Reproductive endocrinology: Metformin or thiazolidinedione therapy in PCOS?

  title={Reproductive endocrinology: Metformin or thiazolidinedione therapy in PCOS?},
  author={Anjali Grover and Maria A. Yialamas},
  journal={Nature Reviews Endocrinology},
Insulin resistance has a key role in the pathogenesis of polycystic ovary syndrome, a common endocrinopathy that affects young women. Therefore, the use of insulin-sensitizing agents has been studied extensively in this patient population. Given the effectiveness of metformin and thiazolidinediones in previous studies, the question arises: is one class better than the other? 

Android Subcutaneous Adipose Tissue Topography in Females with Polycystic Ovary Syndrome: A Visible Phenotype Even in Juveniles

It is evident, that females with PCos, especially the overweight ones, have a higher risk for developing type 2 diabetes and it is suggested, that insulin resistance is even more common in overweight patients with PCOS that in lean females.

Metformin associated lactic acidosis in Auckland City Hospital 2005 to 2009.

Lactic acidosis is an uncommon but significant complication of use of metformin which carries a high risk of morbidity and should be treated with caution.



Metformin vs thiazolidinediones for treatment of clinical, hormonal and metabolic characteristics of polycystic ovary syndrome: a meta‐analysis

It is important to compare the efficacy and safety of ISDs such as metformin and thiazolidinediones for the treatment of polycystic ovary syndrome.

Metformin in polycystic ovary syndrome

Overall, available data supports the therapeutic usefulness of metformin on cardiometabolic risk and reproduction assistance in PCOS women.

Polycystic ovary syndrome.

  • D. Ehrmann
  • Medicine, Biology
    The New England journal of medicine
  • 2005
Management of women with PCOS is individualized and should depend on the patient’s symptoms as well as their risk for development of various complications, including type 2 diabetes, metabolic syndrome, and obstructive sleep apnoea.

Responses of serum androgen and insulin resistance to metformin and pioglitazone in obese, insulin-resistant women with polycystic ovary syndrome.

It is suggested that piog litazone is as effective as metformin in improving insulin sensitivity and hyperandrogenism, despite an increase in body weight, body mass index, and the waist to hip ratio associated with pioglitazone.

Troglitazone improves ovulation and hirsutism in the polycystic ovary syndrome: a multicenter, double blind, placebo-controlled trial.

Troglitazone improves the ovulatory dysfunction, hirsutism, hyperandrogenemia, and insulin resistance of PCOS in a dose-related fashion, with a minimum of adverse effects.

Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome.

Clomiphene is superior to metformin in achieving live birth in infertile women with the polycystic ovary syndrome, although multiple birth is a complication.

Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome.

It is concluded that the MBS and its components are common in women with PCOS, placing them at increased risk for cardiovascular disease and different features that may reflect more severe insulin resistance.

Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome.

It is concluded that women with PCOS should periodically have an OGTT and must be closely monitored for deterioration in glucose tolerance, particularly among those with IGT, the subgroup at highest risk for subsequent development of NIDDM.

systematic review and meta-analysis Metformin in polycystic ovary syndrome:

Meta-analysis showed that metformin is effective in achieving ovulation in women with polycystic ovary syndrome and has an effect in reducing fasting insulin Concentrations, blood pressure, and low densitylipoprotein cholesterol.