The effects of metformin with lifestyle therapy in polycystic ovary syndrome: a randomized double-blind study
Open accessAbstract
Objective To determine if the combination of lifestyle (caloric restriction and exercise) and metformin (MET) would be superior to lifestyle and placebo (PBO) in improving the polycystic ovary syndrome (PCOS) phenotype.Design Double-blind randomized 6-month trial of MET versus PBO.Setting Two academic medical centers.Patient(s) One hundred fourteen subjects with PCOS were randomized to MET (N = 55) or PBO (N = 59).Intervention(s) Subjects collected urine daily for ovulation monitoring, had monthly monitoring of hormones and weight and determination of body composition by dual-energy x-ray absorptiometry, glucose tolerance, and were evaluated for quality of life at baseline and completion.Main outcome measure(s) Ovulation rates and testosterone levels.Result(s) Dropout rates were high. There was no significant difference in ovulation rates. Testosterone levels were significantly lower compared with baseline in the MET group at 3 mos but not at 6 mos. There were no differences in weight loss between groups, but MET showed a significant decline at 6 months compared with baseline (-3.4 kg, 95% confidence interval -5.3 to -1.5 kg). We noted divergent effects of MET versus PBO on oral glucose tolerance test indices of insulin sensitivity (increased) and secretion (worsened). Total bone mineral density increased significantly in MET. There were no differences in quality of life measures between the groups. The MET group had increased diarrhea and headache, but fewer bladder infections and musculoskeletal complaints.Conclusion(s) The addition of metformin to lifestyle therapy produced little reproductive or glycemic benefit in women with PCOS, although our study had limited power owing to a high dropout rate. It is not possible at baseline to identify women likely to drop out.
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Ladson et al. found no significant differences in quality of life between metformin plus lifestyle and placebo plus lifestyle.
“Ladson et al. 35 studied quality of life (subgrouped into physical, emotional, and general wellbeing) and found no significant differences between the comparison groups.”
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Cites
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011 · see citing works
Tuomilehto, J., Lindström, J., Eriksson, J. G., Valle, T. T., Hämäläinen, H., Ilanne-Parikka, P., Keinänen-Kiukaanniemi, S., Laakso, M., Louheranta, A., Rastas, M., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200105033441801 · Cited by 10,873 · cited 2× · see citing works
“002 Copyright a2011 American S also used in PCOS (2, 3).”
MethodMatsuda, M., & DeFronzo, R. A. (1999) · Diabetes Care · doi:10.2337/diacare.22.9.1462 · Cited by 5,621 · see citing works
Perceived exertion as an indicator of somatic stress
Borg, G. (1970) · Journal of Rehabilitation Medicine · doi:10.2340/1650197719702239298 · Cited by 4,723 · see citing works
A Critical Evaluation of Simple Methods for the Estimation of Free Testosterone in Serum
Vermeulen, A., Verdonck, L., & Kaufman, J. M. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.10.6079 · Cited by 3,824 · see citing works
Hilbe, J. M. (2007) · Cambridge University Press eBooks · doi:10.1017/cbo9780511811852.007 · Cited by 1,998 · see citing works
Ehrmann, D. A. (2005) · New England Journal of Medicine · doi:10.1056/nejmra041536 · Cited by 1,884 · see citing works
Legro, R. S. (1999) · Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.84.1.165 · Cited by 1,743 · see citing works
Self-citationImpact of Overweight on the Risk of Developing Common Chronic Diseases During a 10-Year Period
Field, A. E., Coakley, E. H., Must, A., Spadano, J. L., Laird, N., Dietz, W. H., Rimm, E., & Colditz, G. A. (2001) · Archives of Internal Medicine · doi:10.1001/archinte.161.13.1581 · Cited by 1,694 · see citing works
Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome
Legro, R. S., Barnhart, H. X., Schlaff, W. D., Carr, B. R., Diamond, M. P., Carson, S. A., Steinkampf, M. P., Coutifaris, C., McGovern, P. G., Cataldo, N. A., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa063971 · Cited by 1,027 · see citing works
Self-citationHirsutism: Implications, etiology, and management
Hatch, R., Rosenfield, R. L., Kim, M. H., & Tredway, D. R. (1981) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(81)90746-8 · Cited by 1,013 · see citing works
Consensus on infertility treatment related to polycystic ovary syndrome
The Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group March 2–3, 2. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.09.041 · Cited by 719 · see citing works
Carey, D., Jenkins, A. B., Campbell, L. V., Freund, J., & Chisholm, D. J. (1996) · Diabetes · doi:10.2337/diab.45.5.633 · Cited by 659 · see citing works
Phillips, D. I. W., Clark, P. M., Hales, C. N., & Osmond, C. (1994) · Diabetic Medicine · doi:10.1111/j.1464-5491.1994.tb00273.x · Cited by 631 · see citing works
Azziz, R., Ehrmann, D. A., Legro, R. S., Whitcomb, R. W., Hanley, R. M., Fereshetian, A. G., O’Keefe, M., & Ghazzi, M. N. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.4.7375 · Cited by 539 · see citing works
Self-citationMoran, L. J., Pasquali, R., Teede, H. J., Hoeger, K. M., & Norman, R. J. (2009) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.09.018 · Cited by 444 · see citing works
Escobar-Morreale, H. F., Botella-Carretero, J. I., Álvarez‐Blasco, F., Sancho, J., & Millán, J. L. S. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-1490 · Cited by 389 · see citing works
Azziz, R. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.86.4.1626 · Cited by 378 · see citing works
Wu, R.-R., Zhao, J.-P., Jin, H., Shao, P., Fang, M.-S., Guo, X.-F., He, Y.-Q., Liu, Y.-J., Chen, J.-D., & Li, L.-H. (2008) · JAMA · doi:10.1001/jama.2007.56-b · Cited by 366 · see citing works
Cronin, L., Guyatt, G. H., Griffith, L. E., Wong, E. Y. L., Azziz, R., Futterweit, W., Cook, D., & Dunaif, A. E. (1998) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.83.6.4990 · Cited by 348 · see citing works
Tang, T., Glanville, J., Hayden, C. J., White, D., Barth, J. H., & Balen, A. H. (2006) · Human Reproduction · doi:10.1093/humrep/dei311 · Cited by 335 · see citing works
Metformin for the treatment of the polycystic ovary syndrome
Nestler, J. E. (2008) · New England Journal of Medicine · doi:10.1056/nejmct0707092 · Cited by 313 · see citing works
Hoeger, K. M., Kochman, L., Wixom, N., Craig, K., Miller, R. K., & Guzick, D. S. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.02.104 · Cited by 278 · see citing works
Thomson, R. L., Buckley, J. D., Noakes, M., Clifton, P. M., Norman, R. J., & Brinkworth, G. D. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-0751 · Cited by 277 · see citing works
Chang, R. J., Heindel, J. J., & Dunaif, A. E. (2002) · CRC Press eBooks · doi:10.3109/9780203910948 · Cited by 263 · see citing works
Hoeger, K., Davidson, K., Kochman, L., Cherry, T., Kopin, L., & Guzick, D. S. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-0461 · Cited by 256 · see citing works
Metformin Reduces Serum C-Reactive Protein Levels in Women with Polycystic Ovary Syndrome
Morin-Papunen, L. C., Rautio, K., Ruokonen, A., Hedberg, P. S. M., Puukka, M., & Tapanainen, J. S. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-021688 · Cited by 245 · see citing works
Jones, G. L., Hall, J., Balen, A. H., & Ledger, W. J. (2007) · Human Reproduction Update · doi:10.1093/humupd/dmm030 · Cited by 244 · see citing works
Palomba, S., Giallauria, F., Falbo, A., Russo, T., Oppedisano, R., Tolino, A., Colao, A., Vigorito, C., Zullo, F., & Orio, F. (2008) · Human Reproduction · doi:10.1093/humrep/dem391 · Cited by 235 · see citing works
Recruitment and Retention of Minority Women in Cancer Screening, Prevention, and Treatment Trials
Brown, D. R., Fouad, M. N., Basen-Engquist, K. M., & Tortolero‐Luna, G. (2000) · Annals of Epidemiology · doi:10.1016/s1047-2797(00)00197-6 · Cited by 227 · see citing works
Nandi, A. A., Chen, Z., Patel, R., & Poretsky, L. (2014) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2013.10.003 · Cited by 189 · see citing works
McElduff, F. (2008) · Journal of the Royal Statistical Society Series A (Statistics in Society) · doi:10.1111/j.1467-985x.2008.00538_6.x · Cited by 168 · see citing works
Legro, R. S., Chiu, P., Kunselman, A. R., Bentley, C. M., Dodson, W. C., & Dunaif, A. E. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-0219 · Cited by 125 · see citing works
Self-citationLachin, J. M., Christophi, C. A., Edelstein, S. L., Ehrmann, D. A., Hamman, R. F., Kahn, S. E., Knowler, W. C., Nathan, D. M., & on behalf of the DPP Research Group (2007) · Diabetes · doi:10.2337/db06-0918 · Cited by 107 · see citing works
Thiboutot, D., Zaenglein, A., Weiss, J., Webster, G., Calvarese, B., & Chen, D. (2008) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2008.06.040 · Cited by 99 · see citing works
Kassam, A., Overstreet, J. W., Snow-Harter, C., Souza, M. J. D., Gold, E. B., & Lasley, B. L. (1996) · Environmental Health Perspectives · doi:10.1289/ehp.96104408 · Cited by 90 · see citing works
Zborowski, J. V., Cauley, J. A., Talbott, E. O., Guzick, D. S., & Winters, S. J. (2000) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.85.10.6902 · Cited by 89 · see citing works
Ibáñez, L., López‐Bermejo, A., Díaz, M., Marcos, M. V., & de Zegher, F. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-0013 · Cited by 83 · see citing works
O’Connor, K. A., Brindle, E., Miller, R. C., Shofer, J. B., Ferrell, R. J., Klein, N. A., Soules, M. R., Holman, D. J., Mansfield, P. K., & Wood, J. W. (2006) · Human Reproduction · doi:10.1093/humrep/dei497 · Cited by 69 · see citing works
Tang, T. H., Glanville, J., Hayden, C. J., White, D. M., Barth, J. H., & Balen, A. H. (2006) · Obstetrical & Gynecological Survey · doi:10.1097/01.ogx.0000197800.07214.dc · Cited by 65 · see citing works
Thomson, R. L., Buckley, J. D., Moran, L., Noakes, M., Clifton, P. M., Norman, R. J., & Brinkworth, G. D. (2009) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2009.02177.x · Cited by 59 · see citing works
Zinman, B., Harris, S. B., Gerstein, H. C., Young, T. K., Raboud, J., Neuman, J., & Hanley, A. J. (2005) · Diabetes Obesity and Metabolism · doi:10.1111/j.1463-1326.2005.00540.x · Cited by 35 · see citing works
Katcher, H. I., Kunselman, A. R., Dmitrović, R., Demers, L. M., Gnatuk, C. L., Kris‐Etherton, P. M., & Legro, R. S. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.01.035 · Cited by 26 · see citing works
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Azziz, R., Carmina, E., Chen, Z., Dunaif, A., Laven, J. S. E., Legro, R. S., Lizneva, D., Natterson-Horowtiz, B., Teede, H. J., & Yildiz, B. O. (2016) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2016.57 · Cited by 2,005 · see citing works
Self-citationLegro, R. S., Arslanian, S. A., Ehrmann, D. A., Hoeger, K. M., Murad, M. H., Pasquali, R., & Welt, C. K. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-2350 · Cited by 1,919 · see citing works
Self-citationTang, T., Lord, J. M., Norman, R. J., Yasmin, E., & Balen, A. H. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003053.pub5 · Cited by 698 · see citing works
Kolotkin, R. L., & Andersen, J. R. (2017) · Clinical Obesity · doi:10.1111/cob.12203 · Cited by 590 · see citing works
Drug repurposing for cancer therapy
Xia, Y., Sun, M., Huang, H., & Jin, W.-L. (2024) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-024-01808-1 · Cited by 443 · see citing works
Naderpoor, N., Shorakae, S., de Courten, B., Misso, M. L., Moran, L. J., & Teede, H. J. (2015) · Human Reproduction Update · doi:10.1093/humupd/dmv025 · Cited by 334 · see citing works
Morley, L. C., Tang, T., Yasmin, E., Norman, R. J., & Balen, A. H. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003053.pub6 · Cited by 296 · see citing works
Obesity and PCOS: Implications for Diagnosis and Treatment
Legro, R. S. (2012) · Seminars in Reproductive Medicine · doi:10.1055/s-0032-1328878 · Cited by 280 · see citing works
Self-citationNaderpoor, N., Shorakae, S., de Courten, B. V., Misso, M. L., Moran, L., & Teede, H. J. (2016) · Human Reproduction Update · doi:10.1093/humupd/dmv063 · Cited by 256 · see citing works
Legro, R. S., Dodson, W. C., Kris-Etherton, P. M., Kunselman, A. R., Stetter, C. M., Williams, N. I., Gnatuk, C. L., Estes, S. J., Fleming, J., Allison, K. C., et al. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-2778 · Cited by 242 · see citing works
Self-citationRençber, S. F., Özbek, S. K., Eraldemir, F. C., Sezer, Z., Kum, T., Ceylan, S., & Güzel, E. (2018) · Journal of Ovarian Research · doi:10.1186/s13048-018-0427-7 · Cited by 230 · see citing works
Malin, S. K., Gerber, R., Chipkin, S. R., & Braun, B. (2011) · Diabetes Care · doi:10.2337/dc11-0925 · Cited by 236 · see citing works
Penzias, A. S., Bendikson, K. A., Butts, S. F., Coutifaris, C., Falcone, T., Fossum, G., Gitlin, S., Gracia, C. R., Hansen, K. R., LaBarbera, A. R., et al. (2017) · Fertility and Sterility · doi:10.1016/j.fertnstert.2017.06.026 · Cited by 181 · see citing works
Treatment strategies for women with polycystic ovary syndrome
Jin, P., & Xie, Y. (2017) · Gynecological Endocrinology · doi:10.1080/09513590.2017.1395841 · Cited by 175 · see citing works
Depression and Anxiety in Polycystic Ovary Syndrome: Etiology and Treatment
Cooney, L. G., & Dokras, A. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0834-2 · Cited by 173 · see citing works
Exercise Interventions in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis
Patten, R. K., Boyle, R. A., Moholdt, T. T., Kiel, I. A., Hopkins, W. G., Harrison, C. L., & Stepto, N. K. (2020) · Frontiers in Physiology · doi:10.3389/fphys.2020.00606 · Cited by 165 · see citing works
Kite, C., Lahart, I. M., Afzal, I., Broom, D. R., Randeva, H., Kyrou, I., & Brown, J. E. (2019) · Systematic Reviews · doi:10.1186/s13643-019-0962-3 · Cited by 155 · see citing works
Obesity and Reproductive Function
Jungheim, E. S., Travieso, J. L., Carson, K. R., & Moley, K. H. (2012) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2012.09.002 · Cited by 151 · see citing works
Facchinetti, F., Bizzarri, M., Benvenga, S., D’Anna, R., Lanzone, A., Soulage, C. O., Renzo, G. C. D., Hod, M., Cavalli, P., Chiu, T. T. Y., et al. (2015) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2015.09.024 · Cited by 144 · see citing works
Measures of health-related quality of life in PCOS women: a systematic review
Behboodi Moghadam, Z., Fereidooni, B., Saffari, M., & Montazeri, A. (2018) · International Journal of Women's Health · doi:10.2147/ijwh.s165794 · Cited by 129 · see citing works
Effects of Gastric Bypass Surgery on Female Reproductive Function
Legro, R. S., Dodson, W. C., Gnatuk, C. L., Estes, S. J., Kunselman, A. R., Meadows, J. W., Kesner, J. S., Krieg, E. F., Rogers, A. M., Haluck, R. S., et al. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-2205 · Cited by 119 · see citing works
Self-citationPolycystic ovary syndrome: reviewing diagnosis and management of metabolic disturbances
Spritzer, P. M. (2014) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/0004-2730000003051 · Cited by 118 · see citing works
Domecq, J. P., Prutsky, G., Mullan, R. J., Sundaresh, V., Wang, A. T., Erwin, P. J., Welt, C., Ehrmann, D., Montori, V. M., & Murad, M. H. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-2374 · Cited by 115 · see citing works
Ganie, M. A., Khurana, M. L., Nisar, S., Shah, P. A., Shah, Z. A., Kulshreshtha, B., Gupta, N., Zargar, M. A., Wani, T. A., Mudasir, S., et al. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-1040 · Cited by 109 · see citing works
Longterm management of Polycystic Ovarian Syndrome (PCOS)
Bates, G. W., & Legro, R. S. (2013) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2012.10.029 · Cited by 106 · see citing works
Self-citationA Novel Approach for Polycystic Ovary Syndrome Prediction Using Machine Learning in Bioinformatics
Nasim, S., Almutairi, M. S., Munir, K., Raza, A., & Younas, F. (2022) · IEEE Access · doi:10.1109/access.2022.3205587 · Cited by 105 · see citing works
Kazemi, M., Hadi, A., Pierson, R. A., Lujan, M. E., Zello, G. A., & Chilibeck, P. D. (2020) · Advances in Nutrition · doi:10.1093/advances/nmaa092 · Cited by 104 · see citing works
Haqq, L., McFarlane, J., Dieberg, G., & Smart, N. (2014) · Endocrine Connections · doi:10.1530/ec-14-0010 · Cited by 101 · see citing works
Review of nonalcoholic fatty liver disease in women with polycystic ovary syndrome
Kelley, C. E. (2014) · World Journal of Gastroenterology · doi:10.3748/wjg.v20.i39.14172 · Cited by 101 · see citing works
Mutsaerts, M. A. Q., Kuchenbecker, W. K. H., Mol, B. W., Land, J. A., & Hoek, A. (2013) · Human Reproduction · doi:10.1093/humrep/det026 · Cited by 100 · see citing works
Role of Oxidative Stress in Obese and Nonobese PCOS Patients
Uçkan, K., Demir, H., Turan, K., Sarıkaya, E., & Demir, C. (2022) · International Journal of Clinical Practice · doi:10.1155/2022/4579831 · Cited by 97 · see citing works
Panidis, D., Tziomalos, K., Papadakis, E., Vosnakis, C., Chatzis, P., & Katsikis, I. (2013) · Endocrine · doi:10.1007/s12020-013-9971-5 · Cited by 93 · see citing works
Dietary Interventions and Quality of Life: A Systematic Review of the Literature
Carson, T. L., Hidalgo, B., Ard, J. D., & Affuso, O. (2013) · Journal of Nutrition Education and Behavior · doi:10.1016/j.jneb.2013.09.005 · Cited by 91 · see citing works
Pernicova, I., Kelly, S., Ajodha, S. J., Sahdev, A., Bestwick, J. P., Gabrovska, P. N., Akanle, O., Ajjan, R., Kola, B., Stadler, M., et al. (2020) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(20)30021-8 · Cited by 90 · see citing works
Kazemi, M., Kim, J. Y., Wan, C., Xiong, J. D., Michalak, J., Xavier, I. B., Ganga, K., Tay, C. T., Grieger, J. A., Parry, S. A., et al. (2022) · Human Reproduction Update · doi:10.1093/humupd/dmac023 · Cited by 89 · see citing works
Turner‐McGrievy, G. M., Davidson, C. R., Wingard, E. E., & Billings, D. L. (2014) · Nutrition Research · doi:10.1016/j.nutres.2014.04.011 · Cited by 73 · see citing works
Kim, C. H., Chon, S. J., & Lee, S. H. (2020) · Scientific Reports · doi:10.1038/s41598-020-64776-w · Cited by 76 · see citing works
Melin, J., Forslund, M., Alesi, S., Piltonen, T., Romualdi, D., Spritzer, P. M., Tay, C. T., Pena, A., Witchel, S. F., Mousa, A., et al. (2023) · European Journal of Endocrinology · doi:10.1093/ejendo/lvad098 · Cited by 72 · see citing works
Effects of metformin on blood pressure in nondiabetic patients
Zhou, L., Liu, H., Wen, X., Peng, Y., Tian, Y., & Zhao, L. (2016) · Journal of Hypertension · doi:10.1097/hjh.0000000000001119 · Cited by 71 · see citing works
Legro, R. S., Brzyski, R. G., Diamond, M. P., Coutifaris, C., Schlaff, W. D., Alvero, R. J., Casson, P. R., Christman, G. M., Huang, H., Yan, Q., et al. (2013) · Fertility and Sterility · doi:10.1016/j.fertnstert.2013.08.056 · Cited by 64 · see citing works
Self-citationInterventions for hirsutism (excluding laser and photoepilation therapy alone)
van Zuuren, E. J., Fedorowicz, Z., Carter, B., & Pandis, N. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010334.pub2 · Cited by 65 · see citing works
Mental Health and Physical Activity in Women with Polycystic Ovary Syndrome: A Brief Review
Conte, F., Banting, L., Teede, H. J., & Stepto, N. K. (2014) · Sports Medicine · doi:10.1007/s40279-014-0291-6 · Cited by 65 · see citing works
Exercise and Polycystic Ovary Syndrome
Woodward, A., Klonizakis, M., & Broom, D. R. (2020) · Advances in experimental medicine and biology · doi:10.1007/978-981-15-1792-1_8 · Cited by 64 · see citing works
Comparative Analysis of Machine Learning Algorithms in Diagnosis of Polycystic Ovarian Syndrome
Hassan, M. M., & Mirza, T. (2020) · International Journal of Computer Applications · doi:10.5120/ijca2020920688 · Cited by 65 · see citing works
Saadati, S., Mason, T., Godini, R., Vanky, E., Teede, H., & Mousa, A. (2025) · Diabetes, obesity and metabolism · doi:10.1111/dom.16422 · Cited by 74 · see citing works
Metformin use and risk of fracture: a systematic review and meta-analysis of observational studies
Salari-Moghaddam, A., Sadeghi, O., Keshteli, A. H., Larijani, B. A., & Esmaillzadeh, A. (2019) · Osteoporosis International · doi:10.1007/s00198-019-04948-1 · Cited by 62 · see citing works
Jiskoot, G., Timman, R., Beerthuizen, A., Dietz de Loos, A., Busschbach, J., & Laven, J. (2020) · Obesity · doi:10.1002/oby.22980 · Cited by 56 · see citing works
Ladson, G., Dodson, W. C., Sweet, S. D., Archibong, A. E., Kunselman, A. R., Demers, L. M., Lee, P. A., Williams, N. I., Coney, P., & Legro, R. S. (2011) · Fertility and Sterility · doi:10.1016/j.fertnstert.2011.05.048 · Cited by 56 · see citing works
Self-citationCurrent perspectives of insulin resistance and polycystic ovary syndrome
Pauli, J. M., Raja-Khan, N. T., Wu, X., & Legro, R. S. (2011) · Diabetic Medicine · doi:10.1111/j.1464-5491.2011.03460.x · Cited by 55 · see citing works
Self-citationFemale Obesity and Assisted Reproductive Technologies
Kumbak, B., Oral, E., & Bükülmez, O. (2012) · Seminars in Reproductive Medicine · doi:10.1055/s-0032-1328879 · Cited by 53 · see citing works
Mazza, A., Fruci, B., Guzzi, P. H., D'Orrico, B., Malaguarnera, R., Veltri, P., Fava, A., & Belfiore, A. (2013) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2013.04.016 · Cited by 50 · see citing works
Shorakae, S., Boyle, J. A., & Teede, H. J. (2014) · Internal Medicine Journal · doi:10.1111/imj.12495 · Cited by 48 · see citing works
Jing-hua, S., Ruan, X., Gu, M., Wang, L., Wang, H., & Mueck, A. O. (2017) · Gynecological Endocrinology · doi:10.1080/09513590.2017.1407752 · Cited by 49 · see citing works
Exercise Recommendations for Women with Polycystic Ovary Syndrome: Is the Evidence Enough?
Stepto, N. K., Patten, R. K., Tassone, E. C., Misso, M. L., Brennan, L., Boyle, J. A., Boyle, R. A., Harrison, C. L., Hirschberg, A. L., Marsh, K. A., et al. (2019) · Sports Medicine · doi:10.1007/s40279-019-01133-6 · Cited by 50 · see citing works
Stener‐Victorin, E., Baghaei, F., Holm, G., Janson, P. O., Olivecrona, G., Lönn, M., & Mannerås-Holm, L. (2011) · Fertility and Sterility · doi:10.1016/j.fertnstert.2011.11.010 · Cited by 48 · see citing works
Patten, R. K., Pascoe, M. C., Moreno‐Asso, A., Boyle, R. A., Stepto, N. K., & Parker, A. G. (2021) · BMC Public Health · doi:10.1186/s12889-021-12280-9 · Cited by 46 · see citing works
Garzia, E., Galiano, V., Marfia, G., Navone, S., Grossi, E., & Marconi, A. (2022) · Reproductive Biology and Endocrinology · doi:10.1186/s12958-021-00876-0 · Cited by 25 · see citing works
Diagnosis and Challenges of Polycystic Ovary Syndrome in Adolescence
Agapova, S. E., Cameo, T., Sopher, A. B., & Oberfield, S. E. (2014) · Seminars in Reproductive Medicine · doi:10.1055/s-0034-1371091 · Cited by 44 · see citing works
Wu, Y., Li, P., Zhang, D., & Sun, Y. (2017) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2017.5650 · Cited by 41 · see citing works
Patten, R. K., McIlvenna, L. C., Moreno‐Asso, A., Hiam, D., Stepto, N. K., Rosenbaum, S., & Parker, A. G. (2023) · Scientific Reports · doi:10.1038/s41598-023-29503-1 · Cited by 49 · see citing works
SMOTE-Based Automated PCOS Prediction Using Lightweight Deep Learning Models
Ahmad, R., Maghrabi, L. A., Khaja, I. A., Maghrabi, L. A., & Ahmad, M. (2024) · Diagnostics · doi:10.3390/diagnostics14192225 · Cited by 38 · see citing works
Zuuren, E. J., & Fedorowicz, Z. (2016) · British Journal of Dermatology · doi:10.1111/bjd.14486 · Cited by 35 · see citing works
Effects of obesity treatment on female reproduction: results do not match expectations
Legro, R. S. (2017) · Fertility and Sterility · doi:10.1016/j.fertnstert.2017.02.109 · Cited by 35 · see citing works
Self-citationRuan, X., Jing-hua, S., Gu, M., Wang, L., Wang, H., & Mueck, A. O. (2018) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-018-4762-0 · Cited by 35 · see citing works
Adherence to treatment for polycystic ovarian syndrome: A systematic review
Parker, M., Warren, A., Nair, S., & Barnard, M. (2020) · PLoS ONE · doi:10.1371/journal.pone.0228586 · Cited by 35 · see citing works
Abdalla, M. A., Shah, N., Deshmukh, H., Sahebkar, A., Östlundh, L., Al-Rifai, R. H., Atkin, S. L., & Sathyapalan, T. (2022) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/20420188221127142 · Cited by 33 · see citing works
Ferreira, G. D., Germeyer, A., Machado, A. D. B., do Nascimento, T. L., Strowitzki, T., Brum, I. S., Corleta, H. V. E., & Capp, E. (2014) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2014.01.009 · Cited by 30 · see citing works
Weng, S., Luo, Y., Zhang, Z., Su, X., & Peng, D. (2020) · Endocrine · doi:10.1007/s12020-020-02190-y · Cited by 29 · see citing works
Impact of hypocaloric dietary intervention on ovulation in obese women with PCOS
Jarrett, B. Y., & Lujan, M. E. (2016) · Reproduction · doi:10.1530/rep-16-0385 · Cited by 29 · see citing works
Altinok, M. L., Ravn, P., Andersen, M., & Glintborg, D. (2018) · Gynecological Endocrinology · doi:10.1080/09513590.2018.1460343 · Cited by 28 · see citing works
Li, L., Li, C., Pan, P., Chen, X., Wu, X., Ng, E. H. Y., & Yang, D. (2015) · PLoS ONE · doi:10.1371/journal.pone.0144072 · Cited by 28 · see citing works
Yen, H., Chang, Y.-T., Yee, F.-J., & Huang, Y. (2020) · American Journal of Clinical Dermatology · doi:10.1007/s40257-020-00565-5 · Cited by 27 · see citing works
Woodward, A., Broom, D. R., Dalton, C., Metwally, M., & Klonizakis, M. (2020) · Trials · doi:10.1186/s13063-019-3962-7 · Cited by 26 · see citing works
Woodward, A., Broom, D. R., Harrop, D., Lahart, I. M., Carter, A., Dalton, C., Metwally, M., & Klonizakis, M. (2019) · Journal of Diabetes & Metabolic Disorders · doi:10.1007/s40200-019-00425-y · Cited by 24 · see citing works
Puberty in the Female and Its Disorders
Rosenfield, R. L., Cooke, D. W., & Radovick, S. (2021) · Elsevier eBooks · doi:10.1016/b978-0-323-62520-3.00016-6 · Cited by 22 · see citing works
Current treatment for polycystic ovary syndrome: focus on adolescence
Street, M. E., Cirillo, F., Catellani, C., Dauriz, M., Lazzeroni, P., Sartori, C., & Moghetti, P. (2020) · Minerva Pediatrics · doi:10.23736/s0026-4946.20.05861-2 · Cited by 19 · see citing works
Yamamoto, S., Noguchi, H., Takeda, A., Arakaki, R., Uchishiba, M., Imaizumi, J., Minato, S., Kamada, S., Kagawa, T., Yoshida, A., et al. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23158207 · Cited by 19 · see citing works
Abdalla, M. A., Shah, N. Z., Deshmukh, H., Sahebkar, A., Östlundh, L., Al‐Rifai, R. H., Atkin, S. L., & Sathyapalan, T. (2021) · Clinical Endocrinology · doi:10.1111/cen.14623 · Cited by 18 · see citing works
Iwasa, T., Matsuzaki, T., Mayila, Y., Kawakita, T., Yanagihara, R., & Irahara, M. (2019) · Gynecological Endocrinology · doi:10.1080/09513590.2019.1631276 · Cited by 18 · see citing works
Hu, J., Han, J., Min, J., Jin, J., & Zhu, J. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-072904 · Cited by 17 · see citing works
Key signalling pathways underlying the aetiology of polycystic ovary syndrome
Walters, K. A., Moreno-Asso, A., Stepto, N. K., Pankhurst, M. W., Paris, V. R., & Rodgers, R. J. (2022) · Journal of Endocrinology · doi:10.1530/joe-22-0059 · Cited by 17 · see citing works
Effects of distinct Polycystic Ovary Syndrome phenotypes on bone health
Mills, E., Abbara, A., Dhillo, W. S., & Comninos, A. N. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1163771 · Cited by 17 · see citing works
Abdel-Maboud, M., Menshawy, A., Hasabo, E. A., Abdelraoof, M. I., Alshandidy, M., Eid, M., Menshawy, E., Outani, O., & Menshawy, A. (2021) · PLoS ONE · doi:10.1371/journal.pone.0254412 · Cited by 16 · see citing works
RetractedBak Foong pills combined with metformin in the treatment of a polycystic ovarian syndrome rat model
Liu, W., Liu, W., Fu, Y., Wang, Y., & Zhang, Y. (2015) · Oncology Letters · doi:10.3892/ol.2015.3466 · Cited by 15 · see citing works
Moll, E., van Wely, M., Lambalk, C. B., Bossuyt, P. M., & van der Veen, F. (2012) · Human Reproduction · doi:10.1093/humrep/des310 · Cited by 15 · see citing works
Women's experience of polycystic ovary syndrome management: A systematic review and meta‐synthesis
Guan, M., Li, R., Shen, Q., Wang, G. P., Li, Z., Xiao, M., & Lei, J. (2023) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.15031 · Cited by 12 · see citing works
Contrasting Bone Profiles in PCOS Are Related to BMI: A Systematic Review and Meta-analysis
Rissetti, G., Piovezan, J. M., Premaor, M. O., & Comim, F. V. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgae325 · Cited by 10 · see citing works
Wang, A., Noel, M., Christ, J. P., Corley, J., Lenhart, N. J., Cedars, M. I., & Huddleston, H. G. (2023) · F&S Reports · doi:10.1016/j.xfre.2023.12.004 · Cited by 10 · see citing works
Metabolic complications of glucocorticoids – Prevention by metformin
Sanpawithayakul, K., & Korbonits, M. (2023) · Annales d Endocrinologie · doi:10.1016/j.ando.2023.05.002 · Cited by 8 · see citing works
Evaluating the Effects of Metformin Use on Height in Children and Adolescents
Kuzik, N., Myette‐Côté, É., Carson, V., Slater, L., & Boulé, N. G. (2015) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2015.2186 · Cited by 8 · see citing works
Moazzam, A., Saleem, A., Shah, S., Hussain, L., Baig, M. M. F. A., Alshammari, A., Albekairi, N. A., & Akhtar, M. F. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e29015 · Cited by 7 · see citing works
Bahtiyar, G., & Sacerdote, A. S. (2011) · InTech eBooks · doi:10.5772/26350 · Cited by 7 · see citing works
Huang, R., Zhao, P., Xu, J., Liu, D., Luo, F., & Dai, Y. (2017) · Journal of Cellular Biochemistry · doi:10.1002/jcb.26410 · Cited by 6 · see citing works
Garcia-Hernandez, S. C., Porchia, L. M., Pacheco-Soto, B. T., López‐Bayghen, E., & González-Mejía, M. E. (2021) · Gynecological Endocrinology · doi:10.1080/09513590.2021.1913114 · Cited by 6 · see citing works
Broskey, N. T., Klempel, M. C., Gilmore, L. A., Sutton, E. F., Altazan, A. D., Burton, J. H., Ravussin, É., & Redman, L. M. (2017) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2017-00459 · Cited by 6 · see citing works
Mizgier, M., Sansoni, V., Więckowska, B., Jarząbek‐Bielecka, G., Formanowicz, D., Kędzia, W., Banfi, G., & Lombardi, G. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1477992 · Cited by 5 · see citing works
Ryssdal, M., Skage, J. E., Jarmund, A. H., Hanem, L. G. E., Løvvik, T. S., Giskeødegård, G. F., Iversen, A., & Vanky, E. (2025) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.18320 · Cited by 5 · see citing works
Changes in antral follicle dynamics following weight loss in women with polycystic ovary syndrome
Carter, F. E., Jarrett, B. Y., Lee, N. D., Zaman, N., Reich, A., Wilson, K. A., Oldfield, A. L., Brink, H. V., & Lujan, M. E. (2025) · Human Reproduction · doi:10.1093/humrep/deaf169 · Cited by 4 · see citing works
Diet and exercise in the management of PCOS: Starting from the basics
Markantes, G. Κ., Tsichlia, G., & Georgopoulos, N. A. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-823045-9.00010-9 · Cited by 4 · see citing works
Obesity in polycystic ovary syndrome and infertility
Messinis, I. E., Messini, C. I., & Dafopoulos, K. C. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-817919-2.00003-6 · Cited by 4 · see citing works
- Authors
- Ladson, G., Dodson, W. C., Sweet, S. D., Archibong, A. E., Kunselman, A. R., Demers, L. M., Williams, N. I., Coney, P., & Legro, R. S.
- Affiliations
- Meharry Medical College (US)
- Pennsylvania State University (US)
- Virginia Commonwealth University (US)
- Corresponding author
- Legro, Richard S.
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2011-03
- Volume
- 95
- Issue
- 3
- Pages
- 1059-1066.e7
- ISSN
- 0015-0282 (ISSN-L)
- PMC
- PMC3073705
- OpenAlex
- W2146522847
- Cited by
- 138
- References
- 45
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 6 · 2023: 9 · 2022: 9 · 2021: 11 · 2020: 13 · 2019: 5 · 2018: 5 · 2017: 11 · 2016: 8 · 2015: 10 · 2014: 14 · 2013: 11 · 2012: 8
- FWCI
- 10.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Pennsylvania
- Pennsylvania State University
- Penn State College of Medicine
- National Center for Research Resources (MO1 RR10732, C06RR016499, U54RR026140, M01RR010732)
- National Institute on Minority Health and Health Disparities (U54MD007593)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (U54HD044315)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Keywords
- polycystic ovary syndrome, metformin, lifestyle therapy, caloric restriction, physical activity, ovulation rate, testosterone, insulin sensitivity, insulin secretion, glucose tolerance, weight loss, bone mineral density, quality of life, adverse drug reactions
- MeSH terms
- Adult, Diet, Reducing, Double-Blind Method, Female, Humans, Hypoglycemic Agents, Life Style, Metformin, Ovulation, Patient Dropouts, Polycystic Ovary Syndrome, Testosterone, Exercise, Placebo Effect, Treatment Outcome, Caloric Restriction, Glycemic Index
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