Combined oral contraceptives plus spironolactone compared with metformin in women with polycystic ovary syndrome: a one-year randomized clinical trial

Alpañés, Macarena; Álvarez‐Blasco, Francisco; Fernández‐Durán, Elena; Luque‐Ramírez, Manuel; Escobar-Morreale, Héctor F.

doi:10.1530/eje-17-0516

Cited by 25 publications

(23 citation statements)

References 40 publications

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“…In addition to metformin, other drugs used as comparators in the randomized clinical trials were clomiphene citrate, oral contraceptives, ethinylestradiol, desogestrel, simvastatin, rosiglitazone, orlistat, n-acetylcysteine, letrozole, calcium & vitamin D, pioglitazone, saxagliptin, spironolactone, flutamide, lipoic acid, monacolin K and myo-inositol. Non-pharmacologic therapies used in clinical trials were lifestyle modifications such as caloric restriction and exercise [3-12].…”

Section: Reviewmentioning

confidence: 99%

“…When metformin was used with other pharmacologic agents, there was a recovery of menstrual cycles as well. Of the articles collected, the randomized clinical trials involving metformin showed improvement in menstrual cycle irregularity with metformin [3, 10-17]. Table 2 shows the analysis of various parameters seen in the randomized clinical trials.…”

Section: Reviewmentioning

confidence: 99%

“…Treating menstrual irregularities is a crucial component to the polycystic ovarian syndrome. Menstrual irregularities caused by polycystic ovaries leads to infertility, resulting in distress among women trying to conceive [1-3].…”

Section: Introductionmentioning

confidence: 99%

“…The exact mechanism of metformin in regulating menstrual cycle is still unknown. However, it may be attributed to insulin sensitization thereby targeting the insulin resistance caused by androgen excess [1-3]. This literature review is aimed to determine the effectiveness of metformin in regulating menstrual cycles among females with the polycystic ovarian syndrome.…”

Section: Introductionmentioning

confidence: 99%

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Is Metformin the Answer for Distressed Females with Menstrual Irregularities?

Tejpal

Poudel

Jahan

2019

Cureus

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This literature review is aimed to determine if metformin alone improves menstrual irregularities in females with the polycystic ovarian syndrome. The current literature review involves females with polycystic ovarian syndrome experiencing menstrual irregularity. The data was collected in PubMed and inclusion criteria included articles published in the past 10 years, articles involving only humans, articles written in the English language and considering women age 19 or more. The number of discovered articles was 1550 after the first search and only 25 articles that met the inclusion criteria were selected after quality assessment. The selected 25 articles that met the inclusion criteria after a review showed evidence for regulating menstrual cycles with metformin therapy alone among females with the polycystic ovarian syndrome. When metformin was used in addition to other pharmacologic agents, there was a more significant restoration of menstrual cycles. Monotherapy with metformin is found to be highly effective in treating menstrual irregularities experienced among patients with the polycystic ovarian syndrome. Greater improvement was noted with the addition of another agent to metformin.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is Metformin the Answer for Distressed Females with Menstrual Irregularities?

Tejpal

Poudel

Jahan

2019

Cureus

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“…As a result, these patients are treated with the insulin sensitized metformin. However, recent clinical studies have shown that combined oral contraceptives plus spironolactone are more effective than metformin for symptoms of PCOS [30] , suggesting that alterations in the sex hormone production by the ovaries is the predominant element in the PCOS etiology. Estrogen therapy has important beneficial effects also on the metabolic alterations of Turner syndrome (TS), a genetic disorder caused by the partial or complete absence of one of the X chromosomes in females.…”

Section: The Reproductive Status and Metabolism In Mammalsmentioning

confidence: 99%

Sex, metabolism and health

Maggi

Torre

2018

Molecular Metabolism

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BackgroundEpidemiological and clinical studies have largely demonstrated major differences in the prevalence of metabolic disorders in males and females, but the biological cause of these dissimilarities remain to be elucidated. Mammals are characterized by a major change in reproductive strategies and it is conceivable that these changes subjected females to a significant evolutionary pressure that perfected the coupling between energy metabolism and reproduction.Scope of reviewThis review will address the plausibility that female liver functions diverged significantly from males given the role of liver in the control of metabolism. Indeed, it is well known that the liver is sexually dimorphic, and this might be relevant to explain the lower susceptibility to hepatic diseases and liver-derived metabolic disturbances (such as the cardiovascular diseases) characteristic of females during their fertile period. Furthermore, estrogens and the hepatic ERα play a significant role in liver sexual-specific functions and in the control of metabolic functions.ConclusionsA better grasp of the role of male and female sex steroids in the liver of the two sexes may therefore represent an important element to conceive novel treatments aimed at preventing metabolic diseases particularly in ageing women or limiting undesired side effect in the treatment of gender dysphoria.

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