The effects of metformin on hyperandrogenism and menstrual functions in insulin resistant adolescents with PCOS

Aim: To investigate the effects of metformin therapy on hyperandrogenism and menstrual functions in adolescent patients with polycystic ovary syndrome (PCOS) and insulin resistance (IR). Materials and Methods: In this study, 50 adolescents with PCOS were included. Hormonal and ultrasonographic assessments were done at the early follicular phase. On the day of 19-21 of the cycle, progesterone levels were measured and patients were questioned for menstrual periods. Body-mass-indexes (BMI), waist-hip ratios, and Ferriman-Gallwey scores were calculated for all patients. IR is diagnosed according to HOMA index and insulin-resistant patients were instructed to use 1500 mg/day metformin for 3 months. After treatment ended, measurements were repeated by the same researcher. Results: Mean age and BMI values were similar between groups. Although the values of BMI and waist/hip ratio decreased after treatment, the decrement didn't reach the values of the IR- group. Free testosterone levels were significantly higher in IR+ subjects compared to IR negatives and significantly decreased after treatment. Sex hormone-binding globulin levels were increased with metformin treatment and as a result, free androgen indexes were decreased. 17 OH progesterone levels were significantly higher in the IR+ group and regressed to similar levels with IR negatives after treatment. While mean levels of fasting insulin were 19.21IU/ml in the IR+ group, it regressed to 13.14IU/ml after treatment. Also fasting glucose/insulin ratios were increased as expected. Finally, a significant improvement in the treatment group was observed at menstrual irregularity. Conclusion: Consequently, this study supports the conclusion that metformin reduces hyperandrogenism and improves menstrual and ovulatory functions.