Statement prepared by RJ Norman, W. Kidosn, M. Zaccharin
Prepared on behalf of the Endocrine Society of Australia, Australian
Diabetes Society, Australasian Paediatric Endocrine Group, and Australasian Society for the Study of Obesity.
Polycystic ovary syndrome (PCOS) is an important condition associated with menstrual abnormalities, infertility, weight disorders, diabetes mellitus and consequences of excess androgen production and hyperlipidaemia. Insulin resistance is commonly found in these patients and may contribute to the disordered ovarian function. Reduction of insulin resistance is of clinical value and is best achieved in the first instance by life-style modification, mainly to achieve weight loss via diet and exercise. Drugs that improve insulin sensitivity, such as metformin, may play an increasing role in management in the future although definitive evidence for clinical efficacy is scanty. Metformin should only be tried after advice on life-style modification for women who are anovular or have menstrual irregularities. Only a small proportion of anovulatory women may be expected to respond on metformin alone and addition of clomiphene citrate may be of value. Metformin has not yet been proven to reduce hirsutism, improve the lipid abnormalities of PCOS or reduce longer-term complications in this condition. Because of the relative safety and cost of this drug, as well as the possible long-term benefits of the reduction of insulin resistance, metformin may prove to be of benefit following more evidence from properly planned randomised controlled trials.