Hyperandrogenism and Menstrual Imbalance Are the Best Predictors of Metformin Response in PCOS Patients

January 2022 in “ Reproductive Biology and Endocrinology ”

Emanuele Garzia, Valentina Galiano, Giovanni Marfia, Stefania Elena Navone, Enzo Grossi, Anna Maria Marconi

hyperandrogenism menstrual imbalance metformin Polycystic Ovary Syndrome PCOS Body Mass Index BMI free-androgen-index FAI serum testosterone insulin resistance

TLDR High levels of male hormones and irregular periods best predict how well PCOS patients will respond to metformin treatment.

The study involved 108 women with Polycystic Ovary Syndrome (PCOS) treated with 1500 mg/day of metformin. After 6 months, 52.4% of obese patients showed a Body Mass Index (BMI) reduction and 50.6% of hyperandrogenemic women showed a decrease in free-androgen-index (FAI). The response rates at 12 months were 30.6% and 47% respectively. The study concluded that menstrual pattern imbalance and ovarian androgens excess are the best predictors of metformin response. Lower serum testosterone levels at baseline were found to be the major predictor of treatment discontinuation. The study also found that metformin's effects in women with PCOS are not heavily dependent on the presence of insulin resistance. The research also noted a high dropout rate, with 12.9% of women discontinuing treatment due to side effects and 29.6% discontinuing due to perceived ineffectiveness or missed follow-ups.

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Research cited in this study

7 / 7 results

research Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline

1265 citations, October 2013 in “The Journal of Clinical Endocrinology and Metabolism”

The guideline suggests using specific criteria to diagnose PCOS, recommends various treatments for its symptoms, and advises screening for related health issues.

research Acne Severity and the Global Acne Grading System in Polycystic Ovary Syndrome

22 citations, August 2013 in “International journal of gynaecology and obstetrics”

Acne severity in women with PCOS is linked to younger age, lower body weight, and more body hair, but not to hormone levels.

research Defining Hyperandrogenaemia According to the Free Androgen Index in Chinese Women: A Cross-Sectional Study

19 citations, March 2012 in “Clinical Endocrinology”

FAI values above 6.4 may suggest high androgen levels and increased metabolic risks in Chinese women of reproductive age.

Epidemiology, Diagnosis, and Management of Hirsutism: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome Society

research Epidemiology, Diagnosis, and Management of Hirsutism: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome Society

378 citations, November 2011 in “Human reproduction update”

Experts recommend using evidence-based methods to diagnose and treat hirsutism, focusing on symptoms and underlying causes.

Criteria for Defining Polycystic Ovary Syndrome as a Predominantly Hyperandrogenic Syndrome: An Androgen Excess Society Guideline

research Criteria for Defining Polycystic Ovary Syndrome as a Predominantly Hyperandrogenic Syndrome: An Androgen Excess Society Guideline

1744 citations, August 2006 in “The Journal of Clinical Endocrinology and Metabolism”

Polycystic Ovary Syndrome should be seen mainly as a condition of excess male hormones, with a focus on this in its definition.

research Revised 2003 Consensus on Diagnostic Criteria and Long-Term Health Risks Related to Polycystic Ovary Syndrome

4809 citations, January 2004 in “Fertility and Sterility”

The 2003 consensus updated PCOS diagnosis criteria and highlighted increased risks of diabetes and heart disease for those affected.

research Classification of the Types of Androgenetic Alopecia (Common Baldness) Occurring in the Female Sex

666 citations, September 1977 in “British Journal of Dermatology”

Common baldness, also known as Androgenetic Alopecia, is caused by a combination of genetic factors and hormones called androgens.

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research Visual Diagnosis: An Adolescent Female With Increasing Hair Growth

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The girl has a hormonal imbalance causing increased hair growth and other male characteristics.

research 28-Year-Old Woman with Hyperprolactinemia and Its Relationship to Polycystic Ovary Syndrome

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research The Efficacy of 24-Month Metformin for Improving Menses, Hormones, and Metabolic Profiles in Polycystic Ovary Syndrome

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Metformin improves menstrual cycles and hormone levels in women with PCOS, mostly within the first 6 months.

research Improvement of Endothelial Function with Metformin and Rosiglitazone Treatment in Women with Polycystic Ovary Syndrome

56 citations, July 2008 in “European journal of endocrinology”

Metformin and rosiglitazone improve blood vessel function in women with PCOS, with metformin also reducing insulin resistance and testosterone levels.

research The Pathophysiology of Polycystic Ovary Syndrome: Understanding PCOS and Its Endocrinology

131 citations, August 2004 in “Best Practice & Research in Clinical Obstetrics & Gynaecology”

The conclusion is that PCOS is caused by ovarian sensitivity to hormones and disrupted hormone control, possibly due to ovarian factors, and more research is needed.

Hyperandrogenism and Menstrual Imbalance Are the Best Predictors of Metformin Response in PCOS Patients

Research cited in this study

research Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline

research Acne Severity and the Global Acne Grading System in Polycystic Ovary Syndrome

research Defining Hyperandrogenaemia According to the Free Androgen Index in Chinese Women: A Cross-Sectional Study

research Epidemiology, Diagnosis, and Management of Hirsutism: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome Society

research Criteria for Defining Polycystic Ovary Syndrome as a Predominantly Hyperandrogenic Syndrome: An Androgen Excess Society Guideline

research Revised 2003 Consensus on Diagnostic Criteria and Long-Term Health Risks Related to Polycystic Ovary Syndrome

research Classification of the Types of Androgenetic Alopecia (Common Baldness) Occurring in the Female Sex

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