Metformin or Oral Contraceptives for Adolescents With Polycystic Ovarian Syndrome: A Meta-analysis

Khalifah, Reem Al; Flórez, Iván D.; Dennis, Brittany B.; Thabane, Lehana; Bassilious, Ereny

doi:10.1542/peds.2015-4089

Cited by 69 publications

(71 citation statements)

References 48 publications

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“…Metformin was accompanied by a greater improvement of BMI, while the use of OCP was associated with improvement in menstrual regularity (modest) and acne (mild). The conclusion was that these estimates were derived from low-quality evidence involving small studies and that further research is required [227]. …”

Section: Treatment Of Pcosmentioning

confidence: 99%

An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence

Ibáñez¹,

et al. 2017

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This paper represents an international collaboration of paediatric endocrine and other societies (listed in the Appendix) under the International Consortium of Paediatric Endocrinology (ICPE) aiming to improve worldwide care of adolescent girls with polycystic ovary syndrome (PCOS)¹. The manuscript examines pathophysiology and guidelines for the diagnosis and management of PCOS during adolescence. The complex pathophysiology of PCOS involves the interaction of genetic and epigenetic changes, primary ovarian abnormalities, neuroendocrine alterations, and endocrine and metabolic modifiers such as anti-Müllerian hormone, hyperinsulinemia, insulin resistance, adiposity, and adiponectin levels. Appropriate diagnosis of adolescent PCOS should include adequate and careful evaluation of symptoms, such as hirsutism, severe acne, and menstrual irregularities 2 years beyond menarche, and elevated androgen levels. Polycystic ovarian morphology on ultrasound without hyperandrogenism or menstrual irregularities should not be used to diagnose adolescent PCOS. Hyperinsulinemia, insulin resistance, and obesity may be present in adolescents with PCOS, but are not considered to be diagnostic criteria. Treatment of adolescent PCOS should include lifestyle intervention, local therapies, and medications. Insulin sensitizers like metformin and oral contraceptive pills provide short-term benefits on PCOS symptoms. There are limited data on anti-androgens and combined therapies showing additive/synergistic actions for adolescents. Reproductive aspects and transition should be taken into account when managing adolescents.

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Section: Treatment Of Pcosmentioning

confidence: 99%

An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence

Ibáñez¹,

et al. 2017

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“…Increasing evidence supports a central role of insulin resistance and its compensatory hyperinsulinemia in the pathogenesis of this syndrome (Baptiste, Battista, Trottier, & Baillargeon, ). Insulin resistance plays a major role in the development of cardiometabolic disturbances associated with PCOS such as dysglycemia, hyperlipidemia, and obesity (Al Khalifah, Florez, Dennis, Thabane, & Bassilious, ).…”

Section: Introductionmentioning

confidence: 99%

Insulin resistance improvement by cinnamon powder in polycystic ovary syndrome: A randomized double‐blind placebo controlled clinical trial

Hajimonfarednejad

Nimrouzi

Heydari

et al. 2017

Phytotherapy Research

108

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Our aim is to assess the effect of cinnamon powder capsules on insulin resistance, anthropometric measurements, glucose and lipid profiles, and androgens of women with polycystic ovarian syndrome (PCOS). Out of 80 women that were diagnosed as PCOS by Rotterdam Criteria, 66 were enrolled in this randomized double-blind placebo-controlled clinical trial. All of the PCOS women were taking medroxy progesterone acetate 10 mg/day for the last 10 days of their menstrual cycles. The cases were randomly allocated to 2 groups. The women in the first group were treated by cinnamon powder capsules 1.5 g/day in 3 divided doses for 12 weeks and the second group by similar placebo capsules. Anthropometric measurements, fasting blood sugar, fasting insulin, blood glucose 2 hr after taking 75 g oral glucose, HbA1c, testosterone, dehydroepiandrosterone sulphate, homeostatic model assessment for insulin resistance, triglyceride, and cholesterol (low-density lipoprotein, high-density lipoprotein, and total) before and after the intervention were evaluated and compared as outcome measures. Fasting insulin (p = .024) and homeostatic model assessment for insulin resistance (p = .014) were reduced after 12 weeks in the cinnamon group compared with the placebo. There was also a significant decrease in low-density lipoprotein in cinnamon group (p = .004) as compared with baseline that caused significant difference with placebo (p = .049). However, changes in other outcome measurements did not lead to statistically significant difference with placebo. The present results suggest that complementary supplementation of cinnamon significantly reduced fasting insulin and insulin resistance in women with PCOS.

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“…Anthropometric outcomes were assessed by 10 reviews. Seven reviews (n = 3 comparing metformin vs thiazolidinediones, n = 2 comparing metformin vs placebo, n = 1 comparing metformin vs COCPs and n = 1 comparing combination therapy with metformin and clomiphene citrate vs clomiphene citrate alone) reported results favouring metformin in terms of BMI and/or waist‐hip ratio. There was no significant difference in anthropometric outcomes when metformin was compared to acarbose or orlistat, or when combination therapy with metformin and statin was compared to metformin alone .…”

Section: Resultsmentioning

confidence: 99%

Pharmacological and surgical treatment of nonreproductive outcomes in polycystic ovary syndrome: An overview of systematic reviews

Tay

Joham

Hiam

et al. 2018

Clinical Endocrinology

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Metformin or Oral Contraceptives for Adolescents With Polycystic Ovarian Syndrome: A Meta-analysis

Abstract: BACKGROUND: Polycystic ovarian syndrome (PCOS) is a common disease. There is limited evidence to support various treatment choices. This leads to variable treatment practices.

Cited by 69 publications

References 48 publications

An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence

An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence

Insulin resistance improvement by cinnamon powder in polycystic ovary syndrome: A randomized double‐blind placebo controlled clinical trial

Pharmacological and surgical treatment of nonreproductive outcomes in polycystic ovary syndrome: An overview of systematic reviews

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