Human Reproduction, Vol. 17, No. 8, 1950-1953,
August 2002
© 2002 European Society of Human Reproduction and Embryology
Debates continued |
Should patients with polycystic ovarian syndrome be treated with metformin?
An enthusiastic endorsement
Division of Endocrinology and Metabolism, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA 23298, USA. E-mail: nestler{at}hsc.vcu.edu
Insulin resistance is a prominent feature of polycystic ovarian syndrome (PCOS), and women with the disorder are at increased risk for the development of other diseases that have been linked to insulin resistance—namely, type 2 diabetes and cardiovascular disease. This association between insulin resistance and PCOS must guide the chronic management of the disorder, and accumulating evidence suggests that administration of insulin-sensitizing drugs to individuals at high risk for type 2 diabetes decreases the rate of conversion to overt disease. In contrast, limited evidence exists to suggest that oral contraceptive pills—the currently standard therapy for PCOS—may actually decrease insulin sensitivity and induce impaired glucose tolerance in women with PCOS. Hence, PCOS should be regarded as a general health issue and the use of insulin-sensitizing drugs such as metformin should be considered for the prevention of type 2 diabetes.
Key words: metformin/oral contraceptives/polycystic ovarian syndrome/type 2 diabetes
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