1. Metformin induces a prompt decrease in LH-stimulated testosterone response in women with PCOS independent of its insulin-sensitizing effects.
- Author
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Kurzthaler D, Hadziomerovic-Pekic D, Wildt L, and Seeber BE
- Subjects
- Adrenal Cortex metabolism, Adrenal Cortex physiopathology, Adult, Body Mass Index, Double-Blind Method, Female, Follow-Up Studies, Humans, Hyperandrogenism etiology, Hyperandrogenism prevention & control, Hyperinsulinism etiology, Hyperinsulinism prevention & control, Hypoglycemic Agents adverse effects, Luteinizing Hormone genetics, Metformin adverse effects, Overweight complications, Ovulation drug effects, Polycystic Ovary Syndrome complications, Polycystic Ovary Syndrome metabolism, Polycystic Ovary Syndrome physiopathology, Recombinant Proteins chemistry, Recombinant Proteins genetics, Testosterone blood, Weight Gain drug effects, Young Adult, Adrenal Cortex drug effects, Hypoglycemic Agents therapeutic use, Insulin Resistance, Luteinizing Hormone antagonists & inhibitors, Metformin therapeutic use, Polycystic Ovary Syndrome drug therapy, Testosterone metabolism
- Abstract
Background: The use of insulin-sensitizing drugs has been shown to improve both the reproductive and the metabolic aspects of PCOS. However, the mechanisms by which metformin exerts its effects in PCOS are still not completely understood. There is growing evidence of a direct effect of metformin on ovarian steroidogenesis, independent of its effects on insulin sensitivity., Methods: We evaluated the short-term effects of metformin compared to placebo on basal and LH- stimulated androgen secretion as well as on hormonal and metabolic parameters in 19 women with PCOS during a four-day randomized, double-blinded placebo-controlled clinical trial. In a three month follow-up evaluation, we investigated the longer-term therapeutic effects of metformin on ovulation, metabolic and endocrine parameters., Results: Compared to placebo, 2 days of metformin was associated with a borderline significant reduction in the free androgen index (FAI) (p = 0.05) and with a reduction in the serum concentration of LH-stimulated testosterone (T) (p = 0.03). Following three months of use, a decline in serum T was observed, independent of changes in weight, metabolic parameters, or insulin sensitivity., Conclusions: In women with PCOS, Metformin induces a prompt decrease in LH-stimulated T secretion after only several days of use. This action precedes the medication's effects on insulin sensitivity or weight loss.
- Published
- 2014
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