Hormonal
In nonobese adolescents and young women with PCOS, treatment with flutamide (62.5 mg/d) and metformin (850 mg/d) reverses hyperinsulinemic hyperandrogenism, reduces abdominal fat mass, and increases lean body mass.
For nonobese women with PCOS, combining low-dose flutamide (62.5 mg) and metformin (850 mg) daily at dinner for 9 months can significantly improve body composition by reducing abdominal fat and increasing lean mass, without necessarily changing total body weight. This approach addresses the underlying hormonal and metabolic drivers of PCOS more effectively than oral contraceptive monotherapy.
In girls receiving flutamide-metformin, all abnormal indices reverted toward normal... Over 9 months, body weight did not change detectably in any of the treatment groups; however, body adiposity was reduced strikingly more by low-dose flutamide-metformin than by OC in monotherapy... In comparison to the girls on OC, those on flutamide-metformin lost a mean of approximately 4 kg of fat, and gained approximately 4 kg of lean mass within 9 months.
Why this rating
Randomized controlled trial with clear outcomes, though open-labeled and relatively small sample size (n=32 for teens).
Source
Ethinylestradiol-Drospirenone, Flutamide-Metformin, or Both for Adolescents and Women with Hyperinsulinemic Hyperandrogenism: Opposite Effects on Adipocytokines and Body Adiposity
Lourdes Ibáñez et al. · The Journal of Clinical Endocrinology & Metabolism · 2004
DOI 10.1210/jc.2003-031281
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