PCOS, insulin and the case for myo-inositol

PCOS is not one condition. It is a cluster — irregular ovulation, androgen excess, polycystic ovarian morphology — and a majority of presentations sit on a foundation of insulin resistance.

Myo-inositol and D-chiro-inositol are naturally occurring compounds involved in insulin signalling. Studies have most often used a 40:1 ratio of myo to D-chiro, mirroring the ratio found in plasma.

Reported outcomes include improved cycle regularity, improved markers of insulin sensitivity and reduced free androgen index. It is not a substitute for medical care, and anyone with a PCOS diagnosis should be tracking bloodwork with a clinician.

Ayurveda approaches the same picture through kapha and ama — sluggish metabolism and accumulated metabolic residue — with herbs such as cinnamon, fenugreek and guduchi. The two frameworks converge more than they conflict.