Metformin is effective for polycystic ovary syndrome
Metformin is an effective treatment to achieve ovulation in women with polycystic ovary syndrome, research shows.
A meta-analysis of 13 trials of metformin was carried out, involving
543 women with polycystic ovary syndrome. The results showed that ovulation
was achieved in 46 per cent of those given metformin compared with 24
per cent given placebo. The odds ratio for achieving ovulation in the
metformin group compared with placebo was 3.88 (95 per cent confidence
interval 2.25–6.69). When metformin was given in combination with
clomifene, ovulation occurred in 76 per cent of women compared with 42
per cent of those given clomifene alone (odds ratio 4.41, 95 per cent
confidence interval 2.37–8.22).
The study also found that metformin had beneficial biochemical effects.
Alongside features such as infertility, anovulation and hyperandrogenism,
impaired glucose tolerance can occur in polycystic ovary syndrome. Metformin
reduced fasting insulin concentrations and also reduced low density lipoprotein
cholesterol. No evidence of an effect on body mass index was found.
The researchers conclude: “[Metformin’s] choice as a first-line
agent seems justified, and there is some evidence of benefit on variables
of the metabolic syndrome.” However, they add: “Patients
need to be aware that it is not a ‘weight loss’ drug. Metformin
should therefore always be used as an adjuvant to general lifestyle improvements
and not as a replacement for increased exercise and improved diet” (BMJ 2003;327:951). |
