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
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    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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