Metformin therapy in women with polycystic ovary syndrome

To determine the effect of metformin on insulin resistance, testosterone level and gonadotrophin levels in obese patients with polycystic ovarian syndrome and to study menstrual pattern among them. Prospective follow up observational study. The Ain Shams University Maternity Hospital during the period from 1st of January 1998 to 30th of June 1999. 60 obese women with PCOS were enrolled in the study, 50 patients completed the study. Metformin was given 1500 mg/day for 12 weeks, serum LH, FSH, fasting insulin, fasting glucose, total and free testosterone and serum progesterone were measured at the beginning and after 12 weeks of metformin therapy. Menstrual length was decreased from [47.18 +/- 3.26 to 33.54 +/- 6.06 days], BMI did not decrease and also waist hip ratio. There is also decrease in LH level from 13.98 +/- 2.1 to 7.94 +/- 1.15 mlu/mL, fasting insulin level decreased from 25.48 +/- 2.37 micro U/mL to 14.06 +/- 1.73 micro U/mL. There was a decrease in the level of both free and total testosterone and spontaneous ovulation in 62% of patients as detected by serum progesterone after 12 weeks of study. Metformin therapy in obese women with PCOS is safe, cheap and effective therapy in reducing abnormal high testosterone, decreasing insulin level, restoration of normal menses and ovulation

effect of metformin on the endocrine variables in clomiphene resistant polycystic ovarian disease

To investigate the effect of metformin on the endocrine variables in clomiphene resistant polycystic ovarian disease [PCOD]. Departments of Obstetrics and Gynaecology, Internal Medicine and Clinical Pathology, Faculty of Medicine, Tanta University, Egypt. Thirty-three infertile women due to PCOD were enrolled and divided into 23 cases received oral metformin 850 ma/ twice daily for 8 weeks and 10 cases received placebo for the same period. Basic hormonal parameters, serum glucose and insulin were tested before and after treatment. Metformin led to 65% improvement in acne score, 57% menstrual improvement and significant reduction of serum LH androstenedione, DHEAS, free testosterone, glucose and insulin. Highly significant elevation of SHBG was observed. The mean fasting insulin dropped from 28 uU/ml before to 16 uU/ml after therapy and this drop was significantly correlated to changes in testosterone, free testosterone, SHBG and glucose. Metformin may be suggested as a therapy for women with colomiphene resistant polycystic ovarian disease. It can ameliorate hyperinsulinemia, hyperadrogenemia with their impacton the restoration of regular menses and ovulation; and hence improving the pregnancy capability