October 2003 · Vol. 15, No. 10Metformin for PCOS symptoms: 5 challenging cases
This inexpensive and versatile drug broadens the choices for treating polycystic ovary syndrome. An expert describes its efficacy for common manifestations of PCOS.
ROBERT
L.
BARBIERI,
MDEDITOR-IN-CHIEF
Dr. Barbieri is chief of the department of obstetrics and gynecology at Brigham and Women’s Hospital in Boston, Mass, and Kate Macy Ladd Professor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School. He is editor-in-chief of OBG Management.
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KEY POINTS
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Metformin’s role in treatment of PCOS varies with the patient’s chief complaint, clinical characteristics, and lifestyle.
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The primary uses of metformin in treating PCOS are to induce ovulation in women resistant to clomiphene alone and to treat oligomenorrhea in women who can’t or won’t use oral contraceptives.
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To be a candidate for metformin treatment, a patient must have a serum creatinine lower than 1.4 mg/dL to avoid the risk of developing lactic acidosis.
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Inducing ovulation. Decreasing insulin resistance. Facilitating weight loss. These are a few of the benefits metformin offers women with polycystic ovary syndrome (PCOS). This article’s 5 case histories illustrate a range of major complaints and secondary factors to consider in making prescribing decisions.
The decision to use metformin depends on the patient’s major PCOS-related complaint (TABLE 1), as well as other considerations. In some cases, metformin may not be appropriate at all.
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