Metformin therapy for the reproductive and metabolic consequences of polycystic ovary syndrome

    August 2017 in “Diabetologia
    Susan Sam, David A. Ehrmann
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    TLDR Metformin has limited effectiveness for improving PCOS symptoms and lacks clear benefits, needing more research to confirm its efficacy.
    The document from 2017 reviewed the use of metformin in treating polycystic ovary syndrome (PCOS) and found that while metformin can improve some symptoms of PCOS, its effectiveness, particularly in improving fertility and metabolic outcomes like insulin sensitivity and hyperinsulinaemia, is not consistently significant. A meta-analysis of 16 randomized clinical trials with 630 participants showed no significant effect of metformin on BMI and only a marginal reduction in waist:hip ratio, and a meta-analysis of ten trials with 562 women found no effect on cholesterol or triacylglycerol levels. The document concluded that there is a lack of clear benefit from metformin for PCOS and called for well-designed prospective trials to establish its efficacy. Studies cited within the document, including those by Ehrmann et al. (1997), Naderpoor et al. (2015), Costello et al. (2007), Knowler et al. (2002), and Pasquali et al. (2000), support the potential benefits of metformin combined with lifestyle modifications in managing PCOS, but the need for future research to identify predictors of beneficial response to metformin therapy was emphasized.
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