Diabetes Drug Shows Promise for Ovary Syndrome
Thu Jun 17, 3:35 PM ET
By Anthony J. Brown, MD
NEW YORK (Reuters Health) – Women with a condition called polycystic ovary syndrome (PCOS) suffer from hormonal irregularities that can cause ovulation problems, excess hair, acne and reduced response to insulin that makes them prone to diabetes. Now, researchers have found that a drug used to treat diabetes seems to help.
Treatment with Avandia improved ovulation and insulin sensitivity in women with PCOS and insulin resistance, according to findings presented at the annual meeting of The Endocrine Society in New Orleans.
However, researchers say, further studies are needed to clarify whether Avandia is useful for PCOS patients without insulin resistance.
About 5 to 10 percent of women have PCOS. The underlying problem is an excess of male hormones, or androgens. Insulin resistance leads to elevated levels of insulin, which stimulates androgen release, making the problem worse. Therefore, insulin-sensitizing agents like Avandia could, in theory, improve the symptoms of PCOS, by promoting a drop in insulin levels.
“Over 20 years ago, the association between PCOS and insulin resistance was unearthed,” Dr. Nicholas Cataldo, from Stanford University in California, told Reuters Health. “About 10 years ago, people started using metformin to treat women with PCOS.”
Metformin, an older type of insulin sensitizer, proved to be an effective treatment for PCOS, but “many women experience gastrointestinal side effects, such as diarrhea, nausea, and loss of appetite,” Cataldo said. “So, it has not been an ideal agent.”
This led Cataldo’s group to try the newest insulin sensitizer, Avandia (known technically as rosiglitazone), which was approved for treating type 2 diabetes in 1999.
In a study, 42 women with PCOS and insulin resistance were randomly assigned to take one of three doses of Avandia for 12 weeks.
“As expected, treatment with rosiglitazone improved their insulin resistance and reduced their insulin levels, an effect that was most pronounced with the highest dose,” Cataldo said.
“On the reproductive side, we were happy to see that 55 percent of the women ovulated at least once during the 12-week period. Untreated, these women would probably ovulate just once or twice a year,” the researcher explained.
In addition, Avandia was well tolerated and did not produce the troubling gastrointestinal side effects often seen with metformin, he added.
Because rosiglitazone is limited in its ability to reduce androgen levels, Cataldo said he does not think the drug is suitable to be taken on a continuous basis for treating other PCOS-related problems like excess hair. Rather, “I see the drug being used on a short-term basis as a means to promote ovulation,” he said.