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Use of Insulin Sensitizers in the Polycystic Ovary Syndrome

  • Chapter
Androgen Excess Disorders in Women

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Insulin resistance is a central feature of the polycystic ovary syndrome (PCOS). Women with PCOS suffer both short- and long-term health consequences from insulin resistance and the compensatory hyperinsulinemia associated with PCOS. Short-term consequences include anovulation, hyperandrogenism, infertility, and early pregnancy loss. Over the long term, chronic hyperinsulinemia predisposes women with PCOS to increased risks of diabetes and cardiovascular events. Current data support the use of metformin for treatment of anovulation in women with PCOS, both in monotherapy and in combination with clomiphene in clomiphene-resistant patients. The effect of insulin sensitizers on hirsutism will also be reviewed. In addition, novel evidence, although limited, suggests that insulin sensitizers may play a role in preventing early pregnancy loss. Over the long term, insulin sensitizers may prevent cardiovascular and diabetes complications by ameliorating the metabolic syndrome associated with chronic insulin resistance in PCOS, pending further evidence. Several insulin-sensitizing agents are available commercially: metformin, rosiglitazone, and pioglitazone. Metformin has the most desirable pregnancy safety profile and is the agent that has been most frequently studied in PCOS. In conclusion, there is strong support for the use of insulin-sensitizing drugs, particularly metformin, in women with PCOS.

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Authors and Affiliations

  1. Department of Pharmacy, Virginia Commonwealth University School of Pharmacy, Richmond, VA

    Kai I. Cheang

  2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA

    John E. Nestler

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  1. Kai I. Cheang
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Editors and Affiliations

  1. Center for Androgen Related Disorders, Cedars-Sinai Medical Center; and Department of Obstetrics and Gynecology, and Department of Medicine, The David Geffen School of Medicine at UCLA, Los Angeles, CA

    Ricardo Azziz MD, MPH, MBA

  2. Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA

    John E. Nestler MD

  3. Department of Endocrine Gynaecology and Reproductive Medicine, Lille University Hospital, Lille, France

    Didier Dewailly MD

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Cheang, K.I., Nestler, J.E. (2006). Use of Insulin Sensitizers in the Polycystic Ovary Syndrome. In: Azziz, R., Nestler, J.E., Dewailly, D. (eds) Androgen Excess Disorders in Women. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59745-179-6_38

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  • DOI: https://doi.org/10.1007/978-1-59745-179-6_38

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