多囊卵巢综合征 | PCOS

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多囊卵巢综合征（PCOS）

多囊卵巢综合征（PCOS）影响5%-10%的育龄妇女，是卵巢功能不全和月经不调引起不孕的最常见原因。有几项研究报道，无论体重指数如何，多囊卵巢综合征妇女普遍存在胰岛素抵抗。胰岛素增敏化合物被认为是解决高胰岛素血症引起的卵巢对内源性促性腺激素反应功能障碍的有效治疗方法，这也提示了胰岛素抵抗在多囊卵巢综合征中的重要性。挽救卵巢对内源性促性腺激素的反应可降低高雄激素血症，并重建月经周期和排卵，增加自然怀孕的机会。在胰岛素增敏化合物中，有肌醇。先前的研究已经证明，在大多数多囊卵巢综合征患者中，MYO能够恢复自发的卵巢活动，从而恢复生育能力。现就MYO治疗多囊卵巢综合征（PCOS）的临床疗效、代谢及激素水平进行综述。

症狀包含 :月經不規律或無月經、月經量過多、多毛症、粉刺、盆腔疼痛、難以受孕、黑棘皮症等等

肌醇

本研究的目的是評估肌醇治療對多毛婦女的影響，同時也考慮了血脂模式和胰島素敏感性的變化。46名多毛婦女在第一婦產科學研究所登記，並在基線和接受肌醇治療6個月後進行評估。評估體重指數（BMI）、多毛症、血清總膽固醇、高密度脂蛋白（HDL）膽固醇、低密度脂蛋白（LDL）膽固醇、甘油三酯、載脂蛋白B、脂蛋白（a）、血清腎上腺和卵巢雄激素、空腹血糖和胰島素濃度。未觀察到體重指數的變化。治療後多毛减少（P<0.001）。總雄激素、FSH和LH濃度降低，而雌二醇濃度升高。總膽固醇濃度略有降低，高密度脂蛋白膽固醇濃度升高，低密度脂蛋白膽固醇濃度降低。血清甘油三酯、載脂蛋白B和脂蛋白（a）濃度無明顯變化。通過穩態模型分析，治療後胰島素抵抗（P<0.01）顯著降低。口服肌醇可顯著降低多毛症和高雄激素血症，改善多毛症婦女的异常代謝狀況。(8)

可能適合的補充劑支援:

  • 周期不适(1,2,3)
  • 頭髮稀疏(4)
  • 唇毛(5)
  • 体毛(5)
  • 粉刺(6)
  • 睡眠障碍(7)
Polycystic ovary syndrome (PCOS)
Polycystic ovary syndrome (PCOS) affects 5%-10% of women in reproductive age, and it is the most common cause of infertility due to ovarian dysfunction and menstrual irregularity. Several studies have reported that insulin resistance is common in PCOS women, regardless of the body mass index. The importance of insulin resistance in PCOS is also suggested by the fact that insulin-sensitizing compounds have been proposed as putative treatments to solve the hyperinsulinemia-induced dysfunction of ovarian response to endogenous gonadotropins. Rescuing the ovarian response to endogenous gonadotropins reduces hyperandrogenemia and re-establishes menstrual cyclicity and ovulation, increasing the chance of a spontaneous pregnancy. Among the insulin-sensitizing compounds, there is myo-inosiol (MYO). Previous studies have demonstrated that MYO is capable of restoring spontaneous ovarian activity, and consequently fertility, in most patients with PCOS. With the present review, we aim to provide an overview on the clinical outcomes of the MYO use as a treatment to improve ovarian function and metabolic and hormonal parameters in women with PCOS.

Symptoms include: Irregular or irregular menstruation, Menorrhagia, Hirsutism, Acne, Pelvic Pain, Difficult to conceive, Acanthosis nigricans

Inositol

The aim of this study was to evaluate the effects of myo-inositol treatment in hirsute women; changes in lipid pattern and insulin sensitivity were also considered. Forty-six hirsute women were enrolled at the first Institute of Obstetrics and Gynecology and evaluated at baseline and after receiving myo-inositol therapy for 6 months. Body mass index (BMI), hirsutism, serum concentrations of total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, apolipoprotein B, lipoprotein(a), serum adrenal and ovarian androgens, fasting glucose and insulin concentrations were evaluated. No changes in BMI were observed. The hirsutism decreased after therapy (P < 0.001). Total androgens, FSH and LH concentrations decreased while oestradiol concentrations increased. There was a slight non-significant decrease in total cholesterol concentrations, an increase in HDL cholesterol concentrations and a decrease in LDL cholesterol concentrations. No significant changes were observed in serum triglyceride, apolipoprotein B and lipoprotein(a) concentrations. Insulin resistance (P < 0.01), analysed by homeostasis model assessment, was reduced significantly after therapy. Administration of oral myo-inositol significantly reduced hirsutism and hyperandrogenism and ameliorated the abnormal metabolic profile of women with hirsutism.(8)

Possible supplements supporting::
  • Periodic discomfort(1,2,3)
  • Thinning hair(4)
  • Labial hair(5)
  • Body hair(5)
  • Acne(6)
  • Sleep disturbances(7)
Refs:
  1. Gerli S, Papaleo E, Ferrari A, et al. Randomized, double-blind, placebo-controlled trial: effects of myo-inositol on ovarian function and metabolic factors in women with PCOS. Eur Rev Med Pharmacol Sci. 2007;11:347-354
  2. Costantino D, Minozzi G, Minozzi E, Guaraldi C. Metabolic and hormonal effects of myo-inositol in women with polycystic ovary
    syndrome: a double-blind trial. Eur Rev. Med Pharmacol Sci. 2009;13(2):105-110.
  3. Raffone E, Rizzo P, Benedetto V. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. Gynecol Endocrinol. 2010;26(4):275-280.
  4. Ablon Glynis, MD, FAAD. A Double-blind, Placebo-controlled Study Evaluating the Efficacy of an Oral Supplement in Women with Self-perceived Thinning Hair. J Clin Aesthet Dermatol. v.5(11); 2012 Nov. PMC3509882
  5. M Minozzi,1 G D’Andrea,2 V Unfer2,31First Institute of Obstetrics and Gynecology, University La Sapienza; 2A.G.UN.CO. Obstetrics and Gynecology Centre, Rome, Italy. Treatment of hirsutism with myo-inositol: a prospective clinical study. RBMOnline - Vol 17 No 4. 2008 579-582 Reproductive BioMedicine Online; www.rbmonline.com/Article/3299 on web 20 August 2008.
  6. Michele Pezza, Valentina Carlomagno, Ambulatorio di Dermatologia Casa di Cura Villa Maria Passo di Mirabella Eclano (AV), Italy. Inositol in women suffering from acne and PCOS: a randomized study . DOI: 10.15761/GOD.1000203
  7. Renae C Fernandez,1,2,3 Vivienne M. Moore,1,3,4 Emer M Van Ryswyk,5 Tamara J Varcoe,1,2 Raymond J Rodgers,1,2 Wendy. A March,1,3 Lisa J Moran,1,6 Jodie C Avery,1,2 R Doug McEvoy,5,7 and Michael J. Davies1,2. Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies. Journal List Nat Sci Sleep v.10; 2018 PMC5799701
  8. M Minozzi, G D'Andrea, Vittorio Unfer. Treatment of hirsutism with myo-inositol: A Prospective Clinical Study. October 2008Reproductive Biomedicine Online 17(4):579-82. DOI: 10.1016/S1472-6483(10)60248-9
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