Endocrine Abstracts

Polycystic ovary syndrome (PCOS) is the most common endocrine condition affecting women and is associated with hyperinsulinaemia and hyperandrogenism. Obesity is present in at least 30% of cases and plays a vital role in the development and maintenance of PCOS as well as affecting the severity of the clinical and endocrine features. Significant improvements in symptoms of androgen excess and ovulatory function are seen with even a modest weight loss of 5% in women with PCOS. Metformin is used in PCOS to improve insulin resistance and to achieve weight loss, but there is still controversy as to whether or not metformin aids the latter.

The aim of this study was to determine the impact of metformin treatment on overweight patients with PCOS over the period they attended St George’s Hospital Endocrine Unit.

Data was obtained retrospectively on 43 patients with PCOS attending the endocrine clinic at St George’s Hospital and prescribed metformin. Patients attended clinic for an average of 5 years. Changes in weight that occurred whilst on metformin treatment and weight changes while not taking the treatment were determined and compared. The average weight of patients when they first attended clinic was 86.5 kg.

The average weight change whilst on metformin was a loss of 2.17 kg. When the patients were not taking metformin, the average weight change was a gain of 3.8 kg. Side effects due to metformin were a major cause of lack of compliance and 50% of the patients took metformin for <6 months.

In conclusion, patients lost significantly more weight whilst taking metformin than when not on the drug, despite its limitations. Non-compliance was high with gastro-intestinal side effects being the main cause.