2017
DOI: 10.1007/s00125-017-4306-3
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Metformin therapy for the reproductive and metabolic consequences of polycystic ovary syndrome

Abstract: Polycystic ovary syndrome (PCOS), the most common hormonal disorder among women of reproductive age, has various metabolic and reproductive consequences. Metformin was originally shown to lower testosterone levels in women with PCOS in the 1990s, an effect presumably related to its insulin sensitising actions. However, the precise mechanisms of metformin action in PCOS remain unclear and there is considerable heterogeneity in the clinical response to this therapy in women with PCOS. Recent evidence indicates t… Show more

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Cited by 68 publications
(55 citation statements)
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References 58 publications
(90 reference statements)
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“…Thus, it has become one of the most commonly used medications for type 2 diabetes worldwide, with more than 48 million prescriptions filled in the US in 2010. As described elsewhere in this issue of Diabetologia , metformin is also used for diabetes prevention [12] and the treatment of polycystic ovary syndrome [13], and there is hope that its use will expand to other indications, such as cancer treatment and/or prevention [14]. …”
Section: The Problemmentioning
confidence: 99%
“…Thus, it has become one of the most commonly used medications for type 2 diabetes worldwide, with more than 48 million prescriptions filled in the US in 2010. As described elsewhere in this issue of Diabetologia , metformin is also used for diabetes prevention [12] and the treatment of polycystic ovary syndrome [13], and there is hope that its use will expand to other indications, such as cancer treatment and/or prevention [14]. …”
Section: The Problemmentioning
confidence: 99%
“…Hormonal contraceptives alone or combined with anti‐androgens have been the cornerstone for managing menstrual disturbances and clinical or biochemical hyperandrogenaemia; however, some hormonal contraceptives may unfavourably affect the lipid profile in PCOS and increase the risk of thrombosis and cardiovascular events in the general population . Glucose lowering agents including metformin and thiazolidinedione have been shown to be effective in managing the metabolic abnormalities (ie, insulin resistance, hyperinsulinaemia, and diabetes mellitus) and chronic anovulation; however, their use has been inconsistently associated with improvements in weight loss and body composition, menstrual irregularity or clinical symptoms of excess androgens …”
Section: Introductionmentioning
confidence: 99%
“…6 Glucose lowering agents including metformin and thiazolidinedione have been shown to be effective in managing the metabolic abnormalities (ie, insulin resistance, hyperinsulinaemia, and diabetes mellitus) and chronic anovulation; however, their use has been inconsistently associated with improvements in weight loss and body composition, menstrual irregularity or clinical symptoms of excess androgens. 7,8 Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, is a new treatment option for adults with type 2 diabetes 9 ; however, its effects in PCOS have not been previously explored. Its principal action involves inhibition of glucose reabsorption by the kidney, and therefore, glucose excretion via urine.…”
Section: Introductionmentioning
confidence: 99%
“…In their review, Sam and Ehrmann [27] discuss the use of metformin for PCOS. In addition to its reproductive manifestations, PCOS also has metabolic consequences, including insulin resistance, impaired glucose tolerance and type 2 diabetes.…”
mentioning
confidence: 99%