Use of insulin sensitizers in polycystic ovarian syndrome

Curr Opin Investig Drugs. 2005 Oct;6(10):1012-22.

Abstract

Polycystic ovarian syndrome is a common disorder associated with a significant long-term risk of developing type 2 diabetes and cardiovascular diseases. Insulin resistance and hyperinsulinemia play an important role in its pathophysiology and therefore insulin sensitizers have been proposed as a possible treatment option for this condition. In this review, pertinent literature is described that supports the use of insulin sensitizers for the management of short-term (fertility and hyperandrogenism) as well as long-term (type 2 diabetes, cardiovascular diseases and endometrial cancer) clinical issues of the syndrome. There is sufficient evidence in the literature to support the initial use of insulin sensitizers for fertility and the chronic treatment of hyperandrogenism. Furthermore, insulin sensitizers may prevent type 2 diabetes or cardiovascular diseases, whereas some evidence suggests that oral contraceptives could increase these risks. Therefore, although oral contraceptives may provide a more reliable control of menstrual disorders, insulin sensitizers should be considered as a preferential treatment option in women with polycystic ovarian syndrome at an increased risk of developing type 2 diabetes or cardiovascular disease, especially if they do not need contraception.

Publication types

  • Review

MeSH terms

  • Animals
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / metabolism
  • Female
  • Humans
  • Hyperandrogenism / drug therapy
  • Hyperandrogenism / etiology
  • Hyperandrogenism / metabolism
  • Hypoglycemic Agents / therapeutic use*
  • Infertility, Female / drug therapy
  • Infertility, Female / etiology
  • Infertility, Female / metabolism
  • Insulin / metabolism*
  • Insulin Resistance*
  • Metabolic Diseases / drug therapy
  • Metabolic Diseases / etiology
  • Metabolic Diseases / metabolism
  • Polycystic Ovary Syndrome / complications
  • Polycystic Ovary Syndrome / drug therapy*
  • Polycystic Ovary Syndrome / metabolism
  • Pregnancy
  • Pregnancy Outcome
  • Treatment Outcome

Substances

  • Hypoglycemic Agents
  • Insulin