Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age, with implications throughout life from adolescence to menopause.

The stereoisomers of inositol, myo-inositol (MI) and D-chiro-inositol (DCI), are the two most abundant members of a family of nine inositol stereoisomers and are found widely in nature. Inositols act as second messengers for insulin and their deficiency contributes to the various characteristics of PCOS.

It is considered that inositols MI and DCI can reduce insulin resistance, improve ovarian function and reduce androgen levels in women with PCOS. MI promotes glucose uptake and is also involved in pathways mediated by follicle-stimulating hormone (FSH) and affect the proliferation and maturation of follicular cells. Under the influence of insulin, MI is converted to D-chiro-inositol (DCI), which stimulates glycogen production and facilitates glucose uptake. It is described that hyperinsulinemia in PCOS enhances the activity of the ovarian epimerase which enhances DCI synthesis. MI is also considered to enhance aromatase synthesis in follicular cells and therefore reduces androgen production.

Insulin resistance in women with PCOS is associated with high homocysteine (Hcy). Furthermore, intensive treatment for PCOS can affect homocysteine levels. Hyperhomocysteinemia has been extensively associated with increased risk for cardiovascular disorders, such as atherosclerosis, thromboembolism and dyslipidemia. The importance of vitamin B12 in the remethylation of Hcy to methionine is proven and hyperhomocysteinemia is a characteristic of vitamin B12 deficiency. Moreover, plasma Hcy is a sensitive biomarker of folic acid deficiency thus proving that folic acid also plays an important role in preventing Hcy accumulation. In the past it has been shown that treatment with folic acid and vitamin B12 improved insulin resistance in patients with metabolic syndrome.

Melatonin (N-acetyl-5-methoxytryptamine) is secreted by the pineal gland. Some of the most important functions of the rhythmic secretion of melatonin in the blood include the regulation of sleep, the modulation of circadian rhythms and participation in the immune response of the organism. Melatonin is also a powerful endogenous antioxidant and its supplementation has antioxidant and anti-inflammatory effects. Current evidence suggests the involvement of melatonin in ovarian physiology, including ovulation, follicle development, corpus luteum function and oocyte maturation. Furthermore, melatonin deficiency appears to be involved in the pathophysiology of PCOS.

EVA INTIMA® OVASIL thanks to its targeted composition and documented action, improves the metabolic and hormonal profile of women with PCOS contributing to addressing the entire set of its symptoms.