Metformin treatment of polycystic ovary syndrome improves health-related quality-of-life, emotional distress and sexuality.
BACKGROUND
In polycystic ovary syndrome (PCOS), changes in physical appearance, menstrual disturbances and infertility result in psychological distress and reduced quality-of-life. Metformin improves biochemical, clinical and reproductive parameters in PCOS women. In a prospective, observational study, we analysed the effects of metformin treatment on health-related quality-of-life (HRQL), emotional well-being and sexuality in PCOS. No placebo-treated control group was included.


METHODS
Before, during and after 6 months of treatment, changes in clinical and endocrine parameters, quality-of-life, psychological disturbances and sexuality were assessed in 64 PCOS patients using validated questionnaires (SF-36, SCL-90-R) and visual analogue scales. Patients were also compared with published normative data for the validated questionnaires.


RESULTS
During treatment, HRQL, particularly the psychosocial aspects (indicated by significant increases in SF-36 scales Vitality, Social Function, Emotional Role Function, Mental Health, Psychological Sum scale) and emotional well-being (reflected by significant lowering of SCL-90-R scales) improved. These improvements in HRQL were significantly correlated with a reduction in body weight and significantly more pronounced in patients with normalized menstrual cycles. In addition, PCOS women were significantly more satisfied with their sex life and reported higher frequencies of sexual intercourse following treatment.


CONCLUSIONS
Treatment can improve the psychosocial, emotional and psychosexual situation of PCOS patients. Although at least some of these effects may be related to the reduction of individual clinical symptoms (i.e. weight loss, normalization of menstrual disturbances, improvement of acne), this observational study does not allow us to clearly discern the role of symptom constellation and does not preclude non-specific and/or placebo effects. Nevertheless, emotional distress and reduced quality-of-life are clearly not an inevitable consequence of PCOS and should be considered as adjunct treatment goals in future studies.
Division of Endocrinology, Department of Medicine, Institute of Medical Psychology, University of Duisburg-Essen, Germany. susanne.hahn@uni-essen.de
Susanne
S
Hahn
Sven
S
Benson
Sigrid
S
Elsenbruch
Katja
K
Pleger
Susanne
S
Tan
Klaus
K
Mann
Manfred
M
Schedlowski
Walburga Bering
WB
van Halteren
Rainer
R
Kimmig
Onno E
OE
Janssen
D000328:Adult; D005260:Female; D006801:Humans; D008687:Metformin / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D019529:Sexuality / Q000187:drug effects*; D013315:Stress, Psychological / Q000188:drug therapy* / Q000523:psychology
D008687:Metformin