Metformin & PCOS
Sirona Health is pleased to share the latest evidence-based recommendations for managing Polycystic Ovary Syndrome (PCOS) using Metformin.
With obesity affecting a quarter of the population (BMI ≥ 35), it is crucial to explore alternatives to the combined oral contraceptive pill (COCP) for women with PCOS. The use of COCP in patients with a high BMI may increase the risk of blood clots, heart attacks, and strokes. Therefore, it is often avoided in those with a BMI of ≥ 35, where the risks outweigh the benefits.
Insulin resistance is common in women with PCOS, particularly in those with higher BMI (up to 95%), which makes Metformin a valuable option for managing metabolic outcomes such as insulin resistance, glucose, and lipid profiles. It has also been shown to be helpful to reduce BMI and reduce the waist to height ratio.
Here are the most recent guidelines:
Metformin alone should be considered for metabolic outcomes in PCOS patients with a BMI ≥ 25 kg/m2.
Metformin can be used instead of COCP for metabolic indications in PCOS.
For high metabolic risk patients, Metformin in combination with COCP may be most effective.
Metformin may be considered for irregular menstrual cycles where COCP is contraindicated, not accepted or not tolerated.
Limited evidence suggests that metformin alone may be considered in adults with PCOS and a BMI < 25 kg/m2.
Patients taking Metformin should be screened for B12 deficiency, particularly if they have risk factors for it. Mild gastrointestinal symptoms may also be experienced.
It's essential to note that an active lifestyle intervention is as effective as Metformin, and should be optimized before considering drug treatment, or alongside it. Sirona Health can support you by personalizing your lifestyle advice to best fit your commitments and health.
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