Introduction: Polycystic ovary syndrome (PCOS), a common endocrinological disorder of women of reproductive age, affects about 5-20% of women globally. It is diagnosed through the Rotterdam criteria with the presence of two out of three clinical features of oligo-anovulation, hyperandrogenism, and/or polycystic ovaries. Hyperinsulinemia and insulin resistance are central features of PCOS , along with obesity. This study aims to compare three treatment interventions: metformin, inositol, and lifestyle modifications to improve symptoms of PCOS.
Methods: In this four-arm randomized study, 48 women of reproductive age (25-36 years) will be recruited over a 12-week period. Impacts of treatment types (metformin, inositol and lifestyle modifications) will be determined in improving symptoms of PCOS. Control group, “Group A” (N=12) will not be going through any treatment; “Group B” (N=12) will be taking 500 mg of metformin daily, with close assessment of side effects; “Group C” will take 2 g of inositol supplements twice daily with a 40:1 myo-inositol and D-chiro-inositol ratio; and “Group D” will undergo lifestyle modifications, closely monitored by personal trainers, nutritionists, and dietitians, to facilitate weight loss. ANOVA, Pearson’s correlation, and Kruskal-Wallis H test will be conducted to determine significance.
Anticipated Results: PCOS patients of group C, inositol intake, may be seen to have greatest improvements in PCOS symptomatology due to its insulin sensitizing, metabolic, and hormonal influences, with minimal adverse effects.
Discussion: Previous studies have shown inositol consumption to result in significant improvements in insulin resistance, menstrual cycle regularity, Acne score, Ferriman-Gallwey score, endocrine and metabolic parameters, reduced serum levels of total testosterone, and elevated sex hormone binding globulin in women with PCOS. Metformin may yield similar effects to inositol, but greater adverse effects may be present. Through a reduced BMI, lifestyle modifications have shown to significantly reduce total androgen profile, waist circumference, and lipid profile while increasing clinical pregnancy rate by 20%.
Conclusion: The comparison of three treatment modalities may be beneficial for PCOS patients to provide optimal treatment. It may be beneficial to compare a combination of treatment interventions in the future for additive or synergistic effects.
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