Metformin improves menstrual patterns, endocrine and metabolic profile in obese hyperinsulinemic women with a polycystic ovary syndrome.

OBJECTIVE To evaluate the therapeutic effect of metformin on the clinical features, hormonal and metabolic profile in obese women with a hyperinsulinemic polycystic ovary syndrome (PCOS). MATERIAL AND METHODS We analyzed 25 women with PCOS, mean age 27.28+/-7.85 years, BMI 34.42+/-6.61 kg/m2, FerrimanGallwey (F/G) score 17.43+/-5.45 and duration of menstrual cycle 79.2 +/- 54.5 days. Basal hormone measurements included: FSH, LH, total testosterone, DHEAS, 17 alpha OHP and E2. All patients underwent a 75 g oral glucose tolerance test (OGTT), during which fasting and stimulated levels of glucose and insulin were measured at 0', 60' and 120'. The lipid profile was also performed. Both basal and stimulated parameters were analyzed before and after treatment with metformin (500 mg orally, three times daily for 9 months). RESULTS After metformin treatment the mean frequency of menses became significantly more regular (79.2+/-54.5 days vs. 31.61 +/-7.7 days, P<0.01) and mean testosterone level had significantly decreased (2.78+/-1.23 vs. 1.72+/-0.95 ng/ml, (P<0.01). We also observed a statistically significant decrease in the metabolic parameters, both basal insulinemia (22.18 +/- 5.76 vs. 17.19+/-6.67 microU/ml, P<0.01), stimulated insulinemia after 60' (179.18+/-88.96 vs. 136.38+/-75.43 microU/ml, P=0.04), stimulated insulinemia after 120' (163.23 +/-89.2 vs. 88.46 +/- 61.5 U/ml, P<0.01) and glucose response to OGTT on 120' (7.07 +/- 1.82 vs. 6.15 +/-1.52 mmol/L, P=0.04). The levels of HDL cholesterol had increased (0.94+/-0.16 vs. 1.13+/-0.19 mmol/L, P=0.04). No changes were noted on the hirsutism score and other steroid levels. CONCLUSION In women with PCOS treatment with metformin is effective in the lowering of hyperinsulinemia and hyperandrogenemia. In most women metformin improves the menstrual pattern, but has no effect on hirsutism.