PCOS in adolescence: effect of metformin on menstrual irregularities


  • Bhavana Vaikunth Sontakke Department of Obstetrics and Gynecology, Dr. Panjabrao Deshmukh Memorial Medical College, Amravati, Maharashtra, India




Adolescent PCOS, Menstrual irregularities, Metformin


Background: PCOS is an endocrine disorder affecting women across lifespan, initially a disease of the females in the child bearing age group, nowadays maximum adolescent females also present with PCOS. Adolescence PCOS is a heterogenous endocrine disorder diagnosed in 5% to 10% of adolescent girls and is one of the major causes of adolescent hyperandrogenism and menstrual irregularity. Thus, this study was carried out to study the effect of Metformin on adolescent patients with PCOS on Weight reduction and Regularization of Menstrual cycle. Secondary objective is to study the occurrences of various manifestations in patients with PCOS.

Methods: Patients aged 10-20 years diagnosed PCOS attending the outpatient department of OBGY over a period of two years were included in the study. Out of 100 patients, 20 patients were excluded because of other causes of anovulation viz thyroid abnormalities, prolactin level abnormalities and patients who did not turn up for follow up. Study was done on 80 patients of PCOS. Patients were divided into two groups A and B. Group A (n=40) received 500 mgs Metformin and Group B (n=40) received placebo. Results were analysed using statistical package of social sciences (SPSS) 21.0. Statistical significance was set at p ≤0.05.

Results: In the present study Irregular cycle was the commonest occurring menstrual irregularity. Menstrual Cycle was regularised in 95% of the study group while only 35% of the control group. 85% patients in the present test group had lost weight at the end of 6 months while only 55% in the control group had lost weight in 6 months. Thus A 6-month course of metformin improves menstrual cyclicity in women with the PCOS.

Conclusions: In patients with PCOS, the addition of insulin sensitizers viz metformin along with diet and lifestyle modifications has resulted in significant weight loss and improvement in cyclicity of menstrual cycle. Thus, Insulin-sensitizing agents provide a rational approach to the treatment of the metabolic and endocrine abnormalities in PCOS women      


Stein IF, Leventhal ML. Amenorrhoea associated with bilateral polycystic ovaries. Am J Obstet Gynecol. 1935;29:181.

Driscoll DA. Polycystic ovary syndrome in adolescence. Ann NY Acad Sci. 2003;997:49-55.

Archard C, Theirs J. Le virilisme pilaire et son association a L’insufficiency glycolytique (diabetes des femmes a barbe). Bull Acad Nat Med. 1921;86:51.

Nestler JE. Role of hyperinsulinemia in the pathogenesis of polycystic ovary syndrome, and its clinical implications, seminars. Reprod Endocrinol. 1997;15:111-122.

Nestler JE, Jakubowicz DJ, Reamer P, Gunn RD, Allan G. Ovulatory and metabolic effects of D-chiro-inositol in the polycystic ovary syndrome. N Engl J Med. 1999;340(17):1314-20.

Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21:1440-7.

Carey AH, Chan KL, Short F, White DM, Williamson R, Frank S. Evidence for a single gene effect in polycystic ovaries and male pattern baldness. Clin Endocrinol. 1993;38:653.

Cortet-Rudelli C, Dewailly D. Diagnosis of hyperandrogenism in female adolescents. hyperandrogenism in adolescent girls. Armenian Health Network, Health.am. Retrieved on 2006.

Balen AH, Laven JSE, Tan SL, Dewailly D. The ultrasound assessment of the polycystic ovary; international consensus definations. Human Reprod Update. 2003;9:505-14.

Balen AH1, Conway GS, Kaltsas G, Techatrasak K, Manning PJ, West C et al. Polycystic Ovary Syndrome, the spectrum of disorder in 1741 patients. Hum Reprod. Hum Reprod. 1995;10(8):2107-11.

Kirpichnikov D, McFarlane SI, Sowers JR. Metformin: an update. Ann Intern Med. 2002;137(1):25-33.

La Marca A, Artensio AC, Stabile G, Volpe A. Metformin treatment of PCOS during adolescence and the reproductive period. Eur J Obstet Gynecol Reprod Biol. 2005;121(1):3-7

Tang T, Glanville J, Hayden CJ, White D, Barth JH, Balen AH. Combined lifestyle modification and metformin in obese patients with polycystic ovary syndrome: A randomized, placebo- controlled, double-blind multicentre study. Hum Reprod. 2005;21(1):80-9.

Glueck CJ, Wang P, Fontaine R, Tracy T, Sieve-Smith L. Metformin-induced resumption of normal menses in 39 of 43 (91%) previously amenorrheic women with the polycystic ovary syndrome. Metabolism. 1999;48(4):511-9

Kolodziejczyk B, Duleba AJ, Spaczynski RZ, Pawelczyk L. Metformin therapy decreases hyperandrogenism and hyperinsulinemia in women with polycystic ovary syndrome. Fertil Steril. 2000;73:1149-54.

Moghetti P, Castello R, Negri C, Tosi F, Perrone F, Caputo M et al. Metformin effects on clinical features, endocrine and metabolic profiles, and insulin sensitivity in polycystic ovary syndrome: a randomised, double-blind, placebo-controlled 6 month trial, followed by open, long-term clinical evaluation. J Clin Endocrinol Metab. 2000;85:139-46.

Pasquali R, Gambineri A, Biscotti D, Vicennati V, Gagliardi L, Colitta D et al. Effects of long-term treatment with metformin added to hypocaloric diet on body composition, fat distribution, and androgen and insulin levels in abdominally obese women with and without polycystic ovary syndrome. J Clin Endocrinol Metab. 2000;85:2767-74.

Driscoll DA, Ann NY. Polycystic Ovary Syndrome in Adolescence. Acad Sci. 2003;997:49-5521.

Ibanez L, Potau N, Zampolli M, Prat N, Virdis R,Vicens-calvet E et al. Hyperinsulinemia in post pubertal Girls with a history of premature pubarche and functional ovarian hyperandrogenism. J clin Endocrinol Metab. 1996;81:1237-43.

Dunaif A, Scott D, Finegood D, Quintana B, Whitcomb R. The insulin-sensitizing agent troglitazone improves metabolic and reproductive abnormalities in the polycystic ovary syndrome. J Clin Endocrinol Metab. 1996;81:3299-306.

Timpatanapong P, Rojanasakul A. Hormonal [rofiles and prevalence of polycystic ovary syndrome in women with acne. J Dermatol. 1997;24(4):223-9.

Tang T, Glanville J, Hayden CJ, White D, Barth JH, Balen AH. Combined life-style modification and metformin in obese patients with polycystic ovary syndrome (PCOS). Arandomised, placebo-controlled, double-blind multi-centre study. Hum Reprod. 2006;21:80-9.

Diamanti-Kandarakis E, Kouli C, Tsianateli TA. Therapeutic effects of metformin on insulin resistance and hyperandrogenism in polycystic ovary syndrome. Eur J Endocrinol. 1998;138(3):269-74.

Homburg R. Should patients with polycystic ovarian syndrome be treated with metformin? A note of cautious optimism. Hum Reprod. 2002;17(4):853-6).






Original Research Articles