Document Detail

Use of metformin in polycystic ovary syndrome.
MedLine Citation:
PMID:  19084097     Owner:  NLM     Status:  MEDLINE    
Women with polycystic ovary syndrome (PCOS) have a myriad of phenotypic and clinical features that may guide therapeutic options for metabolic protection and ovulation induction. The use of metformin may prove beneficial in a subset of the population of women with PCOS. Hyperinsulinemia, as demonstrated by elevated insulin levels on a 2-hour 75-g load glucose tolerance test, is an important parameter in deciding whether or not to initiate metformin therapy to women with PCOS with the hope of preventing or delaying the onset of type 2 diabetes mellitus (DM). Cardiovascular risk factors including markers of subclinical inflammation, and dyslipidemia may also be improved by metformin therapy. For ovulation induction, metformin is not as effective as clomiphene citrate as first-line therapy for women with PCOS. There are no clear data to suggest that metformin reduces pregnancy loss or improves pregnancy outcome in PCOS, and it is currently recommended that metformin be discontinued with the first positive pregnancy test result, unless there are other medical indications (eg, type 2 DM). This review addresses practical management guidelines for the uses of metformin in women with PCOS.
Ruchi Mathur; Carolyn J Alexander; Jacqueline Yano; Bradley Trivax; Ricardo Azziz
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  199     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-16     Completed Date:  2009-01-22     Revised Date:  2009-07-06    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  596-609     Citation Subset:  AIM; IM    
Department of Obstetrics/Gynecology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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MeSH Terms
Clomiphene / adverse effects,  therapeutic use
Dose-Response Relationship, Drug
Drug Administration Schedule
Follow-Up Studies
Hypoglycemic Agents / adverse effects,  therapeutic use*
Infertility, Female / drug therapy,  etiology
Insulin Resistance*
Metformin / adverse effects,  therapeutic use*
Ovulation / drug effects,  physiology
Polycystic Ovary Syndrome / complications,  diagnosis,  drug therapy*
Pregnancy Rate
Pregnancy, High-Risk
Randomized Controlled Trials as Topic
Risk Assessment
Severity of Illness Index
Thiazolidinediones / adverse effects,  therapeutic use
Treatment Outcome
Young Adult
Reg. No./Substance:
0/Hypoglycemic Agents; 0/Thiazolidinediones; 657-24-9/Metformin; 911-45-5/Clomiphene
Comment In:
Am J Obstet Gynecol. 2009 Jul;201(1):e18; author reply e18-9   [PMID:  19306964 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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