Metformin or GLP 1 Receptor Agonists? Current Views on the Management of Polycystic Ovary Syndrome
Abstract
Background
Polycystic ovary syndrome is a heterogeneous endocrine disorder associated with insulin resistance, hyperandrogenism, and reproductive dysfunction. Pharmacological treatment commonly includes metformin and glucagon like peptide 1 receptor agonists, but their comparative effects across metabolic and reproductive outcomes remain insufficiently integrated .
Aims
To compare the metabolic and reproductive effects of metformin and GLP-1 receptor agonists in women with PCOS and to summarize current evidence on their mechanisms of action.
Methods
A narrative review was conducted based on a literature search in PubMed and Google Scholar for studies published between 2015 and 2025. Randomized controlled trials, meta analyses, systematic reviews, and translational studies evaluating metformin, GLP-1 receptor agonists, or their combination in women with PCOS were included. Outcomes of interest included insulin resistance, body mass index, hormonal parameters, and reproductive outcomes .
Results
Metformin was associated with improvements in insulin resistance, fasting glucose, and menstrual regularity, with modest effects on body weight and androgen levels. GLP-1 receptor agonists were associated with greater reductions in body weight, body mass index, and waist circumference, and with changes in metabolic and hormonal parameters in several studies. Improvements in ovulatory function and pregnancy outcomes were reported in some studies, although results were heterogeneous and…
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