Skip Navigation



Hum. Reprod. Advance Access published online on December 2, 2004
Human Reproduction, doi:10.1093/humrep/deh588
© 2004 by European Society of Human Reproduction and Embryology
This Article
Right arrow FREE Full Text (PDF ) Freely available
Right arrow All Versions of this Article:
20/1/180    most recent
deh588v1
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Cibula, D.
Right arrow Articles by Skrenkova, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Cibula, D.
Right arrow Articles by Skrenkova, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Received November 24, 2003
Revised August 11, 2004
Accepted October 4, 2004

Article

The effect of combination therapy with metformin and combined oral contraceptives (COC) versus COC alone on insulin sensitivity, hyperandrogenaemia, SHBG and lipids in PCOS patients

D. Cibula 1*, M. Fanta 1, J. Vrbikova 2, S. Stanicka 2, K. Dvorakova 2, M. Hill 3, J. Skrha 4, J. Zivny 1, and J. Skrenkova 1

1 Department of Obstetrics and Gynecology, Charles University, Apolinarska 18, Prague 2, 120 00, Czech Republic
2 Institute of Endocrinology, Narodni trida 11, Prague 1, 100 00, Czech Republic
3 Institute of Endocrinology, Narodni trida 11, Prague 1, 100 00,, Czech Republic
4 Department of Internal Medicine, Charles University, U Nemocnice 1, Prague 2, 120 00, Czech Republic

* To whom correspondence should be addressed.
D. Cibula, E-mail: david.cibula{at}iol.cz


  Abstract

BACKGROUND: Neither oral contraceptives (COC) nor metformin are an optimal modality for the long-term treatment of polycystic ovary syndrome (PCOS). The aim of this study was to evaluate whether a combination of both is beneficial over COC monotherapy. METHODS: Altogether, 30 women were included in the study and 28 finished the protocol. The patients were randomly assigned to two groups treated with either COC (COC group) or COC and metformin (1500 mg/day) (METOC group) for 6 months. Anthropometric parameters, androgens, lipids, fasting insulin, glucose and sex hormone binding globulin (SHBG) concentrations were measured before and at the end of the sixth cycle of treatment. The insulin sensitivity index was evaluated using the euglycaemic clamp. RESULTS: There were no significant changes in anthropometric parameters, fasting glucose or insulin sensitivity in either group. Total testosterone, free androgen index, androstenedione and dehydroepiandrosterone decreased and SHBG increased significantly in both groups. When comparing the effect of both treatments, only a more pronounced decrease in free androgen index was found in the METOC group. CONCLUSIONS: Adding metformin slightly modified the treatment effect of COC, causing a more significant decrease in the free androgen index but having no additional positive impact on lipids, insulin sensitivity, SHBG or testosterone. The available data do not offer enough evidence to advocate the standard use of combined treatment in PCOS. Whether the combination might be beneficial for specific subgroups of patients is of further interest.

Keywords: androgens; insulin sensitivity; metformin; oral contraceptives; polycystic ovary syndrome.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Endocr. Rev.Home page
S. Palomba, A. Falbo, F. Zullo, and F. Orio Jr.
Evidence-Based and Potential Benefits of Metformin in the Polycystic Ovary Syndrome: A Comprehensive Review
Endocr. Rev., February 1, 2009; 30(1): 1 - 50.
[Abstract] [Full Text] [PDF]

Home page
 Hum ReprodHome page
S. Nader and E. Diamanti-Kandarakis
Polycystic ovary syndrome, oral contraceptives and metabolic issues: new perspectives and a unifying hypothesis
Hum. Reprod., February 1, 2007; 22(2): 317 - 322.
[Abstract] [Full Text] [PDF]

Home page
 Hum Reprod UpdateHome page
L. Ibanez and F. de Zegher
Low-dose flutamide-metformin therapy for hyperinsulinemic hyperandrogenism in non-obese adolescents and women
Hum. Reprod. Update, May 1, 2006; 12(3): 243 - 252.
[Abstract] [Full Text] [PDF]

Home page
 Hum ReprodHome page
A. Lemay, S. Dodin, L. Turcot, F. Dechene, and J-C. Forest
Rosiglitazone and ethinyl estradiol/cyproterone acetate as single and combined treatment of overweight women with polycystic ovary syndrome and insulin resistance
Hum. Reprod., January 1, 2006; 21(1): 121 - 128.
[Abstract] [Full Text] [PDF]

Home page
 Hum Reprod UpdateHome page
M.A. Checa, A. Requena, C. Salvador, R. Tur, J. Callejo, J.J. Espinos, F. Fabregues, J. Herrero, and (Reproductive Endocrinology Interest Group of the
Insulin-sensitizing agents: use in pregnancy and as therapy in polycystic ovary syndrome
Hum. Reprod. Update, July 1, 2005; 11(4): 375 - 390.
[Abstract] [Full Text] [PDF]

Home page
 Hum Reprod UpdateHome page
J. Vrbikova and D. Cibula
Combined oral contraceptives in the treatment of polycystic ovary syndrome
Hum. Reprod. Update, May 1, 2005; 11(3): 277 - 291.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.