Efficacy of myo‐inositol and d‐chiro‐inositol combination on menstrual cycle regulation and improving insulin resistance in young women with polycystic ovary syndrome: A randomized open‐label study

Abstract Objective To compare the effect of myo‐inositol and d ‐chiro‐inositol in combination (MI + DCI) with combined hormonal contraceptive (CHC) on menstrual cycle regulation in young Indian women with polycystic ovary syndrome (PCOS). Methods Seventy young women with PCOS aged 15–24 years with delayed cycles were randomized into two groups and were treated for 6 months with MI + DCI (550 + 150 mg, 3.6:1 ratio) twice a day and CHC (ethinyl estradiol 20 µg + drospirenone 3 mg) once a day. Results Spontaneous menses resumed in 28 (84.85%) young women on MI + DCI, compared with withdrawal bleeding in 34 (100%) on CHC. The mean cycle length reduced with both MI + DCI (124.54 ± 8.08 to 57.75 ± 3.00 days, P < 0.001) and CHC (105.88 ± 7.96 to 30.53 ± 2.95 days, P < 0.001). Regular menstrual cycles were established in 9 (27.27%) young women with MI + DCI ( P = 0.001) and 30 (88.23%) with CHC ( P < 0.001). Three months after stopping the treatment, 24 young women (85.71%) on MI + DCI and 25 (73.53%) on CHC continued to have spontaneous cycles. Anti‐Müllerian hormone decreased with both the drugs ( P = 0.001), whereas luteinizing hormone ( P = 0.001) and testosterone ( P = 0.04) decreased with CHC and homeostatic model assessment of insulin resistance ( P < 0.001) with MI + DCI. Conclusion Myo‐inositol and d ‐chiro‐inositol in combination (3.6:1 ratio) are effective in regularizing menstrual cycles and improving insulin resistance. Trial registration Clinical Trials Registry of India (CTRI/2018/03/012643). http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=20969&EncHid=&userName=myo‐inositol