title: Role of Metformin in Women's Health: Review of Its Current Place in Clinical Practice and Emerging Indications for Future.
abstract: OBJECTIVE
  Metformin, an oral antihyperglycemic drug, acts as an insulin sensitizer in the treatment of type 2 diabetes mellitus. It has also been widely used in the treatment of polycystic ovary syndrome (PCOS) and gestational diabetes mellitus. Although randomized clinical trials have failed to establish its superiority over other forms of treatment, metformin continues to be a treatment option in specific subgroups of women either alone or as an adjunct with other therapies in management of PCOS.
  This narrative review was conducted to assess the present role of metformin in management of clinical conditions related to women's health. A PubMed search was conducted using the following terms: "metformin," "polycystic," "ovary," "Women's," "health," "gestational," "diabetes," "cancer," and "fertility," and all relevant studies were evaluated for accumulation of evidence.
  
  
  CONCLUSIONS
  Metformin is used as a second-line drug for ovulation induction in women with PCOS who are resistant to clomiphene citrate. Metformin also forms one of the management options in women who need antiandrogen therapy without the need for contraception at the same time. Women with PCOS undergoing in vitro fertilization are likely to benefit from metformin therapy to reduce their risk of ovarian hyperstimulation syndrome. Metformin alone or in combination with insulin has been reported to have similar safety and efficacy to insulin for the treatment of GDM. There is growing evidence that metformin may be associated with a decreased risk of developing cancers and improved response to chemotherapy.
authors.affiliation: Clinical Fellow, Reproductive Medicine Unit, University College London Hospital, London.
authors.forename: Vikram
authors.initials: V
authors.lastname: Sinai Talaulikar
authors.affiliation: Consultant, Regional Fertility Centre, the Royal Victoria Hospitals, Belfast.
authors.forename: Thomas
authors.initials: T
authors.lastname: Tang
authors.affiliation: Consultant, Reproductive Medicine Unit, University College London Hospital, London, UK.
authors.forename: Ephia
authors.initials: E
authors.lastname: Yasmin
mesh_terms: D016588:Anticarcinogenic Agents / Q000494:pharmacology / Q000627:therapeutic use; D002996:Clomiphene / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D016640:Diabetes, Gestational / Q000188:drug therapy; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D008687:Metformin / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control; D010062:Ovulation Induction / Q000379:methods; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy; D011247:Pregnancy
chemical_list: D016588:Anticarcinogenic Agents; D005300:Fertility Agents, Female; D007004:Hypoglycemic Agents; D002996:Clomiphene; D008687:Metformin