Should physicians prescribe metformin to women with polycystic ovary syndrome PCOS?
1. Metformin is not efficient enough in order to regulate menstrual cycles. 2.Metformin is not efficient enough in order to treat hyperandrogenism. 3. Metformin should not be used as a first-line treatment in order to treat infertility. Clomiphene citrate (CC) is the reference treatment. 4. Metformin in addition to CC is not recommended as a second line treatment, after the failure of CC alone. 5. Metformin should not be used during pregnancy in non diabetic women with PCOS, in order to prevent the risk of gestational diabetes. 6. Metformin should be prescribed to PCOS women when they are diabetic, in order to prevent their cardiovascular risk, after lifestyle modification. 7. Metformin should not be used in PCOS non diabetic women in order to lose weight. Metformin should not be used in order to treat dyslipidemia in women with PCOS. 8. In PCOS women, without diabetes, but with fasting hyperglycemia or carbohydrate intolerance, metformin should be prescribed if: BMI>35.
Duranteau
L
L
Service d'endocrinologie pédiatrique, hôpital Saint-Vincent-de-Paul, 82 avenue Denfert-Rochereau, Paris, France. lise.duranteau@cch.aphp.fr
Lefevre
P
P
Jeandidier
N
N
Simon
T
T
Christin-Maitre
S
S
D000328:Adult; D015992:Body Mass Index; D002996:Clomiphene / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000188:drug therapy; D016640:Diabetes, Gestational / Q000188:drug therapy; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007247:Infertility, Female / Q000188:drug therapy; D008597:Menstrual Cycle / Q000187:drug effects; D008687:Metformin / Q000009:adverse effects / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy
D005300:Fertility Agents, Female; D007004:Hypoglycemic Agents; D002996:Clomiphene; D008687:Metformin