Metformin to restore normal menses in oligo-amenorrheic teenage girls with polycystic ovary syndrome (PCOS)11The full text of this article is available via JAH Online at http://www.elsevier.com/locate/jahonline.

Glueck, Charles J.; Wang, Ping; Fontaine, R; Tracy, Trent; Sieve-Smith, Luann

doi:10.1016/s1054-139x(01)00202-6

Cited by 130 publications

(8 citation statements)

References 32 publications

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“…Hyperandrogenemic PCOS phenotypes have the greatest degree of IR and inflammation (34). The presence of ≥3 annual reports of menstrual cycles ≥42 days during ages 14–19 years should focus diagnostic attention on hyperandrogenemia, hyperinsulinemia, and PCOS (30, 31, 35), with a goal of exercise/diet (36) and insulin sensitizers (30–32, 37) to reduce hyperinsulinemia and hyperandrogenemia, and with an ultimate goal of primary prevention of T2DM, coronary heart disease (1, 2), and morbid obesity, all of which are associated with PCOS in adult women.…”

Section: Discussionmentioning

confidence: 99%

Ramifications of adolescent menstrual cycles ≥42 days in young adults

Morrison

Glueck

Daniels

et al. 2011

Fertility and Sterility

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Objective To determine to what degree annual reports from ages 14 to 19 years of menstrual cycles ≥42 days would be associated with increased body mass index (BMI), waist circumference, glucose, insulin, and homeostasis model assessment insulin resistance (HOMA-IR) at ages 14–25 years. Design Prospective 11-year follow-up from ages 14 to 25 years. Setting Urban-suburban schools, post–high school. Patient(s) A total of 370 schoolgirls. Intervention(s) None. Main Outcome Measure(s) BMI, waist, insulin, glucose, HOMA-IR. Result(s) From ages 14 to 19 years, 269 girls had 0/6 annual reports of menstrual cycles ≥42 days, 74 had 1, 19 had 2, and 8 had ≥3. Among these four categories, girls with ≥3 annual reports had highest free T and DHEAS at age 14, highest BMI and waist at ages 14, 19, and 25, highest insulin at age 25, and highest glucose and HOMA-IR at age 24 years. The number of annual reports of menstrual cycles ≥42 days was positively related to change in BMI and waist and inversely with change in high-density lipoprotein cholesterol from ages 14 to 25 years. Conclusion(s) Three or more annual reports of menstrual cycles ≥42 days during ages 14–19 are associated with high BMI, waist circumference, insulin, glucose, and HOMA-IR at ages 14–25 years. (Fertil Steril® 2011;96: 236–40).

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Section: Discussionmentioning

confidence: 99%

Ramifications of adolescent menstrual cycles ≥42 days in young adults

Morrison

Glueck

Daniels

et al. 2011

Fertility and Sterility

Self Cite

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“…Glueck et al studied 11 obese females with PCOS at a dose of 500 mg tid-850 mg three times daily and found that 91% of the girls resumed normal menses. There was reduction in total cholesterol, increased estradiol levels and a downward trend in testosterone levels even when adjusted for weight loss [170]. …”

Section: Polycystic Ovarian Syndrome (Pcos)mentioning

confidence: 99%

Identification and treatment of metabolic complications in pediatric obesity

Ode

Frohnert

Nathan

2009

Rev Endocr Metab Disord

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Metabolic consequences of obesity including insulin resistance, type 2 diabetes mellitus, hyperlipidemia, hypertension, polycystic ovarian syndrome, and nonalcoholic fatty liver infiltration are rapidly emerging in the pediatric population. Identifying effective strategies for identifying and treating these obesity related co-morbidities in children are crucial to the prevention of future cardiovascular disease and poor health outcomes. This review discusses the pathophysiologic connections between obesity, metabolic disease and cardiovascular risk. Current evidence and recommendations for screening and treatment for the metabolic consequences of pediatric obesity are reviewed.

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“…Hyperinsulinemia and hyperandrogenism improve just as much as in adults, but there is an even higher rate at normalizing menses and decreasing hirsutism score in teenagers and young adults [51,52,53]. Metformin administration has been linked to significantly improved insulin levels and regularized menstrual cycles in oligo-amenorrheic teenagers with PCOS [54]. A small, randomized, double blind, placebo-controlled trial of metformin in morbidly obese adolescents showed significant changes in BMI, fasting blood glucose and insulin levels.…”

Section: Treatmentmentioning

confidence: 99%

Current Approaches to the Diagnosis and Treatment of Polycystic Ovarian Syndrome in Youth

2007

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Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in reproductive-age women. It often presents during late adolescence but in some cases certain features are evident even before menarche. PCOS is a spectrum of disorders with any combination of oligo/anovulation, clinical and/or biochemical evidence of androgen excess, obesity, insulin resistance and polycystic ovaries on ultrasound. The pathogenesis is unknown; however, it is a complex multigenetic disorder where disordered gonadotropin release, dysregulation of steroidogenesis, hyperinsulinism and insulin resistance play a role. The diagnosis is based on a typical physical exam (acne, hirsutism, obesity, and acanthosis nigricans) and laboratory evidence of hyperandrogenism, such as elevated free testosterone, androstenedione and dehydroepiandrosterone sulfate (DHEAS), decreased sex hormone-binding globulin (SHBG) and increased luteinizing hormone (LH). An ovarian ultrasound may detect the multiple cysts. Secondary causes of PCOS need to be excluded. There are several classes of medications correcting different parameters of PCOS that can be used alone or in combination. Oral contraceptive therapy is used to reduce androgen and LH levels with resultant improvement in acne and hirsutism, and the induction of regular menses. Antiandrogens are usually required for a substantial improvement in hirsutism score. Insulin sensitizers such as metformin are a new class of drugs utilized in treatment of PCOS. By improving insulin sensitivity and decreasing insulin levels, they improve the unfavorable metabolic profile of patients with PCOS. Metformin also helps to increase SHBG, decrease androgen levels and induce ovulation. Despite all the available medications, life-style changes are the mainstay of therapy as weight loss and exercise improve all parameters of PCOS without the potential side effects of medication.

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Metformin to restore normal menses in oligo-amenorrheic teenage girls with polycystic ovary syndrome (PCOS)11The full text of this article is available via JAH Online at http://www.elsevier.com/locate/jahonline.

Cited by 130 publications

References 32 publications

Ramifications of adolescent menstrual cycles ≥42 days in young adults

Ramifications of adolescent menstrual cycles ≥42 days in young adults

Identification and treatment of metabolic complications in pediatric obesity

Current Approaches to the Diagnosis and Treatment of Polycystic Ovarian Syndrome in Youth

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