If you’ve searched “supplements for PCOS or fertility” you’ve probably come across inositol. It’s arguably the most well-researched supplement for women’s reproductive health these days.
What is inositol and how does it relate to PCOS?
It’s is a natural sugar alcohol that plays many important roles in your body, such as regulating neurotransmitters and hormones. For PCOS and ovarian health, inositol is key. It improves all aspects of PCOS, starting with insulin resistance. Most women with PCOS have some degree of insulin resistance as part of this complex endocrine and metabolic disorder. Reversing insulin resistance is paramount to reversing PCOS. Inositol has been shown to work as well as Metformin in this regard, without the side effects. It’s documented to improve insulin sensitivity, lower triglycerides and blood pressure, and increase HDL (“good” cholesterol).
What else can inositol do for PCOS?
Women with PCOS often have high androgens (“male” hormones) and low sex hormone-binding globulin (SHBG) which binds to androgens to lower excess amounts. Inositol both lowers androgens and raises SHBG, a win-win for PCOS.
PCOS involves disruptions in how the ovaries mature and release eggs from follicles (ovulate). Ovaries have a high need for inositol. This is because they need to uptake a lot of glucose, in order to meet their high-energy requirements. In your ovaries, inositol:
- Controls the uptake of glucose
- Helps your ovary respond to follicle-stimulating hormone (FSH) for egg maturation
- Raises estrogen levels in the ovary, which helps your LH surge – needed for ovulation to happen
- Determines how much testosterone is produced
Inositol is good for egg quality, ovarian response to FSH and LH, insulin sensitivity, ovulation, regular cycles, anxiety, and better SHBG and testosterone levels in PCOS.
Why do women with PCOS need MORE inositol?
It’s not that they need more, it’s that women with PCOS are shown to have lower levels of inositol from the get-go. This is not due to a lack of dietary intake, as it’s high in common foods such as grains, beans, fruits, and nuts. Rather, there appears to be a reduced ability to process, metabolize, and effectively use inositol from foods. We aren’t sure exactly why, but we do know that low inositol is found in women with insulin resistance and PCOS, and research trials consistently show positive results with supplementation.
Does it help fertility for women without PCOS?
Inositol helps fertility for PCOS women by improving egg quality, promoting ovulation, and restoring regular cycles, as research shows. Thus it makes sense that it would improve fertility in general. We don’t have research on inositol and natural fertility. However, benefits were shown for women undergoing IVF who supplemented with inositol:
According to this 2017 review, researchers demonstrated that myo-inositol supplementation can increase pregnancy rate by increasing oocyte and embryo quality during an in vitro fertilization (IVF) program.
You tried it and it didn’t work
You may have heard that inositol supplementation is miraculous for some women – lowering insulin and regulating periods, while it seems to do nothing for others. It turns out that for 30-40% of women, supplemental inositol doesn’t work because it is not well-absorbed. This is termed “inositol resistance.”
This resistance is hypothesized to be due to poor gut health, including dysbiosis – yet another way that gut health and hormone health are intertwined. A fast track to bypass this is to take whey protein or colostrum with inositol. This is because they contain alpha-lactalbumin, a protein that binds with inositol to carry it through your intestinal lining, which bypasses any absorption issues. This study found that 86% of inositol resistant women reversed it with the addition of alpha-lactalbumin.
Also, the duration is important. This study showed no change in SHBG after six months but a significant increase after six months. So if inositol has not worked for you, add whey or colostrum and do it for at least six months.
The populations who can benefit from a good six month trial of inositol:
- All women with PCOS
- Women who are TTC and have issues with egg quality, ovulation timing, or cycle regularity
- Women undergoing IVF
- Bonus: inositol reduces gestational diabetes and is safe to take during pregnancy
The recommended dose is 2000 mg of myo-inositol and 50 mg of d-chiro-inositol twice a day, for six or more months.
Think you have a hormone imbalance? Take my Hormone Balance Quiz and receive a free copy of my guide A Root-Cause Approach to Hormone Balance. This quiz and guide are useful self-assessment tools to harness your cycles and fertility.