A new comprehensive review finds that women who suffer from polycystic ovary syndrome (PCOS) may obtain symptom relief by combining a change in lifestyle emphasizing healthy weight with the drug metformin.
PCOS is associated with a range of symptoms and comorbidities including irregular cycles, infertility, obesity, diabetes, and depression.
As discussed in the journal Human Reproduction Update, researchers at Monash University in Melbourne, Australia, compared the effects of change in lifestyle alone or with placebo, to lifestyle plus metformin.
They found that lifestyle changes combined with taking metformin is associated with more weight loss, with a lower body mass index BMI, and improved menstruation in women.
This is a significant discovery for PCOS sufferers, who are at higher risk of weight gain with both PCOS and obesity combining to yield significant complications across lifespan.
This meta-analysis involved 608 participants aged 12-39 across nine studies, who were given a mixture of dietary advice, behavior education, and access to fitness facilities alone or with placebo, and compared to those given metformin hydrochloride with a change in lifestyle.
Combining the data from nine studies found that lifestyle with metformin was associated with a lower BMI at study completion compared to lifestyle with a placebo.
This review study combined all of the prior quality studies on the topic and found that adding metformin at a standard dose of 1.5-2g daily to lifestyle intervention resulted a lower BMI compared with those who took lifestyle plus placebo.
The senior author of the review, Helena Teede, said, “Achieving and maintaining a healthy weight is key in the management of PCOS and needs engagement and support for affected women in lifestyle modification.”
Teede went on to say that, “The key take home messages are that while lifestyle management is the first and most important step in the management of PCOS, addition of metformin to lifestyle modification appears to provide additional advantages in improving BMI and menstrual cyclicity in the medium term.”
Metformin is a well-established and safe drug used traditionally to treat diabetes, where it controls blood sugar and assists weight management.
While insulin resistance and glucose tolerance were assessed in the review, researchers were unable to determine a difference between lifestyle verse placebo effects because each study used difference measures to record blood sugar metrics. Likewise, the impact of metformin on glucose levels in these non-diabetic women was also insignificant.