PMID: 11925372Apr 2, 2002Paper

Should patients with polycystic ovarian syndrome be treated with metformin? A note of cautious optimism

Human Reproduction
Roy Homburg

Abstract

Hyperinsulinaemia has proved to be a key link in the enigmatic generation of the symptoms of polycystic ovarian syndrome (PCOS), i.e. anovulatory infertility and the skin stigmata induced by hyperandrogenism. Regression of these symptoms may be achieved by reducing the hyperinsulinaemia. As obesity exaggerates the expression of the symptoms induced by hyperinsulinaemia, a low calorie diet and lifestyle change resulting in loss of weight for obese women with PCOS is capable of reversing these symptoms. Insulin-sensitizing agents, predominantly metformin, have been examined for their ability, in all patients with PCOS, to achieve similar beneficial changes to those induced by loss of weight in the obese. While the scientific value of many of these studies is questionable and solid evidence of efficiency and safety is not complete, the honourable intent of lowering high insulin levels in this way prompts the bottom line of this debate to strike a note of cautious optimism that insulin-sensitizing agents will be of some clinical usefulness both in the short-term aiding of infertility treatment and, possibly, in the prevention of the long-term sequelae for this troublesome and very prevalent condition.

Citations

Jul 2, 2003·Fertility and Sterility·Vito S Cardone
Oct 25, 2003·BMJ : British Medical Journal·Jonathan M LordRobert J Norman
Nov 18, 2003·Reproductive Biology and Endocrinology : RB&E·Roy Homburg
Sep 28, 2005·Treatments in Endocrinology·Laurel Stadtmauer, Sergio Oehninger
Apr 25, 2007·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·R K Bhathena
Nov 5, 2003·Expert Opinion on Pharmacotherapy·Roy Homburg
Aug 2, 2002·Expert Opinion on Pharmacotherapy·Charles J GlueckPing Wang
May 10, 2005·Human Reproduction Update·M A ChecaUNKNOWN Reproductive Endocrinology Interest Group of the Spanish Society of Fertility
Mar 30, 2017·Menopause : the Journal of the North American Menopause Society·Mei-Lien PanKuo-Hu Chen
Jan 27, 2004·Medicinski pregled·Aleksandar RadulovićLuka Andelić
May 10, 2005·Human Reproduction·Roy Homburg
Jan 31, 2007·Human Reproduction·Michael F CostelloPeter Sjoblom
Apr 28, 2017·Molecular Medicine Reports·Runqin LiRufei Gao
Feb 27, 2021·Expert Review of Endocrinology & Metabolism·Claudia RaperportRoy Homburg
Aug 28, 2021·International Journal of Environmental Research and Public Health·Mei-Lien PanKuo-Hu Chen

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