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The Interplay Between PMOS and MASLD: Pathophysiology and Evidence-Based Nutritional Interventions.

Ashley Graef¹, Monique J LeMieux¹

¹Nutrition and Food Sciences Department, Texas Woman's University, Denton, TX 76204, USA.

|June 26, 2026

Summary

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This review highlights the link between Polycystic Ovary Syndrome (PCOS) and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). An anti-inflammatory diet, omega-3s, and myo-inositol show promise for managing these interconnected conditions.

Area of Science:

Endocrinology and Metabolic Disorders
Hepatology
Nutritional Science

Background:

Polycystic Ovary Syndrome (PCOS) affects ~18% of reproductive-age women and shares risk factors with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), a global liver condition affecting ~25% of the population.
Common comorbidities in PCOS include dyslipidemia, insulin resistance, hyperandrogenism, central adiposity, and chronic inflammation, increasing MASLD risk.
PCOS and MASLD are interconnected metabolic disorders with overlapping risk factors, necessitating a comprehensive management approach.

Purpose of the Study:

To investigate the pathophysiological links between PCOS and MASLD.
To evaluate the effectiveness of specific nutritional interventions for managing coexisting PCOS and MASLD.

Main Methods:

Keywords:

Mediterranean diet dietary interventions insulin resistance metabolic dysfunction-associated steatotic liver disease myo-inositol narrative review omega-3 fatty acids polycystic ovary syndrome polyendocrine metabolic ovarian syndrome

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A narrative review of approximately 30 articles was performed.

Included studies focused on dietary patterns, macronutrient strategies, and dietary supplements for PCOS and MASLD.

Analysis synthesized evidence on nutritional approaches for these metabolic conditions.

Main Results:

An anti-inflammatory dietary pattern, omega-3 supplementation, and myo-inositol supplementation are identified as evidence-based initial strategies.
Most current evidence is derived from studies focusing on either PCOS or MASLD populations individually.
There is a lack of research on individuals with both coexisting PCOS and MASLD.

Conclusions:

A combined nutritional approach (anti-inflammatory diet, omega-3s, myo-inositol) is recommended for managing coexisting PCOS and MASLD.
Future research should prioritize long-term randomized controlled trials in diverse populations with both conditions.
Nutritional interventions may evolve into primary therapeutic strategies for PCOS and MASLD management.