Effects of Pioglitazone on Menstrual Frequency, Hyperandrogenism and Insulin Resistance in Adoloscents and Young Adults with Polycystic Ovary Syndrome

Abstract 

Study Objective

To study the clinical, metabolic and adverse effects of pioglitazone over a period of 6 months in obese adolescent and young adults with polycystic ovary syndrome.

Design

This was an open labeled study. Each patient served as her own control.

Setting

Outpatient department of a university affiliated teaching hospital.

Participants

Unmarried women (age 15–25 yrs) with chronic anovulatory cycles and obesity, and with clinical evidence of hyperandrogenism.

Interventions

Pioglitazone at a dose of 30 mg once daily for a period of 6 months along with dietary advice and exercise.

Main Outcome Measures

Resumption of normal menstrual cycles, clinical improvement in hyperandrogenism and changes in insulin resistance measured by fasting glucose insulin ratios.

Results

Twenty-two women were enrolled. At the end of the study period 91% of the subjects had regularization of menstrual cycles. There was no change in the modified Ferriman-Gallwey hirsutism scores. Decline in fasting insulin levels at the end of the study was 45.6% from baseline along with significant increase in the fasting glucose/insulin ratio from baseline.

Conclusion

Administration of pioglitazone for 6 months along with advice about diet and physical activity in obese adolescents and young adult women with polycystic ovary syndrome results in significant improvements in menstrual frequency. There is a significant improvement in insulin resistance using the G/I ratio (<7.5 mg/10⁻⁴ U) as the biochemical marker.

Key Words: Polycystic ovary syndrome, Adolescents, Young adults, Pioglitazone, Fasting glucose insulin ratio