Inositol supplementation reduces total testosterone and improves SHBG levels in women with polycystic ovary syndromeInositol may lower testosterone levels in women with PCOS

Clinical endocrinology Published August 2, 2026 Study authors: Tienforti Daniele, Puocci Gennaro, Venditti Claudia, Gizzi Valentina, Pisanò Carlo, Cocci Elisa, Per… PubMed ↗ DOI ↗ Editorial oversight: Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

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Key Takeaway

Consider inositol to reduce total testosterone and improve SHBG in women with polycystic ovary syndrome.

This meta-analysis evaluated the effects of inositol supplementation on biochemical markers of hyperandrogenism in 440 women diagnosed with polycystic ovary syndrome (PCOS). The analysis focused on serum total testosterone (TT), calculated free testosterone (cFT), free androgen index (FAI), and sex hormone-binding globulin (SHBG).

The synthesis indicates that inositol supplementation leads to a significant reduction in serum total testosterone (SMD -1.30; 95% CI -2.17 to -0.42) and an increase in SHBG levels. Additionally, reductions were noted in both cFT and FAI. Notably, the most consistent and largest reduction in TT was observed specifically in normal-weight women (BMI < 25 kg/m2) with an SMD of -2.97 (95% CI -3.78 to -2.16).

The authors note substantial heterogeneity for several outcomes and highlight that subgroup findings regarding BMI and HOMA-IR are exploratory. No significant improvements were detected in overweight or obese women, nor in women with insulin resistance when analyzed independently of BMI. These findings suggest inositol may be a useful intervention for managing biochemical hyperandrogenism in PCOS, particularly in normal-weight patients.

How this fits prior evidence

This meta-analysis addresses the management of biochemical hyperandrogenism in polycystic ovary syndrome. While previous evidence has explored adjunctive treatments like astaxanthin to address oxidative stress and inflammation, this study specifically evaluates inositol's impact on androgen markers. It complements existing knowledge regarding PCOS complications, such as the 24% prevalence of Gestational Diabetes Mellitus and the role of vitamin D in insulin resistance, by providing data on a specific nutritional supplement for hormonal balance.

Managing the symptoms of Polycystic Ovary Syndrome (PCOS) often involves balancing hormones. One specific challenge is high testosterone, which can affect everything from hair growth to skin health. A review of data involving 440 women found that taking inositol was linked to a significant drop in total testosterone levels.

The study also showed that inositol helped increase sex hormone-binding globulin (SHBG), a protein that helps regulate hormones in the blood. These changes were most consistent and strongest in women with a normal body weight. While the findings are promising for hormonal balance, it is important to note that the results were less clear for women who were overweight or obese.

Because this research involved several different studies, there was some variation in the results across different groups. Additionally, the data on insulin resistance and weight-specific outcomes were preliminary. If you have PCOS and are considering adding inositol to your routine, talk to your doctor to see if it fits your specific health profile.

What this means for you:

Inositol may help lower high testosterone levels in women with PCOS, especially for those with a normal weight.

Common questions

Does inositol work for everyone with PCOS?

The results were not the same for everyone. While inositol was linked to lower testosterone and higher sex hormone-binding globulin, these effects were most consistent and strongest in women with a normal weight (BMI under 25). The study did not find significant improvements for overweight or obese women when looking at those groups separately.

What specific hormones does inositol affect?

The research showed that inositol was associated with a reduction in total testosterone, calculated free testosterone, and the free androgen index. It also showed an increase in sex hormone-binding globulin (SHBG). These markers help doctors measure how much and what type of androgens are circulating in the body.

Is it safe to take inositol for PCOS?

The study did not report any specific side effects or safety concerns during the review. However, because results can vary based on individual factors like weight and insulin resistance, you should always speak with your healthcare provider before starting a new supplement.

Study Details

Study typeMeta analysis

Sample sizen = 440

EvidenceLevel 1

PublishedAug 2026

PMID41947399

View Original Abstract ↓

OBJECTIVE: To evaluate the effect of inositol supplementation on biochemical hyperandrogenism in women with polycystic ovary syndrome (PCOS) and to explore whether metabolic phenotype modifies the endocrine response. DESIGN: Systematic review and meta-analysis of randomized controlled trials conducted in accordance with PRISMA guidelines. PATIENTS: Women diagnosed with PCOS according to established criteria (NIH, Rotterdam, or AE-PCOS). Nine eligible trials comprising a total of 440 participants were included. MEASUREMENTS: Primary outcomes were serum total testosterone (TT), calculated free testosterone (cFT), free androgen index (FAI), and sex hormone-binding globulin (SHBG). Prespecified subgroup analyses explored differences according to body mass index (BMI) and insulin resistance (HOMA-IR). RESULTS: Inositol supplementation was associated with significant reductions in TT (SMD -1.30; 95% CI -2.17 to -0.42), cFT, and FAI, together with an increase in SHBG. Substantial heterogeneity was observed for several outcomes. In subgroup analyses, the largest and most consistent reduction in TT was observed among normal-weight women (BMI < 25 kg/m²) (SMD -2.97; 95% CI -3.78 to -2.16), with minimal heterogeneity (I² = 9%). No significant improvements were detected in overweight or obese women, nor in women with insulin resistance when considered independently of BMI. These subgroup findings should be interpreted as exploratory. CONCLUSIONS: Inositol supplementation is associated with improvements in biochemical hyperandrogenism in women with PCOS, with evidence of phenotype-dependent variability. The most consistent biochemical response was observed in normal-weight individuals. These findings support a metabolically informed, hypothesis-generating framework and highlight the need for adequately powered, phenotype-stratified trials incorporating clinically meaningful outcomes, including standardized measures of hirsutism, ovulatory function, and patient-reported endpoints.

Inositol supplementation reduces total testosterone and improves SHBG levels in women with polycystic ovary syndromeInositol may lower testosterone levels in women with PCOS

How this fits prior evidence

Common questions

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