Which medications in the drug class Insulin-sensitizing drugs are used in the treatment of Androgen Excess?

Updated: Mar 14, 2018
  • Author: Mohamed Yahya Abdel-Rahman, MD, MSc; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Answer

Insulin-sensitizing drugs

Hyperinsulinemia has been shown to increase ovarian androgen production [95] and decrease SHBG production [96] . Consequently, reducing insulin levels with insulin-sensitizing agents such as metformin should lower total and free androgen levels. However, the effects on hirsutism are not clearly better than if OCs are used; some studies have shown insulin-sensitizing agents to improve hirsutism and others have not. [97, 98, 99, 100] One systematic review and one meta-analysis of 8 trials collectively found no significant difference in hirsutism scores between COCs and metformin. [101, 102] On the other hand, antiandrogen drugs (spironolactone, cyproterone acetate, and flutamide) have been found to significantly reduce hirsutism scores when compared to metformin in a recent meta-analysis. [102]

Metformin (Glucophage, Riomet, Fortamet, Glumetza)

Reduces hepatic glucose output, decreases intestinal absorption of glucose, and increases glucose uptake in the peripheral tissues (muscle and adipocytes). Major drug used in patients who are obese and have type 2 diabetes. Effective in inducing ovulation in PCOS anovulatory women.


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