Mei-Jou Chen

Women with polycystic ovary syndrome treated with metformin for 24 months experienced more regular menstrual cycles and improvements in most profiles regardless of weight, according to findings published in The Journal of Clinical Endocrinology & Metabolism.

Mei-JouChen, MD, PhD, professor in the College of Medicine at National Taiwan University, National Taiwan University Livia Shangyu Wan Scholar and visiting staff member in the department of obstetrics and gynecology at National Taiwan University Hospital in Taipei, and colleagues evaluated data on 119 women with PCOS who had normal weight (median age, 24.5 years; n = 72) or overweight (median age, 25 years; n = 47) to determine the effects of metformin use for 24 months on menstruation and changes in anthropometric, hormonal and metabolic parameters. Participants enrolled in the study between 2008 and 2013.

The proportion of participants with normal menstrual cycles increased from baseline to month 24 in all participants regardless of BMI or testosterone status.

At month 24, BMI, levels of testosterone and luteinizing hormone, free androgen index and luteinizing hormone/follicle-stimulating hormone ratios were all lower compared with baseline in all participants.

In further analyses, four subgroups were created when researchers combined BMI and testosterone status: normal weight with normal testosterone (n = 49), normal weight with elevated testosterone (n = 23), overweight with normal testosterone (n = 27) and overweight with elevated testosterone (n = 20). The normal weight with elevated testosterone group experienced the greatest improvements in menstruation from baseline to 6 months compared with the other three groups (OR = 7.21; 95% CI, 2.35-22.17); improvements were maintained throughout the study period. Improvements in menstruation were observed in all four groups at 6 months with 42% to 47% of participants having normal menses. No further changes in menstrual patterns were observed in any group after 6 months except for the overweight with normal testosterone group. The highest predicted proportion of participants with normal menses was observed at 12 months and continued to 24 months.

“Metformin treatment can improve the hormone profiles and menstruation in women with PCOS, but its effectiveness differs among subgroups of different baseline phenotypes,” Chen told Endocrine Today. “Different BMI and androgen phenotypes at baseline can serve as patient selection criteria or prognostics for metformin use. Further studies are needed to investigate the factors that determine the treatment efficacy of metformin in different phenotypic subgroups of women with PCOS.” – by Amber Cox


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