Rosiglitazone (Avandia) therapy may improve ovulation and insulin sensitivity in women with polycystic ovary syndrome and insulin resistance, according to a new study.
Insulin resistance, a common finding in PCOS women, leads to elevated levels of insulin, which stimulates androgen release, making the problem worse. Therefore, by promoting a drop in insulin levels, insulin-sensitizing agents may improve the symptoms of PCOS.
For many years, metformin (Glucophage) has been used to treat insulin resistance associated with polycystic ovarian syndrome. However, many women experience gastrointestinal side effects such as diarrhea, nausea, and loss of appetite.
Rosiglitazone is not to be confused with troglitazone, an insulin sensitizer approved for use in 1997, which was studied briefly as a treatment for PCOS before it was taken off the market in 2000 after being linked to rare but serious liver side effects..
In this study, 42 women with PCOS and insulin resistance were randomized to receive one of three rosiglitazone doses for 12 weeks. Treatment with rosiglitazone improved their insulin resistance and reduced their insulin levels. Those receiving the highest dose has the best effect. 55% of the women ovulated at least once during the 12-week period.
In addition, rosiglitazone was well tolerated and did not produce the troubling gastrointestinal side effects often seen with metformin.
Because rosiglitazone is limited in its ability to reduce androgen (male hormone) levels, the lead author of the study said he does not envision the drug being taken on a continuous basis for problems like hirsutism. Rather, he sees the drug being used on a short-term basis as a means to promote ovulation.
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Findings were presented in June 2004 at the 86th annual meeting of The Endocrine Society.
Cataldo, NA et al, Improvement in insulin sensitivity followed by ovulation and pregnancy in a woman with polycystic ovary syndrome who was treated with rosiglitazone, Fertil Steril. 2001 Nov;76(5):1057-9
