The efficacy of 24-month metformin for improving menses, hormone and metabolic profiles in polycystic ovary syndrome.

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The efficacy of 24-month metformin for improving menses, hormone and metabolic profiles in polycystic ovary syndrome.

J Clin Endocrinol Metab. 2018 Jan 09;:

Authors: Yang PK, Hsu CY, Chen MJ, Lai MY, Li ZR, Chen CH, Chen SU, Ho HN

Abstract
Context: The long-term effects of metformin in women with polycystic ovarian syndrome (PCOS) are inadequately studied.
Objective: The effects of metformin on women with PCOS over 24-month with respect to menses, hormones and metabolic profiles are assessed.
Design: Prospective cohort.
Setting: A reproductive endocrinology clinic in a university-affiliated medical center.
Patients: 119 women with PCOS, defined by the Rotterdam criteria, were enrolled.
Intervention: Metformin was given daily for 24 months.
Main Outcome Measures: The primary outcome was the proportion of patients with regular menstruation during treatment. Changes in anthropometric, hormonal, and metabolic parameters were also assessed. Analyses were performed using segmented regression analysis with a generalized estimating equation methodology. Outcomes are expressed as magnitude of change from the baseline.
Results: Both overweight and normal-weight women with PCOS had increased menstrual frequency and decreased body mass index (BMI), testosterone, and luteinizing hormone levels in the first 6-month. Further stratification showed that normal-weight women exhibiting elevated testosterone at baseline had the largest magnitude of improvement at 6-month (OR: 7.21, 95% CI: 2.35-22.17), whereas overweight patients with normal testosterone were most likely to achieve normal menses at 12-month (0.63, 95% CI: 0.47-0.77).
Conclusions: Metformin was associated with improvements in the menstrual cycle and most hormonal profiles in overweight and normal-weight women with PCOS over 24 months of treatment. Most parameters reached maximal response and steady state after 6 months. Phenotypic differences in baseline BMI and testosterone level can be utilized as patient selection criteria or treatment prognostics.

PMID: 29325133 [PubMed - as supplied by publisher]

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