--- title: "Evidence: insulin second-messenger" description: "Inositols are an effective and safe treatment for PCOS, showing similar benefits to metformin for many outcomes." url: "https://magellanlongevity.com/study/s131.md" canonical: "https://magellanlongevity.com/study/s131.html" html: "https://magellanlongevity.com/study/s131.html" type: "study" study_key: "s131" journal: "Reprod Biol Endocrinol" year: 2023 pmid: "36703143" doi: "10.1186/s12958-023-01055-z" citations: 1 updated: 2026-09-02 author: "Gabriel Radu, DO" author_credentials: "Physiatrist (PM&R). NY medical license 275110. NPI 1376861765." publisher: "Magellan Longevity" content_format: "markdown" --- # Evidence: insulin second-messenger [Home](https://magellanlongevity.com/) › [Research map](https://magellanlongevity.com/longevity-research-map.html) › Evidence: insulin second-messenger **HTML version:** https://magellanlongevity.com/study/s131.html · **In the Magellan app:** https://magellanlongevity.com/#/study/s131 ## Citation | Field | Value | | --- | --- | | Journal | Reprod Biol Endocrinol | | Year | 2023 | | PMID | [36703143](https://pubmed.ncbi.nlm.nih.gov/36703143/) | | DOI | [10.1186/s12958-023-01055-z](https://doi.org/10.1186/s12958-023-01055-z) | | Study key | s131 | ## Takeaway 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? ## Hypothesis Inositols may be a potential alternative to metformin for treating PCOS, with comparable efficacy and safety. ## Methods 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). ## Results 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). ## Conclusion 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. ## Verbatim from the abstract > Inositol is an effective and safe treatment in PCOS ## Mean Differences of Inositol vs. Placebo in PCOS Outcomes | Measure | Mean Difference | | --- | --- | | 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.* ## Where this study is used on Magellan This paper is one of the citations behind the evidence grade on the pages below. Grades are assigned from the published research and are independent of affiliate commissions. | Compound or device | Evidence grade | Graded pages | | --- | --- | --- | | Myo-Inositol | Moderate evidence | [Myo-Inositol](https://magellanlongevity.com/p/131.md) | ## Reference 1. **Evidence: insulin second-messenger** Reprod Biol Endocrinol 2023 · [PMID 36703143](https://pubmed.ncbi.nlm.nih.gov/36703143/) · [DOI 10.1186/s12958-023-01055-z](https://doi.org/10.1186/s12958-023-01055-z) > Inositol is an effective and safe treatment in PCOS ## Structured data ```json {"@context":"https://schema.org","@graph":[{"@type":"MedicalWebPage","@id":"https://magellanlongevity.com/study/s131.html#page","url":"https://magellanlongevity.com/study/s131.html","name":"Evidence: insulin second-messenger","description":"Inositols are an effective and safe treatment for PCOS, showing similar benefits to metformin for many outcomes.","inLanguage":"en","isPartOf":{"@type":"WebSite","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"author":{"@type":"Person","name":"Gabriel Radu, DO","jobTitle":"Physiatrist (PM&R)","identifier":[{"@type":"PropertyValue","name":"NPI","value":"1376861765"},{"@type":"PropertyValue","name":"NY medical license","value":"275110"}]},"publisher":{"@type":"Organization","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"encoding":{"@type":"MediaObject","encodingFormat":"text/markdown","contentUrl":"https://magellanlongevity.com/study/s131.md"},"dateModified":"2026-09-02"},{"@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://magellanlongevity.com/"},{"@type":"ListItem","position":2,"name":"Research map","item":"https://magellanlongevity.com/longevity-research-map.html"},{"@type":"ListItem","position":3,"name":"Evidence: insulin second-messenger","item":"https://magellanlongevity.com/study/s131.html"}]},{"@type":"ScholarlyArticle","@id":"https://magellanlongevity.com/study/s131.html#study","name":"Evidence: insulin second-messenger","headline":"Evidence: insulin second-messenger","datePublished":"2023","isPartOf":{"@type":"Periodical","name":"Reprod Biol Endocrinol"},"identifier":"PMID:36703143","url":"https://pubmed.ncbi.nlm.nih.gov/36703143/","sameAs":"https://doi.org/10.1186/s12958-023-01055-z","abstract":"Inositols are an effective and safe treatment for PCOS, showing similar benefits to metformin for many outcomes."}]} ``` ## Related on Magellan Longevity - [Myo-Inositol](https://magellanlongevity.com/p/131.md) — product graded on this and related evidence - [A randomized controlled trial comparing myoinositol with metformin versus metformin…](https://magellanlongevity.com/study/d37265016.md) - [Comparison of two insulin sensitizers, metformin and myo-inositol, in women with PCOS](https://magellanlongevity.com/study/d27808588.md) - [Longevity research map](https://magellanlongevity.com/longevity-research-map.html) - [Evidence-based longevity supplements](https://magellanlongevity.com/longevity-supplements.md) ## Scope and disclosures Educational information, not medical advice. Nothing here is intended to diagnose, treat, cure, or prevent any disease. Talk to your physician before starting any supplement or device, especially if you are pregnant, nursing, or taking medication. Editorial firewall: evidence grades are assigned from the published research and are independent of any affiliate commission. As an Amazon Associate, Magellan Longevity earns from qualifying purchases. Reviewed for accuracy by a board-certified physician (DO).