Myoinositol or D-chiro-inositol for PCOS symptoms in adolescents: a narrative review

Introduction Polycystic ovary syndrome (PCOS) treatment in adolescents currently focuses on lifestyle interventions, with pharmacological treatment options often limited to hormonal contraceptives. Several of these carry broad side-effect profiles and are not always accepted by young girls. There is growing interest in non-hormonal therapies for PCOS. We aimed to collate the evidence on the use of myoinositol or D-chiro-inositol in the improvement of PCOS symptoms in symptomatic adolescents. Content Design Narrative review. Methods A systematic literature review identifying key articles from inception to March 2023. Participants Female adolescents (aged 12–19 years) with PCOS or PCOS-like features. Intervention Myoinositol or D-chiro-inositol with or without additional interventions. Comparison Any other treatment, including lifestyle interventions, hormonal therapy, metformin or no treatment. Main outcome measures Improvement in symptoms, quality of life and adverse effects. Summary Eight studies were included: two randomised open-label trials, one quasi-randomised and three non-randomised interventional studies, one case-control study and one cohort study. All studies showed improvements in some biochemical markers, metabolic parameters or clinical symptoms, but these were not reproducible across all studies. Outlook The benefit of myoinositol in adolescents with PCOS remains unclear, with limited high-quality evidence. This review highlights the need for robustly conducted research to inform clinical practice.