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Effects of metformin on adrenal steroidogenesis in women with polycystic ovary syndrome

Antonio La Marca, Giuseppe Morgante, Tiziana Paglia, Liliana Ciotta, Antonio Cianci, Vincenzo De Leo

Fertility and Sterility, 1999

103 citations

Abstract

OBJECTIVE: To determine whether the administration of metformin, an insulin-sensitizing agent, is followed by changes in adrenal steroidogenesis in women with polycystic ovary syndrome (PCOS).

DESIGN: Prospective trial.

SETTING: Department of Obstetrics and Gynecology, University of Siena, Siena, Italy.

PATIENT(S): Fourteen women with PCOS.

INTERVENTION(S): Blood samples were obtained before (-15 and 0 minutes) and after (15, 30, 45, and 60 minutes) the administration of ACTH (250 microg). Metformin then was given at a dosage of 500 mg three times a day for 30-32 days, at which time the pretreatment study was repeated.

MAIN OUTCOME MEASURE(S): The adrenal androgen responses to ACTH before and after treatment with metformin.

RESULT(S): Ovulation occurred in two women (14%) in response to metformin treatment. A significant reduction in basal concentrations of free testosterone and a significant increase in concentrations of sex hormone-binding globulin were observed. The administration of metformin was associated with a significant reduction in the response of 17alpha-hydroxyprogesterone, testosterone, free testosterone, and androstenedione to ACTH. The ratio of 17alpha-hydroxyprogesterone to progesterone, which indicates 17alpha-hydroxylase activity, and the ratio of androstenedione to 17alpha-hydroxyprogesterone, which indicates 17,20-lyase activity, were significantly lower after a month of metformin treatment, indicating a reduction in the activities of these enzymes.…

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