Polycystic ovary syndrome and treatment with metformin: literature analysis

Kamilė Bertašiūtė1, Miglė Vidrinskaitė1

1 Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences


Polycystic Ovary Syndrome (PCOS) is multifactorial clinical syndrome, which causes endocrinologic, reproductive health and metabolic disorders. Nowadays the problem is relevant, as the population of women with PKS is as high as 6-20%. Patients’ quality of life is often affected by the predominant symptoms: irregular menstruation, anovulation, infertility, hirsutism, acne, depression and increased anxiety, weight gain and obesity, and symptoms caused by hyperglycemia. The pathophysiology of the syndrome has not yet been fully clarified, but it has been found that insulin resistance may be a major aspect of the pathogenesis of this syndrome and subsequent symptoms. Insulin resistance is found to in more than 60% of PKS patients, whether or not they are obese or of normal weight. Untreated PKS can lead to serious health problems such as diabetes and heart problems. The diagnosis of PKS is based on the Rotterdam criteria, the treatment is often complex and personalized for each patient. Also the correction of life habits is also recommended as a first line treatment. Metformin is usually given to reduce insulin resistance. Administration of metformin alone and in combination with Clomiphen citrate has shown not only positive changes in weight and reproductive system in PKS patients, but also adverse effects on the development of more severe cardiovascular and metabolic diseases. However, metformin often causes unwanted gastrointestinal manifestations that need to be considered before prescribing it to each patient taking into a count the patients‘  detailed medical history and comorbidities.

Keywords: polycystic ovarian syndrome, metformin, obesity, anovulation.