Effects of Metformin on serum Insulin, Anti-Mullerian Hormone and on Androgen Levels in patients with Polycystic Ovarian Syndrome

Abstract

PCOS is an endocrinolgical disorder that affects 5% - 10% of the population. Hyprinsulinemia forms the basis of the disorder, and hyperandrogenemia that characterizes the disorder is a consequence of hyperinsulinemia. On this basis, metformin an insulin sensitizing agent had been evaluated to determine its effect on insulin, androgen and AMH levels. The study included 50 hyperandrogenic PCOS patients who were prescribed metformin in a dose of 1700 mg daily for a period of six months. The effect of metformin was evaluated over 3 and 6 months of treatment. Metformin produced significant reduction in both fasting and postprandial insulin levels, the effect was more significant in the first three months of treatment and levels continued to decrease over the course of treatment. However there was no effect on fasting or postprandial serum glucose levels. The reduction in hyperinsulinemia was reflected on androgen levels, serum SHBG levels increased from 16.53nm/ml to 47.13nm/ml and consequently free testosterone levels decreased significantly from 2.9 at the beginning of the study to 1.7 by the end of the study. DHEAS levels were significantly decreased 285.55 ug/dl to 154.83 ug/dl. However metformin did not show significant change in total testosterone levels. The effect of metformin on androgens was more pronounced during the first three months of treatment and continued through the remaining course of treatment.