Metformin Usage in Polycystic Over Syndrome

Polycystic ovary syndrome (PCOS), a heterogeneous and complex syndrome, is the most common endocrinopathy that affects women during their reproductive years. Its etiopathogenesis is not completely elucidated and it has been proposed that there are multiple causative factors such as increased insulin resistance, dyslipidemia, and hyperandrogenemia. There have been often presented clinical and biochemical disorders such as insulin resistance, compensatory hyperinsulinemia, hyperandrogenemia, obesity, ovulation disorders, infertility, dyslipidemia in women with PCOS. There is no definitive treatment for the cause, and the treatment plan changes according to symptoms and wishes of the patient. There is a wide range of treatment options which varies depending on the individual and desired clinical effect we target. No pharmacologic agent that is currently used and/or newly developed do relieve all symptoms and give the same result in every patient. Metformin appears to be a potent therapeutic agent in PCOS, with a potentially broad spectrum of effects that can cure almost all symptoms and signs associated with PCOS. However, the results of some studies in which metformin is used,are not compatible and confusing. Different clinical responses to metformin in women with PCOS may result from heterogeneous nature of the PCOS phenotype, different dosage and duration of metformin and genetic variation of OCT1 which is a metformin transporter protein. Dividing into subgroups according to clinical and biochemical parameters, phenotypes in women with PCOS needs to be described in detail. There is a need for multicenter, well-designed, prospective studies to accurately demonstrate the efficacy of metformin. To summarize the relationship between PCOS and metformin by looking over current literature and to draw attention to the use of metformin in PCOS is the target of this review