How does metformin help for PCOS?

BJOG. 2006 Jul;113(7):817-24.

The effect of metformin on fat distribution and the metabolic syndrome in women with polycystic ovary syndrome--a randomised, double-blind, placebo-controlled trial.Lord J,Thomas R,Fox B, Acharya U,Wilkin T.

Department of Obstetrics and Gynaecology, Royal Cornwall Hospital, Truro, Cornwall, UK. jonathan.lord@pms. Ac.uk

Objectives:

To establish whether metformin has a significant action in reducing visceral fat and improving other metabolic parameters in women with polycystic ovary syndrome (PCOS).

Design:

Randomised, double-blind, placebo-controlled trial.

Setting:

Reproductive medicine clinic.

Population:

Forty women with anovulatory PCOS.

Methods:

Participants were randomised into receiving metformin 500 mg three times a day or placebo for 3 months.

Settings, Design and Main Outcome Measures:

Fat distribution was measured by computed tomography scan. Secondary outcome measures included serum indices of the metabolic syndrome and evidence of ovulation.

Results:

We found no significant differences in any of the measures of fat distribution between the placebo and metformin groups. The metformin group had significantly lower total cholesterol (P= 0.02), low-density lipoprotein cholesterol (P= 0.02) and cholesterol:high-density lipoprotein cholesterol ratio (P= 0.05), but there was no statistically significant treatment effect on androgens, insulin, insulin resistance, triglycerides, ovulation or pregnancy.

Conclusions:

Metformin has no clinically significant effect in reducing visceral fat mass, although it does have a beneficial effect on lipids. This trial lends support to the growing evidence that metformin is not a weight loss drug. Metformin might therefore be used as an adjunct to lifestyle modification in women with PCOS, but not as a substitute for it.

See Also:

PCOS - Polycystic Ovary Syndrome

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