Polycystic Ovaries Research Today is a free monthly online journal that collates and summarizes the latest research about Polycystic Ovaries, including details on treatment, symptoms, polycystic ovary syndrome, infertility. | ||||||||
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Metformin versus oral contraceptive pill in polycystic ovary syndrome: a Cochrane review.Costello MF, Shrestha B, Eden J, Johnson NP, Sjoblom P Division of Obstetrics and Gynaecology, School of Women's and Children's Health, University of New South Wales, Royal Hospital for Women, Sydney, NSW, 2031, Australia. mfcostello@unsw.edu.au BACKGROUND: The object of this review was to compare metformin versus oral contraceptive pill (OCP) treatment in polycystic ovary syndrome. METHODS: A systematic review and meta-analysis employing the principles of the Cochrane Menstrual Disorders and Subfertility Group was undertaken. RESULTS: Four randomized controlled trials (RCTs) (104 subjects) were included. Limited data demonstrated no evidence of a difference in effect between metformin and the OCP on hirsutism, acne or development of type 2 diabetes mellitus. There were no trials assessing diagnosis of cardiovascular disease or endometrial cancer. Metformin, in comparison with the OCP, was less effective in improving menstrual pattern [Peto odds ratio (OR) 0.08, 95% confidence interval (CI) 0.01-0.45) and in reducing the serum total testosterone level weighted mean difference (WMD) 0.54, 95% CI 0.22-0.86] but more effective in reducing fasting insulin (WMD -3.46, 95% CI - 5.39 to -1.52) and not increasing fasting triglyceride (WMD -0.48, 95% CI - 0.86 to -0.09) levels. Limited data demonstrated no evidence of a difference in effect between the two therapies on reducing fasting glucose or total cholesterol levels and severe adverse events. CONCLUSIONS: The limited RCT evidence to date does not show adverse metabolic risk with the use of the OCP compared with metformin. Further long-term RCTs are required. Published 19 April 2007 in Hum Reprod, 22(5): 1200-9.
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