Effect of myo-inositol and D-chiro-inositol combination therapy on improvement in menstrual irregularities and biochemical characteristics in patients with polycystic ovarian syndrome

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Objective: To compare improvement in menstrual irregularity and hormone levels in females with polycystic ovarian syndrome (PCOS) treated with myo-inositol (MI) and D-chiro-inositol (DCI) combination therapy versus placebo. Design: Randomized Controlled Trial Place and Duration of Study: Obstetrics and Gynecology department, Nishtar Hospital Multan. Over 06 months (1st June 2025 to 30th November 2025). Methodology: Sixty women aged 18-45 years with PCOS were enrolled and allocated to combination therapy or placebo for three months. Menstrual irregularity was defined as amenorrhea, oligomenorrhea, or menorrhagia. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone levels were obtained at baseline and after three months. Monthly follow up assessed improvement in menstrual regularity. Data analysis was performed through SPSS version 27. Quantitative variables are reported as mean ± SD and qualitative as number and proportion. Between group comparison was done through t-test for quantitative variables and chi-square test for categorical variables. P-value below 0.05 was considered substantial. Results: Mean age was 32.2±6.2 years, 65% married, 51.7% obese and oligomenorrhea was commonest (51.7%) irregularity. Baseline age, marital status, obesity and menstrual irregularities were comparable between groups. Improvement in menstrual irregularities was higher with combination therapy than placebo (70% vs. 20%, p<0.001). After three months, serum FSH (6.3±1.1 vs. 8.6±1.6 mIU/ml, p<0.001), LH (12.3±12.3 vs. 24.5±13.2 mIU/ml, p<0.001), and testosterone levels (24.5±13.2 vs. 31.8±20.4, p=0.012), were substantially lower in the combination therapy group in contrast to placebo. Conclusion: Myo-inositol with D-chiro-inositol combination therapy improved menstrual irregularity and hormonal profile than folic acid alone in women with PCOS.

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