Metformin vs myoinositol: which is better in obese polycystic ovary syndrome patients? A randomized controlled crossover study
Abstract
CONTEXT: Due to the central role of metabolic abnormalities in the pathophysiology of polycystic ovary syndrome (PCOS), insulin sensitizing agents have been proposed as a feasible treatment option. OBJECTIVE: To investigate which is the more effective between metformin and myoinositol (MYO) on hormonal, clinical and metabolic parameters in obese patients with PCOS. STUDY DESIGN: Crossover randomized controlled study. PATIENTS: ) were randomized to receive metformin (850 mg twice a day) or MYO (1000 mg twice a day) for 6 months. After a 3 month washout, the same subjects received the other compound for the following 6 months. MEASUREMENTS: Ultrasonographic pelvic examinations, hirsutism score, anthropometric and menstrual pattern evaluation, hormonal profile assays, oral glucose tolerance test (OGTT) and lipid profile at baseline and after 6 months of treatment were performed. RESULTS: Both metformin and MYO significantly reduced the insulin response to OGTT and improved insulin sensitivity. Metformin significantly decreased body weight and improved menstrual pattern and Ferriman-Gallwey score. Metformin treatment was also associated with a significant decrease in LH and oestradiol levels, androgens and anti-müllerian hormone levels. None of these clinical and hormonal changes were observed during MYO administration. CONCLUSIONS: Both treatments improved the glyco-insulinaemic features of obese PCOS patients, but only metformin seems to exert a beneficial effect on the endocrine and clinical features of the syndrome.
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Three included studies enrolled women with PCOS with an overweight or obese BMI classification.
“Three studies enrolled women with PCOS with an overweight or obese BMI classification (29, 44, 54).”
From Inositol for Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis to Inform the 2023 Update of the International Evidence-based PCOS Guidelines (2024) · cites this paper as [54]
In women with PCOS, gastrointestinal adverse events are less common with myo-inositol than with metformin (6 RCTs, OR 0.09, 95% CI 0.02 to 0.37; moderate certainty).
“In a meta-analysis of 6 trials, GI AEs were less common in the MI group compared with metformin (OR 0.09, 0.02 to 0.37, I2 = 69%, 6 trials, Fig. 5Q) (26, 33, 51-54).”
From Inositol for Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis to Inform the 2023 Update of the International Evidence-based PCOS Guidelines (2024) · cites this paper as [54]
Two included studies investigated overweight and obese women with polycystic ovary syndrome.
“In the case of two studies, BMI was also an inclusion criterion, meaning they investigated overweight and obese women with PCOS [43, 51].”
From Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials (2023) · cites this paper as [51]
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- Authors
- Tagliaferri, V., Romualdi, D., Immediata, V., De Cicco, S., Di Florio, C., Lanzone, A., & Guido, M.
- Affiliations
- Università Cattolica del Sacro Cuore (IT)
- Department of Obstetrics and Gynaecology Università Cattolica del Sacro Cuore Roma Italy
- Corresponding author
- Immediata, Valentina
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2017-02-10
- Volume
- 86
- Issue
- 5
- Pages
- 725-730
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2578533685
- Cited by
- 40
- References
- 37
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 6 · 2023: 9 · 2022: 2 · 2021: 4 · 2020: 6 · 2019: 5 · 2018: 3 · 2017: 2
- FWCI
- 5.08
- Type
- journal article
- Language
- en
- Update notices
- correction (2026-09-15)
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Archive of Doctoral Theses and Digital Collections (University of Calabria) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università degli Studi dell Aquila (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Keywords
- metformin, myo-inositol, polycystic ovary syndrome, obesity, insulin sensitizers, insulin resistance, insulin sensitivity, menstrual pattern, hirsutism, androgens, anti-Müllerian hormone, luteinizing hormone, estradiol, weight loss, lipid profile
- MeSH terms
- Adult, Female, Humans, Hypoglycemic Agents, Inositol, Metformin, Obesity, Polycystic Ovary Syndrome, Outcome Assessment, Health Care, Cross-Over Studies, Young Adult
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