Comparison of metformin and thiazolidinediones in the management of polycystic ovary syndrome

Abstract

Polycystic ovary syndrome (PCOS) is a common and prevalent disorder associated with important short-term and long-term health consequences. Standard therapy has consisted of oral contraceptives, but these may aggravate long-term health risks. Emerging therapy for the syndrome is the use of insulin-sensitizing drugs, namely the biguanide metformin and the thiazolidinediones. These drugs may improve not only the anovulation and hyperandrogenism of the disorder, but they may also exert salutary effects on the dysmetabolic syndrome and decrease the long-term risks of type 2 diabetes and cardiovascular disease. Among the insulin-sensitizing drugs, metformin is currently the agent of choice because of the weight of scientific evidence in managing the syndrome, its effects on weight and lipids, and its reassuring safety profile during pregnancy.