Metformin in the Treatment of Polycystic Ovary Syndrome: A Literature Review

A review of the literature regarding metformin in the treatment of PCOS was performed using the PubMed database; search terms "polycystic ovary syndrome, metformin in PCOS, clomiphene citrate (CC), metformin in insulin resistance, pregnancy in PCOS, fertility restoring, metformin-mechanism of action, and androgens level reducing" were applied. PrisMa ConsiderationsThe review adheres to PRISMA guidelines.A tabular summary of the included studies, detailing the intervention, dosage, outcomes, and key findings, are shown in Table 1. introduCtionRecent data indicate that at least 20% of women of childbearing age may be affected by PCOS. 1 PCOS is one of the most complex and multifactorial endocrine disorders.It has a genetic basis, but environmental factors also strongly influence the prevalence of the condition. 2The diagnosis of PCOS requires two of the following three criteria to be met: chronic anovulation, biochemical and/or clinical hyperandrogenism, and polycystic ovarian morphology. 3nsulin resistance and obesity often occur together with this condition. 2Excessive fat accumulation due to hyperandrogenism increases insulin resistance, which in turn triggers disease progression. 4Restoring fertility, alleviating the symptoms of hyperandrogenism, achieving an average body weight, and regulating menstrual disorders are the main desired outcomes of PCOS treatment.Depending on the patient's preference, different treatment methods are used. 5Metformin-the oral antidiabetic drug-has been used in the treatment of PCOS for almost 30 years.Its use has a positive effect on the treating process.Metformin increases insulin sensitivity and estrogen secretion, decreases androgen production by the ovaries, and affects the production of sex hormone-binding globulin (SHBG). 6 PurPoseThe purpose of this article is to review the latest publications, mostly from 2015 to 2022, which state the medical approach with metformin to polycystic ovary syndrome (PCOS), its advantages, as well as potential burdens and adversary effects of this pharmacological treatment.