alone, or combined with D-chiro inositol, the following observations were noted:

• Seven of the nine studies showed a significant decrease in fasting insulin in PCOS women who received myo-inositol.
• Seven of the nine studies showed a decrease in testosterone concentrations.
• Myo-inositol supplementation of up to 24 weeks showed an increase in sex hormone binding globulin (SHBG) – if SHBG levels are low, there could be more free sex hormones for your body to use. In women, this can lead to weight gain, excess facial hair, acne, mood changes and irregular periods.

So, to summarise, more evidence is starting to show that myo-inositol and D-chiro-inositol can benefit women with PCOS. The administration of myo-inositol - D-chiro-inositol has shown better clinical results than myo-inositol alone. These benefits include a reduction in insulin resistance, a reduction in serum androgen levels, reduced risk of cardiovascular diseases, increased menstrual cycle regularity and spontaneous ovulation.

1. Bizzarri M, Carlomagno G. Inositol: History of an effective therapy for polycystic ovary syndrome. Eur Rev Med Pharmacol Sci. 2014;18:1896–903.
2. Kalra B, Kalra, S, Sharma, JB. The inositols and polycystic ovary syndrome. Indian J Endocrinol Metab. 2016 Sep-Oct; 20(5): 720–724.
3. Carlomagno G, Unfer V, Roseff S. The D-chiro-inositol paradox in the ovary. Fertil Steril. 2011;95:2515–6
4. Unfer V., Facchinetti F., Orru B., Giordani B. and Nestler J. (2017) Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocr. Connect. 6, 647–658 10.1530/EC-17-0243