Endocrine Abstracts

Metformin 500 mg three times daily had been advised to our patients suffering from the polycystic ovary syndrome by the Rotterdam criteria who did not want to take contraceptive pills. More recently, we have included life style changes to metformin taking: increased physical activity, low glycaemic index diet (with calorie restriction for the obese). The efficacy of the two treatment forms was compared. The metformin only group consisted of 27 patients (age 18–39 years, mean, 26); the metformin + life style changes group of 28 age-matched patients. The following parameters were registered at the beginning and the end of a 6-month treatment period: global acne score, Ferriman-Gallwey hirsutism score (FG), body mass index (BMI), and the waist-hip circumference ratio (W/H). By the end of the treatment period, both acne and FG improved significantly in both treatment groups, without significant difference between treatment forms: acne 8.6±5.7 vs 9.3±6.0 (P=0.67); FG 2.5±2.0, vs. 2.6±1.6 (P=0.83). BMI and WH remained practically unchanged in the metformin only group: 0.26±1.0 (NS) and 0.001±0.02 (NS). BMI improved in the metformin + life style group by 0.9±1.1 (P<0.001); and W/H by 0.015±0.03 (P<0.05). Life style changes did not show in additional improvement of hyperandrogenic symptoms compared to metformin only but diminished BMI and W/H. Based on these results we advise the continuation of the triple basal treatment consisting of metformin with low glycaemic index diet and increased physical activity (as triple basal therapy) to all patients with PCOS for long-term assessment.