This review identified that COCP therapy has benefits for management of hyperandrogenism and menstrual regulation. Metformin combined with the COCP may be useful for management of metabolic features. There is minimal evidence of benefits of adding an anti-androgen to COCP therapy. Metformin alone has benefits for adult women for management of weight, hormonal and metabolic outcomes, especially for women with BMI ≥ 25 kg/m² . There is inadequate evidence to suggest the optimal COCP formulation, or dosing regimen and formulation of metformin.
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Teede et al. (2019) studied this question.
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