Effect of flutamide and metformin administered alone or in combination in dieting obese women with polycystic ovary syndrome

Gambineri, Alessandra; Pelusi, Carla; Genghini, Silvia; Morselli-Labate, Antonio Maria; Cacciari, M; Pagotto, Uberto; Pasquali, Renato

doi:10.1111/j.1365-2265.2004.01973.x

Cited by 186 publications

(144 citation statements)

References 51 publications

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“…The limited utility of the fT assay (due to its low sensitivity) did not impugn the results. The evident decrease in serum androgen levels was in agreement with ours and other previous reports (6,18,19,21,22,25,31,32,34,(36)(37)(38), and in disagreement with others (16,23,27,29,30) using different doses of Flu and smaller sizes of the subject sample enrolled. Hence, although Flu is considered a pure anti-androgen, the main action of which is attributed to its peripheral antiandrogenic properties, our data also confirm a direct inhibitory effect on androgen secretion, resulting from a blockade of the steroidogenic enzymes of androgen biosynthesis in both ovarian thecal and adrenal corticoreticular cells, as has been reported already (18,21,24).…”

Section: Discussionsupporting

confidence: 68%

Retrospective observational study on the effects and tolerability of flutamide in a large population of patients with various kinds of hirsutism over a 15-year period

Paradisi¹,

Venturoli²

2010

European Journal of Endocrinology

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Objective: The aim of the study was to evaluate the long-term effects and tolerability of flutamide (Flu) in hirsute women. To the best of our knowledge, this study represents the largest report, concerning the population studied and the duration of treatment, to evaluate Flu use in hirsutism treatment. Design, patients and methods: Over a 15-year period spanning from January 1991 to January 2006, a total of 414 premenopausal women with hirsutism of different aetiopathogeneses received yearly reducing doses (250, 125 and 62.5 mg/day) of Flu alone or in combination with oral contraceptives for a period varying from at least 3 to 8 years and more. Clinical and endocrine evaluations were assessed half-yearly and yearly respectively in the first 3 years of the study, and yearly in the following years. Liver function evaluations were assessed quarterly. Results: Both the groups of patients under Flu therapy showed a marked decrease in hirsutism scores after 12 months compared with basal values. The maximum drug effect was observed after 2 years, and it was maintained during the following years of treatment. Androgens were strongly suppressed during treatment. During the first year of treatment, 6.0% of patients abandoned the study due to hepatic disorders related to the drug. During the following years with the lowest treatment regimen, none of the patients abandoned the study due to hepatic discomfort. Conclusions: Flu is a satisfactory therapeutic regimen for any form of hirsutism in the long run. Moreover, the use of very low doses of Flu is associated with minimal side-effects and high compliance.

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Section: Discussionsupporting

confidence: 68%

Retrospective observational study on the effects and tolerability of flutamide in a large population of patients with various kinds of hirsutism over a 15-year period

Paradisi¹,

Venturoli²

2010

European Journal of Endocrinology

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“…This is further supported by the effects of anti-androgens like spironolactone, which appear to reduce IR in some (Diamanti-Kandarakis and Panidis, 2007) but not all studies (Cenk Sayin et al, 2003). Also, in a placebo controlled study, the pure anti-androgen flutamide when administered in conjunction with a low-calorie diet to obese women with PCOS, improved hirsutism and hyperandrogenaemia and decreased intraabdominal fat depots (Gambineri et al, 2004;Gambineri et al, 2006). Conversely, molecules which are secreted by the intraabdominal adipose tissue (adipokines) may also promote ovarian androgen production.…”

Section: Pcos and Obesitymentioning

confidence: 99%

Ovarian function and obesity—Interrelationship, impact on women's reproductive lifespan and treatment options

Rachoń

Teede

2010

Molecular and Cellular Endocrinology

125

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Insulin resistance (IR) is a consequence of obesity, and in women it is often inextricably linked with ovarian function leading to clinical reproductive manifestations such as early menarche onset, subfertility and polycystic ovary syndrome (PCOS). Likewise, the dramatic fall in oestrogen production after menopause may contribute to weight gain and changes in adipose tissue distribution.Overall, women who are obese, especially those with reproductive complications including PCOS, have been identified as specific high risk subgroups for further progression through to prediabetes, type 2 diabetes mellitus (T2DM) and potentially cardiovascular disease (CVD). This review focuses on the interrelationship between the ovarian function and obesity as well as its treatment strategies.

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“…In terms of adverse effects, orlistat was associated with gastrointestinal disturbances, sibutramine with small increases in blood pressure and pulse rate, and rimonabant with nervous, psychiatric or gastrointestinal-related effects [116] Women's Health (2007) 3(1) future science group future science group Metformin is increasingly prescribed for PCOS women to treat PCOS-related symptoms. While some studies in PCOS women found that metformin resulted in greater weight loss and fat loss compared with placebo [34,[117][118][119], a recent meta-analysis found that metformin has no net effect on BMI or waist:hip ratio in this population [120]. In contrast, studies in younger non-PCOS patients have consistently shown a beneficial effect of metformin on body weight and body composition [121][122][123][124].…”

Section: Medicationmentioning

confidence: 99%

Obesity Management in Women with Polycystic Ovary Syndrome

Lim

Clifton

Noakes

et al. 2007

Womens Health (Lond Engl)

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Obesity and insulin resistance play an important role in initiating or maintaining ill health in polycystic ovary syndrome (PCOS). This implies that treatment that reduces body weight and insulin resistance would alleviate the symptoms of PCOS. Lifestyle modification has been found to be effective in restoring reproductive function in up to 80% of individuals who achieve at least 5% weight loss. However, long-term weight maintenance is a challenge. This article provides a review of reduced glycemic load diets, including low glycemic index, very low carbohydrate, high-protein and high monounsaturated fat diets, on metabolic and reproductive health in PCOS and non-PCOS populations. Dietary trials in non-PCOS women suggest that higher-protein, reduced glycemic load diets were probably more beneficial than the conventional low-fat, high-carbohydrate diet but further studies are required to confirm this in PCOS women. Similarly, the optimal exercise regime for PCOS women remains to be investigated.Obesity & polycystic ovary syndrome Polycystic ovary syndrome (PCOS) is one of the most common endocrine conditions that affects obese and nonobese women during reproductive age. Its symptoms include irregular menses, infertility, acne and hirsutism (excessive hair growth). During pregnancy, PCOS probably also increases the risk of early miscarriages and complications such as pre-eclampsia and gestational diabetes [1]. As a result of these physical manifestations, women with PCOS tend to have poorer psychological health and lower quality of life [2]. Increasing evidence also suggests that women with PCOS may be at greater risk of developing metabolic diseases such as type 2 diabetes and cardiovascular disease in the long term [3,4].Owing to its heterogeneity, the diagnostic criteria for PCOS have been a contentious issue among experts. The 1990 National Institutes of Health (NIH) meeting defined PCOS as the coexistence of chronic anovulation and hyperandrogenism, with the exclusion of other diseases such as thyroid disorder, hyperprolactinemia, congenital adrenal hyperplasia, androgensecreting tumors and Cushing syndrome [5]. In 2003, this definition was broadened to include women with either hyperandrogenism or anovulation in addition to having polycystic ovaries. Using the previous NIH definition, the prevalence of PCOS was estimated to be 5-8% of women of reproductive age [6][7][8][9]. This number is estimated to increase by 65% using the latest revised diagnostic criteria [10]. Obesity & fat distribution in PCOS womenIt is estimated that 30-60% of women with PCOS are overweight or obese in the Western world [7,[11][12][13][14]. Some suggest that the prevalence of obesity is higher in PCOS women compared with healthy controls [7,15,16]. In a study involving 3094 women, Glueck and colleagues found that approximately 73-78% of women with PCOS aged between 20 and 41 years were obese (body mass index [BMI]>30 kg/m 2 ) compared with 7-14% in the general population [16]. In addition to being potentially predisposed to obesity,...

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Effect of flutamide and metformin administered alone or in combination in dieting obese women with polycystic ovary syndrome

Cited by 186 publications

References 51 publications

Retrospective observational study on the effects and tolerability of flutamide in a large population of patients with various kinds of hirsutism over a 15-year period

Retrospective observational study on the effects and tolerability of flutamide in a large population of patients with various kinds of hirsutism over a 15-year period

Ovarian function and obesity—Interrelationship, impact on women's reproductive lifespan and treatment options

Obesity Management in Women with Polycystic Ovary Syndrome

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