Insulin-lowering medications in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS), one of the most common clinical abnormali ties, is associated with infertility, obesity, and metabolic dysfunction. A significant proportion of obese and lean women with PCOS have greater insu lin resistance than is expected. Resistance is accompanied by a defect in i nsulin secretion, and recent studies have documented a dramatically high ra te of diabetes mellitus and impaired glucose tolerance in this population o f women. Medications that reduce serum insulin levels have been administere d to women with PCOS to study the role of hyperinsulinemia in the pathophys iology and treatment of PCOS. This article presents the evidence for hyperi nsulinemia and insulin resistance in women and reviews the therapeutic repo nse to insulin-lowering agents. Recommendations are made for further resear ch and the use of new agents in the treatment of PCOS.