Is Metformin Appropriate for Girls at Risk for PCOS?

Metformin (Glucophage) is a drug commonly prescribed to adult women who have polycystic ovarian syndrome. Metformin helps to reduce insulin resistance, which a root cause of polycystic ovarian syndrome. However, metformin does have side effects, including gastrointestinal discomfort and eventual vitamin B12 deficiency.

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Metformin may be OK for adults -- but what about younger females, such as young girls or adolescents?

A Spanish study is suggesting that metformin may be useful for girls 8-12 years of age who have an elevated risk of developing polycystic ovary syndrome later on.

The Spaniards evaluated girls with a history of lower birth weight and early appearance of pubic hair. Girls with these characteristics are thought to have a higher risk of future polycystic ovary syndrome.

A group of 38 girls were followed for 7 years. Some were prescribed metformin when they were 8-12 years old, while others were given metformin between 13-14 years of age.

The researchers wanted to know whether giving metformin earlier (8-12 years old) was more effective than starting it later in life (13-14 years old).

The early metformin therapy was found to prevent or delay the development of hirsutism, male hormone excess, lack of menstruation, and PCOS more effectively than late metformin.

The researchers concluded that the time window of late childhood and early puberty may be more critical for the development, and thus for the prevention, of adolescent PCOS than the first years after the first menstrual cycle.

Essentially they are suggesting the time to prevent or slow down future polycystic ovarian disease is in childhood.

Aren't There Any Alternatives?

However, one might wonder about giving a girl at the tender age of 8 a powerful drug such as metformin. In addition, long-term metformin use is known to induce a vitamin B12 deficiency. Growing girls definitely need adequate vitamin B12.

Other than a drug, what can a girl do?

The obvious answer is a super-healthy diet coupled with lots of exercise. Girls at risk of future PCOS should learn to completely avoid junk foods and convenience foods, no matter what the peer pressure is. They should also avoid all soft drinks and be very minimal with fruit juices. More vegetables!!

Source: Ibanez L et al, Early Metformin Therapy (Age 8-12 Years) in Girls with Precocious Pubarche to Reduce Hirsutism, Androgen Excess, and Oligomenorrhea in Adolescence, J Clin Endocrinol Metab. 2011 Jun 1. [Epub ahead of print]

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