Metformin for the treatment of the polycystic ovary syndrome
Abstract
A 23-year-old woman with the polycystic ovary syndrome presents for evaluation and possible treatment. She has a family history of diabetes, is obese, and has impaired glucose tolerance. Metformin therapy is recommended. Metformin increases insulin sensitivity and may reduce the risk of diabetes. In the polycystic ovary syndrome, long-term metformin treatment may increase ovulation, improve menstrual cyclicity, and reduce serum androgen levels.
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In other populations, metformin prevents weight gain and appears to assist with weight loss, prevents and manages type 2 diabetes, gestational diabetes, and fatty liver, and reduces cardiovascular disease in type 2 diabetes.
“It is known in other populations to prevent weight gain and appearstoassistwithweightloss,topreventandmanageDM2,gestational diabetes, fatty liver, and reduce cardiovascular disease in DM2 (Lord et al. , 2003; Desilets et al. , 2008; Nestler, 2008; Batra et al. , 2009; NieuwenhuisRuifrok et al. , 2009; Oppelt et al. , 2010; Diabetes Prevention Program Research Group, 2012; Viollet et al. , 2012)”
From Metformin and lifestyle modification in polycystic ovary syndrome: systematic review and meta-analysis (2015) · cites this paper as Nestler, 2008
Metformin is currently classified as category B in the United States and as category C in Australia.
“and is currently classified as category B in the United States and as category C in Australia (247, 248).”
From Metformin, the Aspirin of the 21st Century: Its Role in Gestational Diabetes Mellitus, Prevention of Preeclampsia and Cancer, and the Promotion of Longevity (2017) · cites this paper as [248]
Maternal side-effects reported with the use of metformin are mainly gastro-intestinal, i.e., nausea and diarrhea.
“Maternal side-effects reported with the use of metformin are mainly gastro-intestinal, i.e., nausea and diarrhea(248).”
From Metformin, the Aspirin of the 21st Century: Its Role in Gestational Diabetes Mellitus, Prevention of Preeclampsia and Cancer, and the Promotion of Longevity (2017) · cites this paper as [248]
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- Authors
- Nestler, J. E.
- Affiliations
- Virginia Commonwealth University (US)
- Corresponding author
- Nestler, John E.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2008-01-03
- Volume
- 358
- Issue
- 1
- Pages
- 47-54
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2100076759
- Semantic Scholar
- f4b14c6984a40041406cef4211cbef144350d0fb
- Cited by
- 313
- References
- 60
- Citations by year
- 2026: 12 · 2025: 9 · 2024: 8 · 2023: 16 · 2022: 13 · 2021: 10 · 2020: 12 · 2019: 14 · 2018: 19 · 2017: 17 · 2016: 13 · 2015: 19 · 2014: 19 · 2013: 26 · 2012: 27
- FWCI
- 3.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- VCU Scholars Compass (Virginia Commonwealth University) (submittedVersion)
- Funders
- U.S. Public Health Service (K24D040237)
- Fogarty International Center (D43TW007692)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD035629)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Kidney Cyst Diseases
- Keywords
- metformin, polycystic ovary syndrome, insulin sensitivity, impaired glucose tolerance, obesity, diabetes risk, ovulation, menstrual cyclicity, androgen reduction
- MeSH terms
- Adult, Female, Humans, Hypoglycemic Agents, Insulin Resistance, Cholesterol, LDL, Metformin, Obesity, Polycystic Ovary Syndrome, Triglycerides, Practice Guidelines as Topic
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