Hormonal
Combining metformin with lifestyle modification (diet and exercise) results in significantly greater reductions in BMI and subcutaneous adipose tissue, and increases menstrual cycle frequency, compared to lifestyle modification alone in women with PCOS over 6 months.
If you have PCOS, combining metformin with lifestyle changes (diet and exercise) leads to better weight loss and more regular periods than lifestyle changes alone. However, metformin by itself does not help with weight loss compared to lifestyle changes. The benefit of adding metformin is primarily seen in weight management and menstrual regulation, not necessarily in improving blood sugar or lipid markers beyond what lifestyle changes achieve.
Lifestyle + metformin were associated with lower BMI (mean difference (MD) 20.73 kg/m2, 95% confidence intervals (CI) 21.14, 20.32, P ¼ 0.0005) and subcutaneous adipose tissue (MD 292.49 cm2, 95% CI 2164.14, 220.84, P ¼ 0.01) and increased number of menstrual cycles (MD 1.06, 95% CI 0.30, 1.82, P ¼ 0.006) after 6 months compared with lifestyle + placebo.
Why this rating
Meta-analysis of 12 RCTs, but studies had small sample sizes, short durations, and varying risk of bias.
Source
Metformin and lifestyle modification in polycystic ovary syndrome: systematic review and meta-analysis
Negar Naderpoor et al. · Human Reproduction Update · 2015
DOI 10.1093/humupd/dmv025
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