PMOS: can inositol or berberine supplements help?

Can Inositol help with PMOS? The inositols are a small family of naturally occurring food constituents. They occur naturally in some beans and pulses, citrus fruits, melon, whole grains, nuts and soy foods. Inositol is also marketed as a dietary supplement. It has been shown that they can reduce insulin resistance, one of the main drivers of PMOS. Inositols can also reduce testosterone levels and improve SHBG (Sex Hormone Binding Globulin) levels, both of which can help in PMOS, particularly if excess hair is a feature. One trial performed over a quarter of a century ago showed they can significantly improve fertility in PMOS. A recent study suggested that a combination of two particular inositols (Myo-inositol and D-chiro-inositol) in a 40:1 ratio appeared effective. Doses up to 4,000mg/day appear safe*. Inositol can occasionally cause nausea and diarrhoea. Women on diabetes medication must discuss with their health professional before starting treatment. Because fertility can be increased, women must also consider taking folic acid supplements if pregnancy is a possibility. * (https://pubmed.ncbi.nlm.nih.gov/29498933/)

Can Berberine help with PMOS? Berberine is a naturally occurring, non-addictive plant alkaloid. It has been used for several thousand years as a herbal medicine. More recently, it has been found to have beneficial effects on the Metabolic Syndrome. It reduces insulin resistance and fasting blood glucose levels, it can lower testosterone levels, and it may help with weight loss. It may even have beneficial effects on the gut microbiome. It appears to improve ovulation. No surprise then that women with PMOS sometimes consider using it. It has to be taken with food. Like inositol, it can cause nausea and diarrhoea. Unlike inositol, it must not be taken by children, pregnant women or women who are breastfeeding their baby. It does not mix well with certain medications: notably, meds for diabetes, including metformin, meds for blood clotting, and certain immunosuppressants. It can cause problems in those taking lithium for bipolar problems or SSRI meds for depression. It can cause a drop in blood pressure, which could cause hypotension in those taking blood pressure meds.