What is the efficacy and safety of inositols in treating Polycystic Ovary Syndrome (PCOS) compared to metformin or placebo?
Myo-Inositol, a randomized controlled trial (Reprod Biol Endocrinol 2023, PMID 36703143) — inositol treatment resulted in a 1.79 times higher risk of regular menstrual cycles compared to placebo (CI: 1.13; 2.85) and showed non-inferiority to metformin for this outcome. The abstract for Myo-Inositol states no limitations.
Source: Reprod Biol Endocrinol 2023, PMID 36703143 ↗ · Research map · How Magellan grades evidence · evidence confidence: medium
Reprod Biol Endocrinol · 2023 · PMID 36703143 · DOI 10.1186/s12958-023-01055-z
Inositols are an effective and safe treatment for PCOS, showing similar benefits to metformin for many outcomes.
The question
What is the efficacy and safety of inositols in treating Polycystic Ovary Syndrome (PCOS) compared to metformin or placebo?
What they tested
Inositols may be a potential alternative to metformin for treating PCOS, with comparable efficacy and safety.
How they did it
A systematic review was conducted by searching CENTRAL, MEDLINE, and Embase for randomized controlled trials (RCTs) from inception until October 20th, 2021. Eligible RCTs included women diagnosed with PCOS and compared any inositols with metformin or placebo. Primary outcome was cycle normalization, and secondary outcomes included BMI, carbohydrate metabolism parameters, and clinical/laboratory hyperandrogenism. Results were reported as risk ratios or mean differences (MDs) with 95% confidence intervals (CIs).
What they found
Twenty-six RCTs with 1691 patients were identified (806 inositol, 311 placebo, 509 metformin). Inositol treatment resulted in a 1.79 times higher risk of regular menstrual cycles compared to placebo (CI: 1.13; 2.85) and showed non-inferiority to metformin for this outcome. Compared to placebo, inositol treatment led to greater decreases in BMI (MD = -0.45), free testosterone (MD = -0.41), total testosterone (MD = -20.39), androstenedione (MD = -0.69), glucose (MD = -3.14), and AUC insulin (MD = -2081.05). Inositol also significantly increased sex-hormone-binding globulin compared to placebo (MD = 32.06).
| BMI | -0.45 | |
|---|---|---|
| Free Testosterone | -0.41 | |
| Total Testosterone | -20.39 | |
| Androstenedione | -0.69 | |
| Glucose | -3.14 | |
| AUC Insulin | -2081.05 | |
| SHBG | 32.06 |
Mean differences in various parameters when comparing inositol treatment to placebo in women with PCOS. Negative values indicate a decrease with inositol, while positive values indicate an increase.
What it means
Inositol is an effective and safe treatment for PCOS. It demonstrated non-inferiority to metformin in most outcomes.
Limitations
The abstract does not explicitly state limitations of the systematic review itself, beyond the scope of the included studies.
Where the published abstract does not list limitations, we say so rather than inventing them. Read the full paper on PubMed before drawing conclusions.
The paper at a glance
| Magellan’s evidence label | insulin second-messenger (our label for this citation — see PubMed for the paper’s own title and authors) |
|---|---|
| Journal | Reprod Biol Endocrinol |
| Year | 2023 |
| PMID | 36703143 ↗ |
| DOI | 10.1186/s12958-023-01055-z ↗ |
| Topic | General aging biology & healthspan |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
Where Magellan uses this paper
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Myo-Inositol
In randomized trials and meta-analyses, myo-inositol (often combined with D-chiro-inositol) has been associated with improved insulin sensitivity—lower fasting insulin and HOMA-IR—restoration of menstrual regularity and ovulation in PCOS, and a reduced incidence of gestational diabetes (a Cochrane review found…
Myo-inositol is a naturally occurring sugar-like compound (a cyclitol, the most abundant of nine…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Molecules & mechanisms in this paper
Each of these is named in the paper’s own words above. Open the monograph for the full mechanism and its other citations.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). What is the efficacy and safety of inositols in treating Polycystic Ovary Syndrome (PCOS) compared to metformin or placebo? [Plain-English summary of Reprod Biol Endocrinol 2023, PMID 36703143, DOI 10.1186/s12958-023-01055-z]. Magellan Longevity. https://magellanlongevity.com/study/s131.html@misc{magellan_s131,
title = {What is the efficacy and safety of inositols in treating Polycystic Ovary Syndrome (PCOS) compared to metformin or placebo?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/s131.html}},
note = {Plain-English summary of PubMed PMID 36703143; DOI 10.1186/s12958-023-01055-z; Reprod Biol Endocrinol 2023. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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