Study on the Effect of Berberine, Myoinositol, and Metformin in Women with Polycystic Ovary Syndrome: A Prospective Randomised Study

Objective: This study was conducted to see the effects of berberine, metformin, and myoinositol in women with polycystic ovary syndrome (PCOS). Materials and Methods: Subjects were randomly assigned via computer-generated randomization to one of the three treatment groups. Group 1 received berberine hydrochloride 500 mg twice daily, group 2 received metformin hydrochloride 500 mg twice daily, and group 3 received myoinositol 1000 mg twice daily to compare clinically (mean weight, waist circumference, waist-to-hip ratio, and body mass index), metabolic (fasting blood sugar, serum fasting insulin, fasting blood sugar/serum fasting insulin [FBS/FI]), hormonal effects (serum total testosterone [TT], serum sex hormone-binding globulin [SHBG] and free androgen index) together with the lipid profile (total cholesterol, serum triglyceride, serum low-density lipoprotein [LDL], very-low-density lipoprotein [VLDL], serum high-density lipoprotein [HDL]) in patients receiving metformin, berberine, and myoinositol before and after three months of treatment. Results: Weight, BMI, waist circumference, waist-hip ratio, FBS, FI and fasting glucose/insulin ratio, total testosterone, free androgen index (FAI), SHBG, total cholesterol, triglycerides, LDL, VLDL, and HDL showed significant differences in three groups after three months of treatment (p<0.0001). Between the three groups, berberine showed greater differences in clinical, hormonal, and lipid parameters compared to metformin and myoinositol, while myoinositol showed greater improvement in carbohydrate metabolic parameters. Conclusions: Metformin, the classical drug used in PCOS, improves all the parameters in polycystic ovary syndrome women. Berberine may have greater potential to reduce the risk of cardiovascular disease than metformin in PCOS patients due to its effect on body composition, lipid profile, and improvement in hormone status. Myoinositol administration improves endocrine parameters and insulin sensitivity. It may be considered as a first-line option in PCOS patients with insulin resistance without prediabetes or diabetes.