Experience of myo-inositol use in patients with oligomenorrhea and insulin resistance
Spiridonova N.V., Popova E.I., Levin V.A., Deviatov I.M.
Oligomenorrhea (OM) is a menstrual disorder that can be associated with various causes including disorders of carbohydrate and fat metabolism. One of the manifestations of impaired carbohydrate metabolism is insulin resistance (IR) which leads to hyperinsulinemia. Excess insulin stimulates the adrenal glands and results in hyperandrogenism, which in turn reduces the sensitivity of estrogen-dependent ovarian receptors to insulin. This condition is further complicated by polycystic ovary syndrome.
Objective: To study the effect of administration of myo-inositol (MI) in combination with alpha-lactalbumin (α-LA) on the length of the menstrual cycle and the rate of carbohydrate metabolism in women with OM and IR.
Materials and methods: An observational study included 30 reproductive-aged patients of with OM and IR, who were administered a three-month course of treatment with the Inofert Forte complex containing MI 600 mg + α-LA + folic acid 200 mcg. The patients were evaluated for the clinical, anamnestic and anthropometric data, bioimpedance analysis of body composition, and the results of an oral glucose tolerance test (OGTT) with insulin before and after the course of therapy.
Results: After the course of treatment with a combination of MI + α-LA, the length of the menstrual cycle became normal in 13/22 (59.1%) patients and was 34.2 (1.0) days in these women. The average length of the menstrual cycle was 38.4 (1.9) days (p<0.001). A decrease in fasting glucose levels was found in 16/30 (53.3%) patients, in 20/30 (66.7%) patients after one hour and in 30/30 (100%) patients after two hours (Δ0.66±0.35, p<0.001). A decrease in fasting insulin levels was noted in 19/30 (63.3%) of the examined patients two hours after OGTT (p<0.04).
Conclusion: The addition of the complex containing MI 600 mg + α-LA + folic acid 200 mcg (Inofert Forte) to the therapy of patients with OM and IR may have a positive effect on the menstrual cycle and may improve metabolic parameters.
Authors' contributions: Spiridonova N.V. – developing the concept and design of the study; Spiridonova N.V., Popova E.I. – collecting and processing the material; Popova E.I., Levin V.A. – statistical processing of the data; Popova E.I., Deviatov I.M. – writing the text; Spiridonova N.V., Levin V.A. – editing the article.
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
Ethical Approval: The study was approved by the Ethical Review Board of the Samara State Medical University, Ministry of Health of Russia.
Patient Consent for Publication: The patients signed informed consent for the publication of their anonymized data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Spiridonova N.V., Popova E.I., Levin V.A., Deviatov I.M.
Experience of myo-inositol use in patients with oligomenorrhea and insulin resistance.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (8): 179-186 (in Russian)
https://dx.doi.org/10.18565/aig.2025.139
Keywords
insulin resistance
hyperinsulinemia
obesity
oral glucose tolerance test (OGTT)
bioimpedance analysis
myo-inositol (MI)
alpha-lactalbumin (α-LA)
oligomenorrhea
References
- Министерство здравоохранения Российской Федерации. Клинические рекомендации. Аменорея и олигоменорея. М.; 2024. 62 с. [Ministry of Health of the Russian Federation. Clinical guidelines. Amenorrhea and oligomenorrhea. Moscow; 2024. 62 p. (in Russian)].
- Dupont J., Scaramuzzi R.J. Insulin signalling and glucose transport in the ovary and ovarian function during the ovarian cycle. Biochem. J. 2016; 473(11): 1483-501. https://dx.doi.org/10.1042/BCJ20160124
- Титова М.С., Колодина М.И., Ляшенко А.С., Ляшенко Е.Н. Применение мио-инозитола у женщин с синдромом поликистозных яичников при вспомогательных репродуктивных технологиях. Медицинский совет. 2022; 16(16): 50-6. [Titova M.S., Kolodina M.I., Lyashenko A.S., Lyashenko E.N. Use of myo-inositol in women with polycystic ovary syndrome in the application of auxiliary reproductive technologies. Meditsinskiy Sovet. 2022; 16(16): 50-6 (in Russian)]. https://dx.doi.org/10.21518/2079-701X-2022-16-16-50-56
- Li M., Chi X., Wang Y., Setrerrahmane S., Xie W., Xu H. Trends in insulin resistance: insights into mechanisms and therapeutic strategy. Signal Transduct. Target. Ther. 2022; 7(1): 216. https://dx.doi.org/10.1038/s41392-022-01073-0
- Аганезова Н.В., Аганезов С.С. Ожирение и репродуктивное здоровье женщины. Акушерство и гинекология. 2016; 6: 18-25. [Aganezova N.V., Aganezov S.S. Obesity and women's reproductive health. Obstetrics and Gynecology. 2016; (6): 18-25 (in Russian)]. https://dx.doi.org/10.18565/aig.2016.6.18-25
- Anagnostis P., Tarlatzis B.C., Kauffman R.P. Polycystic ovarian syndrome (PCOS): long-term metabolic consequences. Metabolism. 2018; 86: 33-43. https://dx.doi.org/10.1016/j.metabol.2017.09.016
- Оксюта В.Н. Исследование биоимпедансных показателей у женщин с бесплодием при гипотиреозе. Репродуктивное здоровье. Восточная Европа. 2013; 6(30): 81-7. [Oksyuta V.N. Study of bioimpedance parameters in women with infertility and hypothyroidism. Reproductive health. Eastern Europe. 2013; 6(30): 81-7 (in Russian)].
- Николаев Д.В., Щелыкалина С.П. Биоимпедансный анализ состава тела человека: медицинское применение, терминология. Клиническое питание и метаболизм. 2021; 2(2): 80-91. [Nikolaev D.V., Shchelykalina S.P. Bioimpedance analysis of human body composition: medical applications, terminology. Clinical nutrition and metabolism. 2021; 2(2): 80-91 (in Russian)]. https://dx.doi.org/10.17816/clinutr72132
- Дадаева В.А., Еганян Р.А., Розанов В.Б., Елиашевич С.О., Громова А.В., Котова М.Б., Иванова Е.И., Драпкина О.М. Особенности компонентного состава тела, физического и психического здоровья женщин с избыточным весом. Профилактическая медицина. 2022; 25(9): 60-9. [Dadaeva V.A., Eganyan R.A., Rozanov V.B., Eliashevich S.O., Gromova A.V., Kotova M.B., Ivanova E.I., Drapkina O.M. Body composition, physical and mental health of overweight females. Russian Journal of Preventive Medicine. 2022; 25(9): 60-9 (in Russian)]. https://dx.doi.org/10.17116/profmed20222509160
- Турчинец А.И., Уварова Е.В., Хащенко Е.П., Кумыкова З.Х. Таргетная терапия синдрома поликистозных яичников. Медицинский совет. 2023; 17(5): 7-13. [Turchinets A.I., Uvarova E.V., Khashchenko E.P., Kumykova Z.Kh. Target therapy of polycystic ovary syndrome. Meditsinskiy Sovet. 2023; 17(5): 7-13 (in Russian)]. https://dx.doi.org/10.21518/ms2023-060
- Пустотина О.А. Инозитол и липоевая кислота в лечении инсулинорезистентности у женщин с синдромом поликистозных яичников. Акушерство и гинекология. 2020; 12: 209-16. [Pustotina O.A. Inositol and lipoic acid in the treatment of insulin resistance in women with polycystic ovary syndrome. Obstetrics and Gynecology. 2020; (12): 209-16 (in Russian)]. https://dx.doi.org/10.18565/aig.2020.12.209-216
- Чернуха Г.Е., Пронина В.А. Коррекция метаболической дисфункции как метод восстановления функции репродуктивной системы у женщин. Медицинский совет. 2023; 17(5): 90-7. [Chernukha G.E., Pronina V.A. Metabolic dysfunction correction as a method of restoring the function of the reproductive system in women. Meditsinskiy Sovet. 2023; 17(5): 90-7 (in Russian)]. https://dx.doi.org/10.21518/ms2023-087
- Monastra G., Sambuy Y., Ferruzza S., Ferrari D., Ranaldi G. Alpha-lactalbumin effect on myo-inositol intestinal absorption: in vivo and in vitro. Curr. Drug Deliv. 2018; 15(9): 1305-11. https://dx.doi.org/10.2174/1567201815666180509102641
- Montanino O.M., Buonomo G., Calcagno M., Unfer V. Effects of myo-inositol plus alpha-lactalbumin in myo-inositol-resistant PCOS women. J. Ovarian Res. 2018; 11(1): 38. https://dx.doi.org/10.1186/s13048-018-0411-2
- Greff D., Juhász A.E., Váncsa S., Váradi A., Sipos Z., Szinte J. et al. Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Reprod. Biol. Endocrinol. 2023; 21(1): 10. https://dx.doi.org/10.1186/s12958-023-01055-z
- Эфендиева Р.М., Дикке Г.Б., Абусуева З.А., Шилова Н.В. Опыт восстановления менструального цикла у пациенток с олиго-/аменореей и ожирением с помощью комплекса, содержащего миоинозитол и D-хироинозитол в соотношении 5:1, фолиевую кислоту и марганец. Акушерство и гинекология. 2025; 2: 110-20. [Efendieva R.M., Dikke G.B., Abusueva Z.A., Shilova N.V. Experience in restoring the menstrual cycle in patients with oligo-/amenorrhea and obesity using a complex containing myo-inositol and D-chiro-inositol in a 5:1 ratio, folic acid, and manganese. Obstetrics and Gynecology. 2025; (2): 110-20 (in Russian)]. https://dx.doi.org/10.18565/aig.2025.31
- Gudović A., Bukumirić Z., Milincic M., Pupovac M., Andjić M., Ivanovic K. et al. The comparative effects of myo-inositol and metformin therapy on the clinical and biochemical parameters of women of normal weight suffering from polycystic ovary syndrome. Biomedicines. 2024; 12(2): 349. https://dx.doi.org/10.3390/biomedicines12020349
- Kamenov Z., Gateva A., Dinicola S., Unfer V. Comparing the efficacy of myo-inositol plus α-lactalbumin vs. myo-inositol alone on reproductive and metabolic disturbances of polycystic ovary syndrome. Metabolites. 2023; 13(6): 717. https://dx.doi.org/10.3390/metabo13060717
- Рintaudi B., Di Vieste G., Corrado F., Lucisano G., Giunta L., D'Anna R. et al. Effects of myo-inositol on glucose variability in women with gestational diabetes. Eur. Rev. Med. Pharmacol. Sci. 2018; 22(19): 6567-72. https://dx.doi.org/10.26355/eurrev_201810_16073
- Чулков В.С., Гаврилова Е.С., Чулков В.С., Минина Е.Е. Репродуктивное здоровье и кардиометаболический риск. Сибирское медицинское обозрение. 2018; 4(112): 13-21. [Chulkov V.S., Gavrilova E.S., Chulkov V.S., Minina E.E. Reproductive health and cardiometabolic risk. Siberian Medical Review. 2018; 4(112): 13-21 (in Russian)]. https://dx.doi.org/10.20333/2500136-2018-4-13-21
- Аметов А.С. Секреция инсулина в норме и при сахарном диабете 2 типа. Сахарный диабет. 2007: 10(4): 11-6. [Ametov A.S. Insulin secretion in normal conditions and in type 2 diabetes. Diabetes mellitus. 2007; 10(4): 11-6 (in Russian)]. https://dx.doi.org/10.14341/2072-0351-5860
- Muraca E., Ciardullo S., Oltolini A., Zerbini F., Bianconi E., Perra S. et al. Resting energy expenditure in obese women with primary hypothyroidism and appropriate levothyroxine replacement therapy. J. Clin. Endocrinol. Metab. 2020; 105(4): dgaa097. https://dx.doi.org/10.1210/clinem/dgaa097
- Cheng K.Y., Chow S.K., Hung V.W., Wong C.H., Wong R.M., Tsang C.S. et al. Diagnosis of sarcopenia by evaluating skeletal muscle mass by adjusted bioimpedance analysis validated with dual-energy X-ray absorptiometry. J. Cachexia Sarcopenia Muscle. 2021; 12(6): 2163-73. https://dx.doi.org/10.1002/jcsm.12825
- Курмаев Д.П., Булгакова С.В., Тренева Е.В., Четверикова И.С., Косарева О.В., Шаронова Л.А., Долгих Ю.А., Мусиенко С.К. Биоимпедансный анализ состава тела женщин пожилого и старческого возраста с сахарным диабетом 2 типа. Современные проблемы здравоохранения и медицинской статистики. 2022; 5: 219-36. [Kurmaev D.P., Bulgakova S.V., Treneva E.V., Chetverikova I.S., Kosareva O.V., Sharonova L.A., Dolgikh Yu.A., Musienko S.K. Bioimpedance analysis of the body composition in elderly and old women with type 2 diabetes mellitus. Current problems of health care and medical statistics. 2022; (5): 219-36 (in Russian)]. https://dx.doi.org/10.24412/2312-2935-2022-5-219-236
- Доброхотова Ю.Э., Лапина И.А., Чирвон Т.Г., Таранов В.В. Новые возможности интегративной терапии пациенток с синдромом поликистозных яичников и нарушениями углеводного и липидного обмена. Результаты сравнительного исследования. РМЖ. Мать и дитя. 2020; 3(3): 169-73. [Dobrokhotova Yu.E., Lapina I.A., Chirvon T.G., Taranov V.V. New prospects of the integrative therapy for polycystic ovary syndrome in women with the disorders of carbohydrate and lipid metabolism: a comparative study. Russian Journal of Woman and Child Health. 2020; 3(3): 169-73 (in Russian)]. https://dx.doi.org/10.32364/2618-8430-2020-3-3-169-173
- Долгих Ю.А., Булгакова С.В., Шаронова Л.А., Тренева Е.В., Косарева О.В., Курмаев Д.П. Синдром поликистозных яичников и метаболический синдром: возможные пути коррекции метаболических нарушений. Экспериментальная и клиническая гастроэнтерология. 2024; (2): 5-14. [Dolgikh Yu.A., Bulgakova S.V., Sharonova L.A., Treneva E.V., Kosareva O.V., Kurmaev D.P. Polycystic ovary syndrome and metabolic syndrome: possible ways to correct metabolic disorders. Experimental and Clinical Gastroenterology. 2024; (2): 5-14 (in Russian)]. https://dx.doi.org/10.31146/1682-8658-ecg-222-2-5-14
- Хамошина М.Б., Епишкина-Минина А.А., Рябова В.А., Елагин И.Б. В петле метаболического риска. StatusPraesens. Гинекология, акушерство, бесплодный брак. 2020; 4(69): 35-41. [Khamoshina M.B., Epishkina-Minina A.A., Ryabova V.A., Elagin I.B. In the metabolic risk loop. StatusPraesens. Gynecology, obstetrics, infertile marriage. 2020; 4(69): 35-41 (in Russian)].
Received 27.05.2025
Accepted 25.07.2025
About the Authors
Nataliya V. Spiridonova, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology, Samara State Medical University, Ministry of Health of Russia, 443099, Russia, Samara, Chapaevskaya str., 89, https://orcid.org/0000-0003-3928-3784Evgeniya I. Popova, applicant at the Department of Obstetrics and Gynecology, Samara State Medical University, Ministry of Health of Russia,
443099, Russia, Samara, Chapaevskaya str., 89, evgeniya1popova@gmail.com, https://orcid.org/0000-0002-7249-1721
Vitaly A. Levin, endocrinologist, Ornament Health AG, Lucerne, Switzerland, https://orcid.org/0009-0000-8758-0842
Ilia M. Deviatov, student at the Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia, 117198, Russia, Moscow, Miklukho-Maklaya str., 6,
https://orcid.org/0000-0002-6025-8148
Corresponding author: Evgeniya I. Popova, evgeniya1popova@gmail.com
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