The management of insulin resistance in polycystic ovary syndrome
Abstract
Polycystic ovary syndrome (PCOS) has reproductive and metabolic implications. Insulin resistance (IR), secondary to genetic and lifestyle factors, is integral in the pathogenesis, metabolic, clinical features and the long-term sequelae in the majority of people with PCOS. Therapeutic strategies targeting IR in PCOS ameliorate clinical features and might reduce long-term sequelae including diabetes. The mainstay for improving IR is lifestyle change; however, feasibility and sustainability remain concerns. In PCOS, metformin reduces IR, improves ovarian function, regulates cycles, lowers androgens, improves clinical hyperandrogenism and potentially improves fertility. Metformin is also likely to delay diabetes onset and has a role in PCOS in those at high risk of diabetes; however, further research is needed to clarify specific target subgroups and clinical indications.
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Hyperinsulinaemia increases androgen production and reduces sex hormone-binding globulin, leading to hyperandrogenism.
“The resulting hyperinsulinaemia increases androgen production and reduces sex hormone-binding globulin (SHBG) leading to hyperandrogenism (Teede et al. , 2007).”
From Metformin and lifestyle modification in polycystic ovary syndrome: systematic review and meta-analysis (2015) · cites this paper as Teede et al., 2007
Insulin resistance and hyperandrogenism play key roles in the aetiology of PCOS.
“IR (defined as reduced insulin sensitivity [IS] compared with control women) and hyperandrogenism play key roles in the aetiology (Teede et al., 2007(Teede et al., , 2010)).”
From Insulin resistance in polycystic ovary syndrome: a systematic review and meta-analysis of euglycaemic–hyperinsulinaemic clamp studies (2016) · cites this paper as Teede et al., 2007
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- Authors
- Teede, H. J., Hutchison, S. K., & Zoungas, S.
- Affiliations
- Jean Hailes (AU)
- Corresponding author
- Teede, Helena J.
- Venue
- Trends in Endocrinology & Metabolism
- Publisher
- Elsevier BV
- Published
- 2007-09
- Volume
- 18
- Issue
- 7
- Pages
- 273-279
- ISSN
- 1043-2760 (ISSN-L)
- OpenAlex
- W2146102404
- Cited by
- 135
- References
- 10
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 3 · 2023: 5 · 2022: 9 · 2021: 8 · 2020: 5 · 2019: 4 · 2018: 7 · 2017: 4 · 2016: 11 · 2015: 8 · 2014: 10 · 2013: 9 · 2012: 10
- FWCI
- 1.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Trends in Endocrinology and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- 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, insulin resistance, metformin, lifestyle intervention, hyperandrogenism, insulin sensitizers, diabetes prevention, ovarian function, fertility, PCOS pathogenesis
- MeSH terms
- Female, Humans, Hyperinsulinism, Hypoglycemic Agents, Insulin Resistance, Metformin, Models, Biological, Polycystic Ovary Syndrome
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