Additive and Dose-Dependent Effects of Coenzyme Q10 Combined With Myoinositol on Insulin Resistance and Hyperandrogenism in Women With Polycystic Ovary Syndrome: A Retrospective Controlled Study.

AIM: Polycystic ovary syndrome (PCOS) is characterized by insulin resistance, hyperandrogenism, and reproductive dysfunction. Myoinositol and coenzyme Q10 (CoQ10) have complementary metabolic and hormonal effects; however, the additive and dose-dependent effects of CoQ10 remain unclear. This study evaluated these effects in women with PCOS.

METHODS

In this retrospective study, 200 women with PCOS were assigned to four groups: myoinositol plus CoQ10 100 mg (n = 55), myoinositol plus CoQ10 200 mg (n = 55), myoinositol alone (n = 45), and untreated controls (n = 45). Fasting insulin, HOMA-IR, total testosterone, and menstrual cycle regularity were assessed at baseline and 6 months. Between-group differences were evaluated using multivariable regression analyses and sensitivity analyses.

RESULTS

All treatment groups showed improvements in metabolic and hormonal parameters, with the greatest effects observed in the combination therapy groups. Myoinositol alone was associated with significant reductions in HOMA-IR (β = -0.219; p < 0.001) and total testosterone (β = -3.145; p < 0.001) compared with untreated controls. The addition of CoQ10 resulted in dose-dependent improvements, with 100 and 200 mg doses demonstrating progressively greater reductions in HOMA-IR (β = -0.308 and -0.571, respectively) and total testosterone (β = -2.847 and -5.325, respectively) (all p < 0.001). Multivariable regression analyses confirmed that both CoQ10 doses remained significantly superior to myoinositol monotherapy. Menstrual cycle regularity improved most in the MI + CoQ10 200 mg group (36.4%).

CONCLUSION

Adjunctive CoQ10 supplementation with myoinositol provides significant and dose-dependent improvements in insulin resistance and hyperandrogenism in PCOS. The magnitude of reduction observed with 200 mg CoQ10 suggests potential clinical relevance, particularly in metabolically compromised patients. Prospective randomized studies are warranted to confirm these findings.