Effects of pioglitazone on menstrual frequency, hyperandrogenism and insulin resistance in adoloscents and young adults with polycystic ovary syndrome.

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.