Simona Dinicola, Vittorio Unfer, Christophe O Soulage, Maria Isidora Margarita Yap-Garcia, Arturo Bevilacqua, Salvatore Benvenga, Daniele Barbaro, Artur Wdowiak, Maurizio Nordio, Didier Dewailly, Marialuisa Appetecchia, Cesare Aragona, Maria Salomè Bezerra Espinola, Mariano Bizzarri, Pietro Cavalli, Annamaria Colao, Rosario D’Anna, Mónica Hebe Vazquez-Levin, Imelda Hernàndez Marin, Zdravko Kamenov, Antonio Simone Laganà, Giovanni Monastra, Mario Montanino Oliva, Ali Cenk Özay, Basilio Pintaudi, Giuseppina Porcaro, Olga Pustotina, Lali Pkhaladze, Nikos Prapas, Scott Roseff, Saghar Salehpour, Annarita Stringaro, Marat Tugushev, Virginia Unfer, Ivana Vucenik, Fabio Facchinetti

Background: D-chiro-inositol is a natural molecule that, in association with its well-studied isomer myo-inositol, may play a role in treating various metabolic and gynecological disorders.

Objectives: This perspective seeks to explore the mechanisms and functions of D-chiro-inositol, laying the foundations to discuss its use in clinical practice, across dysmetabolism, obesity, and hormonal dysregulation.

Methods: A narrative review of all the relevant papers known to the authors was conducted.

Outcome: D-chiro-inositol acts through a variety of mechanisms, acting as an insulin sensitizer, inhibiting the transcription of aromatase, in addition to modulating white adipose tissue/brown adipose tissue trans differentiation. These different modes of action have potential applications in a variety of therapeutic fields including: PCOS, dysmetabolism, obesity, hypoestrogenic/hyperandrogenic disorders, and bone health.

Conclusions: D-chiro-inositol mode of action has been studied in detail in recent years, resulting in a clear differentiation between D-chiro-inositol and its isomer myo-inositol. The insulin sensitizing activities of D-chiro-inositol are well understood; however, its potential applications in other fields, in particular obesity and hyperestrogenic/hypoandrogenic disorders in men and women, represent promising avenues of research that require further clinical study.