SynthesisThe Journal of clinical endocrinology and metabolism2024
Metformin and Combined Oral Contraceptive Pills in the Management of Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis.
Synthesis in The Journal of clinical endocrinology and metabolism, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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Who cites it
35 citing papers in PubMed, 56 citations in OpenAlex.
- Trial
- Where are we in the diagnosis and treatment of hirsutism? A narrative review.Reviews in endocrine & metabolic disorders · 2026Review
- Alnustone ameliorates obesity and polycystic ovary syndrome by remodeling adipose metabolism via AMPK signaling.Science China. Life sciences · 2026Article
- Maternal Metformin Exposure Induces Gut Microbial Shifts in Non-Diabetic Dams and Sex-Stratified Changes in Mouse Offspring.Biomolecules · 2026Article
- Long-term ovarian function risks associated with combined oral contraceptive administration in polycystic ovary syndrome: multisource data integration and protective mechanisms of metformin.Journal of translational medicine · 2026Article
- Therapeutic effects of pomegranate hot-water extract via inhibition of apoptosis and oxidative stress in a DHEA-induced mouse model of PCOS.Integrative medicine research · 2026Article
- The central role of hyperandrogenism in driving metabolic dysfunction in polycystic ovary syndrome: from pathophysiological mechanisms to targeted therapies.Journal of ovarian research · 2026Review
- The stromal microenvironment of ovary: a novel area in polycystic ovary syndrome.Journal of ovarian research · 2026Review
- Integrating evidence-based lifestyle and adjunct therapies for long-term management of polycystic ovary syndrome: mechanistic insights and clinical implications.Frontiers in reproductive health · 2026Review
- Exosomes for Polycystic Ovary Syndrome Treatment: Mechanisms and Therapeutic Potential.International journal of nanomedicine · 2026Review
- Gui Shen Wan ameliorates PCOS-like cellular phenotypes by suppressing TNF-α-mediated inflammation and restoring the PI3K/Akt signaling pathway.Frontiers in immunology · 2026Article
- Synergistic therapeutic effects of metformin and curcumin on polycystic ovary syndrome via regulation of insulin resistance and oxidative stress in a rat model.Frontiers in endocrinology · 2026Article
- Remission of polycystic ovary syndrome based on the recovery of ovarian morphology identified by three-dimensional ultrasonography: a retrospective study.Frontiers in endocrinology · 2026Article
- Comparison of live birth rates between calorie-restricted diet and metformin prior to ovulation induction therapy in women with polycystic ovary syndrome and overweight/obesity: a protocol for a multicenter, randomized comparative effectiveness trial.Frontiers in public health · 2026Article
- Biomaterials for Reproductive Restoration: Translating Engineering Innovations.Biomaterials research · 2026Review
- Ketogenic diet combined with probiotics for polyendocrine metabolic ovarian syndrome: research progress from the perspective of the gut microbiota-host metabolic axis.Frontiers in nutrition · 2026Review
- Mechanism of Zuogui pill in the treatment of polycystic ovary syndrome based on LC-MS and proteomics.Journal of ovarian research · 2025Article
- Transcriptomic Profiling Reveals Potential Genes Involved in the Immune Landscape of Polycystic Ovary Syndrome: An Exploratory Study.Reproductive sciences (Thousand Oaks, Calif.) · 2025Article
- Mechanistic insights into the Bushen Huatan Huoxue Formula and its components in ameliorating obesity-associated polycystic ovary syndrome.Chinese medicine · 2025Article
- Pirfenidone reduces ovarian fibrosis and improves PCOS in letrozole-induced rat model.Biomolecules & biomedicine · 2025Article
Corrections and comments
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Authors and funding
11 authors at 8 institutions in 6 countries.
Funding
Abstract
contextPolycystic ovary syndrome (PCOS) affects more than 1 in 10 women.
objectiveAs part of the 2023 International PCOS Guidelines update, comparisons between combined oral contraceptive pills (COCP), metformin, and combination treatment were evaluated. DATA SOURCES: Ovid Medline, Embase, PsycINFO, All EBM, and CINAHL were searched. STUDY SELECTION: Women with PCOS included in randomized controlled trials (RCTs). DATA EXTRACTION: We calculated mean differences and 95% CIs regarding anthropometrics, metabolic, and hyperandrogenic outcomes. Meta-analyses and quality assessment using GRADE were performed. DATA SYNTHESIS: The search identified 1660 publications; 36 RCTs were included. For hirsutism, no differences were seen when comparing metformin vs COCP, nor when comparing COCP vs combination treatment with metformin and COCP. Metformin was inferior on free androgen index (FAI) (7.08; 95% CI 4.81, 9.36), sex hormone binding globulin (SHBG) (-118.61 nmol/L; 95% CI -174.46, -62.75) and testosterone (0.48 nmol/L; 95% CI 0.32, 0.64) compared with COCP. COCP was inferior for FAI (0.58; 95% CI 0.36, 0.80) and SHBG (-16.61 nmol/L; 95% CI -28.51, -4.71) compared with combination treatment, whereas testosterone did not differ. Metformin lowered insulin (-27.12 pmol/L; 95% CI -40.65, -13.59) and triglycerides (-0.15 mmol/L; 95% CI -0.29, -0.01) compared with COCP. COCP was inferior for insulin (17.03 pmol/L; 95% CI 7.79, 26.26) and insulin resistance (0.44; 95% CI 0.17, 0.70) compared with combination treatment.
conclusionsThe choice of metformin or COCP treatment should be based on symptoms, noting some biochemical benefits from combination treatment targeting both major endocrine disturbances seen in PCOS (hyperinsulinemia and hyperandrogenism).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.