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    While combined the oral contraceptive pill and metformin were technically off-label for the treatment of polycystic ovary syndrome, they had a role in managing the condition in both adults and adolescents, Adelaide paediatric endocrinologist Dr Alexia Peña told the audience at RANZCOG’s Annual Scientific Meeting in Adelaide last week. “We do use them because it is evidence-based in other populations and has been allowed [for use in PCOS] in other countries,” Dr Peña, a member of the international consensus group on Adolescent Polycystic Ovary Syndrome, said. When lifestyle changes and the oral contraceptive pill hasn’t been enough to regulate periods, maintain a healthy weight and minimise androgenic symptoms, the experts recommend adult women add metformin, or even use metformin and lifestyle interventions alone to improve metabolic outcomes. “Metformin, in addition to lifestyle, can be recommended for adult women with PCOS for the treatment of weight, hormonal and metabolic outcomes, but also in adolescents with a clear diagnosis of PCOS or with symptoms of PCOS before the diagnosis is made,” she said. A holistic approach was required first and foremost, and pharmacotherapy should only be used alongside education, counselling, lifestyle and other options such cosmetic therapy, the guideline advised. The 166 recommendations in the new International Guidelines for the Assessment and Management of PCOS were developed following input from 37 professional societies and organisations across 71 countries, involving 40 systematic and 20 narrative reviews. These guidelines formally endorse the Rotterdam PCOS diagnostic criteria in adults, which includes oligo- or anovulation, clinical and/or biochemical hyperandrogenism or polycystic ovaries on ultrasound. Polycystic ovary syndrome - Treatment - NHS Metformin - Wikipedia New guidelines on when to use metformin in PCOS • The Medical.
     
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