The Effects of Metformin with Lifestyle Therapy in Polycystic Ovary Syndrome: A Randomized Double Blind Study

Adding metformin to lifestyle therapy did not significantly improve ovulation rates compared to placebo plus lifestyle in obese women with PCOS, with an ovulation rate ratio of 2.5 (95% CI: 0.9, 6.6;

Effect: null; ovulation rate ratio 2.5 (whether ovulated), 1.2 (number of ovulations given ovulation); CI: 95% CI: (0.9, 6.6) for whether ovulated; 95% CI: (0

Testosterone levels were significantly lower compared to baseline in the metformin group at 3 months but not at 6 months, indicating a transient androgen-lowering effect that did not persist.

Effect: null

Metformin plus lifestyle produced significant weight loss from baseline (-3.4 kg, 95% CI: -5.3, -1.5) at 6 months, but this was not significantly different from placebo plus lifestyle, indicating no a

Effect: null; -3.4 kg from baseline in MET at 6 months; CI: 95% CI: (-5.3, -1.5)

Lifestyle plus placebo showed significant improvement in AUC glucose compared to both baseline and metformin (P<0.001 and P=0.002), while metformin showed divergent effects on OGTT indices — improved

Effect: mixed

Total bone mineral density increased significantly in the metformin group, though the clinical impact is likely minor since PCOS women generally have normal or increased BMD.

Effect: improvement

There were no significant differences in the overall PCOS-specific quality of life well-being scores between metformin + lifestyle and placebo + lifestyle at 6 months, though both groups showed favora

Effect: null

Metformin caused significantly more diarrhea and headaches compared to placebo, with 6 dropouts in the metformin arm due to medication side effects versus none in placebo, though metformin users had f

Effect: adverse; 6 MET dropouts for medication side effects vs 0 PBO