Background: Polycystic ovarian syndrome (PCOS) is characterized by irregular menses, elevated androgens, and insulin resistance. Little information is published about the treatment of adolescent PCOS.
Objectives: The aim of this study was to evaluate metformin versus oral contraceptive pills (OCP) in treating adolescent PCOS. Twenty-two girls were randomized to either treatment for 6 months. The outcomes variables included body mass index (BMI) and free testosterone (FT).
Results: BMI decreased in all patients (metformin p=0.004, OCP p=0.045). FT decreased significantly only with OCP. Insulin resistance measures decreased in all patients but did not reach significance. The only significant difference in any of the variables between the two groups was number of menses. BMI and FT remained less than baseline for 3 months off treatment.
Conclusions: Metformin and OCP have a positive effect on BMI, which persists after treatment is discontinued. FT decreased with both treatments, but only reached significance with OCP.
1. Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, et al. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004;89:2745–9.10.1210/jc.2003-032046Search in Google Scholar
2. Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, et al. Prevalence of the polycystic ovary syndrome in unselected black and white women of the Southeastern United States: a prospective study. J Clin Endocrinol Metab 1998;83:3078–82.10.1210/jc.83.9.3078Search in Google Scholar
3. March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, et al. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod 2010;25:544–51.10.1093/humrep/dep399Search in Google Scholar
4. Asunción M, Calvo RM, San Millán JL, Sancho J, Avila S, et al. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab 2000;85:2434–8.10.1210/jc.85.7.2434Search in Google Scholar
5. Christensen SB, Black MH, Smith N, Martinez MM, Jacobsen SJ, et al. Prevalence of polycystic ovary syndrome in adolescents. Fertil Steril 2013;100:470–7.10.1016/j.fertnstert.2013.04.001Search in Google Scholar
7. Hashemipour M, Faghihimani S, Zolfaghary B, Hovsepian S, Hovsepian F, et al. Prevalence of polycystic ovary syndrome in girls aged 14–18 years in Isfahan, Iran. Horm Res 2004;62:278–82.10.1159/000081842Search in Google Scholar
8. Alvarez-Blasco F, Botella-Carretero JI, San Millán JL, Escobar-Morreale HF. Prevalence and characteristics of the polycystic ovary syndrome in overweight and obese women. Arch Intern Med 2006;166:2081–6.10.1001/archinte.166.19.2081Search in Google Scholar
9. Kahsar-Miller MD, Nixon C, Boots LR, Go RC, Azziz R. Prevalence of polycystic ovary syndrome (PCOS) in first-degree relatives of patients with PCOS. Fertil Steril 2001;75:53–8.10.1016/S0015-0282(00)01662-9Search in Google Scholar
12. Nestler JE, Powers LP, Matt DW, Steingold KA, Plymate SR, et al. A direct effect of hyperinsulinemia on serum sex hormone-binding globulin levels in obese women with the polycystic ovary syndrome. J Clin Endocrinol Metab 1991;72:83–9.10.1210/jcem-72-1-83Search in Google Scholar
15. Rittmaster RS, Deshwal N, Lehman L. The role of adrenal hyperandrogenism, insulin resistance, and obesity in the pathogenesis of polycystic ovarian syndrome. J Clin Endocrinol Metab 1993;76:1295–300.Search in Google Scholar
16. Orio F, Vuolo L, Palomba S, Lombardi G, Colao A. Metabolic and cardiovascular consequences of polycystic ovary syndrome. Minerva Ginecol 2008;60:39–51.Search in Google Scholar
17. Chittenden BG, Fullerton G, Maheshwari A. Polycystic ovary syndrome and the risk of gynecological cancer: a systematic review. Reprod Biomed Online 2009;19:398–405.10.1016/S1472-6483(10)60175-7Search in Google Scholar
18. Coviello AD, Legro RS, Dunaif A. Adolescent girls with polycystic ovary syndrome have an increased risk of the metabolic syndrome associated with increasing androgen levels independent of obesity and insulin resistance. J Clin Endocrinol Metab 2006;91:492–7.10.1210/jc.2005-1666Search in Google Scholar PubMed
20. Geller DH, Pacaud D, Gordon CM, Misra M. State of the art review: emerging therapies: the use of Insulin sensitizers in the treatment of adolescents with polycystic ovary syndrome. Into J Pediatr Endocrinol 2011;2011:9.10.1186/1687-9856-2011-9Search in Google Scholar PubMed PubMed Central
21. Allen HF, Mazzoni C, Heptulla RA, Murray MA, Miller N, et al. Randomized controlled trial evaluating response to metformin versus standard therapy in the treatment of adolescents with polycystic ovary syndrome. J Pediatr Endocrinol Metab 2005;18:761–8.10.1515/JPEM.2005.18.8.761Search in Google Scholar
22. Hoeger K, Davidson K, Kochman L, Cherry T, Kopin L, et al. The impact of metformin, oral contraceptives, and lifestyle modification on polycystic ovary syndrome in obese adolescent women in two randomized, placebo-controlled clinical trials. J Clin Endocrinol Metab 2008;93:4299–306.10.1210/jc.2008-0461Search in Google Scholar PubMed PubMed Central
24. Dunaif A, Scott D, Quintana B, Whitcomb R. The insulin-sensitizing agent troglitazone improves metabolic and reproductive abnormalities in polycystic ovary syndrome. J Clin Endocrinol Metab 1996;81:3299–306.Search in Google Scholar
©2015 by De Gruyter