Use of metformin in patients with polycystic ovary syndrome
DOI:
https://doi.org/10.51481/amc.v49i3.318Keywords:
Metformin, polycystic ovary syndrome, hyperandrogenism, hyperinsulinism, insulin resistance, lactic acidosis, oligomenorrhea, hirsutism, ovulation inductorAbstract
Metformin has been prescribed for treating type II Diabetes Mellitus of patients with normal renal function. It has also been used with the FDA approval for patients with polycystic ovary syndrome as regulator of the menstrual cycle, and for the treatment of hirsutism and as an ovulation inductor.
Since 1980, Burgen et al. pointed the association between hyperandrogenism and hyperinsulinism in patients with polycystic ovary syndrome. The excess of androgens due to the increase of insulin diminish its action.
Metformin mechanism for lowering glucose is a consequence of a decrease in hepatic glucose production and an increase of its utilization. Metformin increases most of insulin biological actions in people with pre-existing insulin resistance and decreases intestinal glucose absorption.
In conclusion, metformin is useful for menstrual cycle regulation in comparison with placebo, is not a first choice treatment for hirsutism, and its use as monotherapy for induction of ovulation has not demonstrated a substantial rate improvement in clinical pregnancy. Evidence shows that metformin associated with clomiphene citrate induces ovulation and improves clinical pregnancy rate.
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