Endocrine Abstracts

Background: Metformin is an established treatment of polycystic ovarian syndrome (PCOS) but patient-reported outcomes with respect to its effects and tolerability have not been widely reported. About 68 patients with PCOS treated with metformin in our clinic were surveyed by questionnaire.

Results:
a. Demographics: 42/68 patients were currently, and 26 previously treated with metformin for PCOS. Median age and BMI was 31 years (range 16–49), and 33.9 (range 20.2–51.8) respectively. Median duration of PCOS was 4 years and 5 months. Median metformin dose and duration of treatment was 1.5g daily, and 12 months respectively. About 22 patients stopped metformin at some point due to side effects (predominantly gastrointestinal), and 8 due to insufficient improvement on metformin. Eight patients changed from metformin to glucophage SR.

b. Response to metformin: 28/68 (41%) reported improvement in menstrual regularity. About 33/68 (49%) reported no change, and 17/68 (25%) improvement in heaviness of period. About 28/68 reported difficulty conceiving. Of these 4 conceived on metformin alone and 1 on metformin and clomiphene. About 26/68 patients reported acne, of which half reported improvement with metformin. About 16/68 (24%) patients reported improved hirsuitism. About 27/68 (40%) patients reported a median weight loss of 4.5kg with metformin. Of those on metformin for at least 6 months, 22/46 (48%) reported median weight loss of 5kg. About 41/68 (60%) patients treated with metformin were happy to continue treatment on it.

Conclusions: A large minority of patients report improvement in menstrual regularity and/or heaviness with metformin, and a significant minority report an improvement in acne and in hirsutism (not reported in many previous studies but consistent with recent meta-analyses). Metformin was associated with significant weight loss in a substantial minority of patients. This report shows that metformin is perceived favourably by patients with respect to its role in treating menstrual disturbance, hirsuitism, acne and obesity associated with PCOS.