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Review Compares Metformin, OCPs for Teens With PCOS

Four randomized controlled trials show benefits for metformin and oral contraceptive pills

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THURSDAY, April 28, 2016 (HealthDay News) -- For adolescents with polycystic ovarian syndrome (PCOS), treatment with metformin and oral contraceptive pills can be beneficial, although evidence is limited, according to a review published online April 28 in Pediatrics.

Reem A. Al Khalifah, M.D., from McMaster University in Hamilton, Canada, and colleagues conducted a systematic review and meta-analysis to examine the use of metformin versus oral contraceptive pills for treatment of PCOS in adolescents. Data were included from four randomized controlled trials (RCTs) with 170 patients.

The researchers found that oral contraceptive pill treatment correlated with a modest improvement in the frequency of menstrual cycle (P < 0.01) and mild reduction of acne scores (P = 0.02). Metformin correlated with a greater body mass index reduction (P < 0.01) and with decreased prevalence of dysglycemia and improved total and low-density lipoprotein cholesterol levels. In terms of the impact on hirsutism, metformin and oral contraceptive pills were similar.

"Current evidence is derived from very low to low quality evidence. Therefore, treatment choice should be guided by patient values and preferences while balancing potential side effects," the authors write. "Future high quality RCTs are needed to address several questions for the treatment of adolescents with PCOS."

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