When Should an Insulin Sensitizing Agent Be Used in the Treatment of Polycystic Ovary Syndrome?

In 2011, Stephen Franks reviewed the use of insulin sensitizing agents like metformin for treating polycystic ovary syndrome (PCOS). The document concluded that while diet and lifestyle changes are the primary treatment for overweight or obese women with PCOS, metformin is widely used but has unproven efficacy except for those with impaired glucose tolerance or diabetes. Metformin may improve ovulation and pregnancy rates in combination with clomiphene but does not increase live birth rates and has limited effects on hirsutism, acne, and alopecia. Its safety and efficacy in adolescents with PCOS are not well-supported by data. The document suggests that metformin's role in PCOS treatment should be considered mainly for those with glucose intolerance, and its utility in managing infertility or hirsutism is limited.