Metformin: an old medication of new fashion: evolving new molecular mechanisms and clinical implications in polycystic ovary syndrome

The document from February 1, 2010, provides a comprehensive review of metformin's role in treating polycystic ovary syndrome (PCOS), a condition affecting 6.6-6.8% of women of reproductive age. Metformin, primarily known as an insulin sensitizer, has been found to have multiple benefits in PCOS management, including improving insulin resistance, ovulation rates, and reducing androgen levels. It also shows potential in reducing the risk of gestational diabetes and possibly early miscarriage in pregnant women with PCOS, although more research is needed to confirm these findings. The drug's impact on weight loss and fat distribution is debated, with some studies indicating benefits, especially when combined with lifestyle changes. Metformin may also improve metabolic syndrome components, endothelial function, and reduce cardiovascular risk factors, but its effects vary depending on the patient's baseline BMI and other factors. While metformin's effectiveness in managing hirsutism in PCOS is less clear, it is generally considered safe with manageable side effects, such as gastrointestinal issues and a low risk of serious adverse events like lactic acidosis. The document underscores the need for further research to establish the efficacy and safety of metformin, particularly during pregnancy and in managing PCOS's dermatological manifestations.