A Review on Metformin: A Double Edged Sword for Polycystic Ovary Syndrome
Abstract
Polycystic ovarian syndrome (PCOS) is a hormonal disorder commonly affecting the women of reproductive age. Common clinical presentations like irregular menstrual cycles, anovulation, hyperandrogenism, hirsutism and infertility occur in these patients. PCOS have been linked with long term conditions like Type II diabetes mellitus and cardiovascular disease. Metformin which is an oral hypoglycemic agents has been used in the treatment of PCOS as it is associated with insulin resistance in PCOS patients. Metformin alone or in combination with other ovulation induction therapies have shown to induce ovulation in women with PCOS. Several studies show that metformin plays an important role in reducing insulin resistance in women with PCOS and also reduce free testosterone levels and increased sex hormone binding globulin (SHBG). Metformin also improved the menstrual irregularities which in turn lead to spontaneous ovulation and better ovarian response to ovulation induction therapies. Nevertheless there is only few evidences showing that metformin improves weight reduction and serum lipids or hirsutism. However more researches and evidences are yet to be known to define whether metformin improves long term health outcomes in patients with PCOS and also the prevention of diabetes, endometrial cancer and cardiovascular diseases.
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