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Related Experiment Videos

Metformin and glitazones: do they really help PCOS patients?

Anush Pillai1, Heejung Bang, Charles Green

  • 1Methodist Family Medicine Residency Program, Houston, TX, USA. aspillai@tmh.tmc.edu

The Journal of Family Practice
|June 5, 2007
PubMed
Summary
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Limited data exists to compare metformin and thiazolidinediones (TZDs) for Polycystic Ovarian Syndrome (PCOS) treatment. Metformin showed minimal impact on PCOS clinical and biochemical markers in this review.

Area of Science:

  • Endocrinology
  • Reproductive Medicine
  • Pharmacology

Background:

  • Polycystic Ovarian Syndrome (PCOS) is characterized by clinical and biochemical abnormalities.
  • Metformin and thiazolidinediones (TZDs) are insulin-sensitizing agents with potential benefits for PCOS management.

Purpose of the Study:

  • To evaluate the evidence for thiazolidinediones (TZDs) or metformin in treating PCOS patients.
  • To compare the effectiveness of metformin versus TZDs in improving PCOS clinical and biochemical features using randomized controlled trials (RCTs).

Main Methods:

  • A comprehensive literature search was conducted across multiple databases (Medline, PubMed, Google Scholar) and through expert contact.
  • Included randomized controlled trials (RCTs) involving women diagnosed with PCOS (NIH criteria 1990) treated with metformin or TZDs as the primary endpoint.

Related Experiment Videos

  • 31 RCTs with 1892 patients were analyzed, focusing on metformin due to insufficient comparative data for TZDs.

    • Main Results:

    • Insufficient data prevented direct comparison between metformin and TZDs.
    • Metformin demonstrated statistically significant but minimal decreases in ovulation rates and LH/FSH ratio, with an increase in fasting insulin.
    • No clinically significant changes were observed with metformin for ovulation rate, pregnancy rate, BMI, waist-to-hip ratio, hirsutism, or various hormone levels.

    Conclusions:

    • A significant lack of high-quality RCT data hinders direct comparison of metformin and TZDs for PCOS treatment.
    • Further large-scale RCTs are necessary to establish the efficacy of these agents in managing PCOS clinical and biochemical features.