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Metformin associated with improvements in the menstrual cycle and most hormonal profiles in overweight and normal-weight women with polycystic ovary syndrome


The long-term effects of Metformin in women with polycystic ovarian syndrome ( PCOS ) are inadequately studied.

The effects of Metformin on women with PCOS over 24-month with respect to menses, hormones and metabolic profiles were assessed in prospective cohort.

119 women with PCOS, defined by the Rotterdam criteria, were enrolled.

Metformin was given daily for 24 months.

The primary outcome was the proportion of patients with regular menstruation during treatment. Changes in anthropometric, hormonal, and metabolic parameters were also assessed.
Analyses were performed using segmented regression analysis with a generalized estimating equation methodology.

Both overweight and normal-weight women with PCOS had increased menstrual frequency and decreased body mass index ( BMI ), testosterone, and luteinizing hormone levels in the first 6-month.

Further stratification showed that normal-weight women exhibiting elevated testosterone at baseline had the largest magnitude of improvement at 6-month ( odds ratio, OR=7.21, 95% CI: 2.35-22.17 ), whereas overweight patients with normal testosterone were most likely to achieve normal menses at 12-month ( OR=0.63, 95% CI: 0.47-0.77 ).

In conclusion, Metformin was associated with improvements in the menstrual cycle and most hormonal profiles in overweight and normal-weight women with PCOS over 24 months of treatment.
Most parameters reached maximal response and steady state after 6 months.
Phenotypic differences in baseline BMI and testosterone level can be utilized as patient selection criteria or treatment prognostics. ( Xagena )

Yang PK et al, J Clin Endocrinol Metab 2018; Epub ahead of print

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