Therapeutic response to metformin in an underweight patient with polycystic ovarian syndrome

Fertil Steril. 2008 Oct;90(4):1197.e1-4. doi: 10.1016/j.fertnstert.2007.11.041. Epub 2008 Jan 28.

Abstract

Objective: To report a case where insulin sensitization restored menses in an underweight woman with polycystic ovarian syndrome (PCOS).

Design: Case report.

Setting: Tertiary care center.

Patient(s): A 19-year-old woman with a body mass index of 16.9 kg/m(2), severe hirsutism, and oligomenorrhea.

Intervention(s): Insulin sensitization with metformin.

Main outcome measure(s): Impact of metformin therapy on menstrual cycle and serum T and fasting insulin levels.

Result(s): Metformin, without weight loss or increased physical activity, resulted in restoration of menstrual cycle, reduction in serum T, and improvement in insulin resistance (IR).

Conclusion(s): This case highlights the contribution of PCOS-related IR, distinct from visceral adiposity, and demonstrates the effectiveness of pharmacological insulin-sensitization independent of weight loss or lifestyle adjustments.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Fetal Proteins
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Insulin / blood*
  • Menstrual Cycle / drug effects*
  • Metformin / administration & dosage*
  • Polycystic Ovary Syndrome / blood
  • Polycystic Ovary Syndrome / diagnosis*
  • Polycystic Ovary Syndrome / drug therapy*
  • T-Box Domain Proteins / blood*
  • Thinness / blood
  • Thinness / diagnosis*
  • Thinness / drug therapy*
  • Treatment Outcome

Substances

  • Fetal Proteins
  • Hypoglycemic Agents
  • Insulin
  • T-Box Domain Proteins
  • Metformin
  • Brachyury protein