The effect of the combination of myoinositol and D-chiroinositol in a ratio of 5:1 on the psychoemotional state and manifestations of androgen-dependent dermopathy in patients with polycystic ovary syndrome

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BACKGROUND

Polycystic ovary syndrome (PCOS) is a common gynecological pathology, manifested by anovulation and hyperandrogenism. The main clinical signs of hyperandrogenism are hirsutism and acne. Many studies have been conducted to study the effect of the combination of myoinositol (MI) with D-chiroinositol (DCI) in a ratio of 5:1 on the hormonal profile of patients with PCOS and androgen-dependent dermopathy.

OBJECTIVE

Evaluation of the effectiveness of combined therapy with MI and DCI in a ratio of 5:1 in the treatment of androgen — dependent dermopathy (acne and hirsutism), as well as analysis of changes in the hormonal profile and the effect of therapy on the level of anxiety and quality of life in patients with PCOS.

MATERIALS AND METHODS

49 patients with PCOS (26.6±3.53 years old) with biochemical and clinical signs of hyperandrogenism were included in the interventional single-center prospective study. There were 43 healthy women in the control group. Each woman with PCOS in the study group was evaluated for the severity of clinical signs of hyperandrogenism — hirsutism and acne. All patients were examined for the following hormonal parameters: LH, FSH, AMH, DHEAS, total testosterone, SHBG, androstenedione, free testosterone and free androgen index (ISA) were calculated. Patients with PCOS received an oral combination of MI and DCI in a ratio of 5:1 for 6 months. The hormonal profile of patients was compared initially, after 3 and 6 months of therapy with the control group. The degree of anxiety as well as the dermatological quality of life index were determined initially and after 6 months of therapy.

RESULTS

A significant increase in the levels of luteinizing hormone (LH), anti-Muller hormone (AMH), dehydroepiandrosterone sulfate (DHEAS), total testosterone, free testosterone, androstendione with a low level of sex hormone binding globulin (SHBG) (p=0.001 for all indicators) were detected before the appointment of therapy in the group of patients with PCOS. Positive dynamics in the treatment of patients with PCOS was observed after 3 months of therapy with a combination of MI+DCI in a ratio of 5:1. There was a decrease in the level of LH (8.0±2.6 vs 12.5±4.5 IU/l, p=0.001), DHEAS (7.7±1.3 vs 8.3±1.3 mmol/l, p=0.013) total testosterone (1.8±0.4 vs 2.5±0.6 nmol/l, p=0.001), free testosterone (20.7±5.7 vs 34.1±9.7 pmol/l, p=0.001), androstendione (11.5±2.0 vs 13.8±2.5 nmol/l, p=0.001), ISA (2.8±0.9 vs 5.6±2.0, p=0.001) compared to the initial values after 6 months of therapy. Initially, all patients with PCOS had acne (22 (45%) had a mild degree, 19 (39%) had a moderate degree and 8 (16%) severe), as well as hirsutism of varying severity. After 6 months of therapy, there were positive results in the treatment of acne, as well as a decrease in the number of patients with severe and moderate hirsutism by 6% and 8%, respectively. The overall score on the Ferriman-Gallway scale also decreased (8.9±3.7 vs 10.1±4.4) (p=0.076). Among patients with PCOS, the degree of anxiety significantly decreased, the number of patients with a slight effect of acne on the quality of life increased by 32%.

CONCLUSIONS

The results of the study showed that the combination of MI with DCI in a ratio of 5:1 can be considered as an effective therapy for biochemical and clinical hyperandrogenism in patients with PCOS. There was an improvement in the psychoemotional state of the patients due to a decrease in anxiety and an improvement in the quality of life.

Keywords:

PCOS

polycystic ovary syndrome

myoinositol

D-chiroinositol

hyperandrogenism

androgen-dependent dermatological manifistations

hirsutism

acne

Authors:

Prilutskaya V.Yu.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Alyautdina O.S.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Sosna N.A.

A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Received:

21.07.2021

Accepted:

26.07.2021

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