Metformin is an insulin-sensitizing medication and is used for reducing insulin resistance. Insulin resistance seems to be a key feature in polycystic ovarian syndrome. In addition to other hormones, insulin helps regulate ovarian function. When someone is insulin resistant, this means that cells throughout the body do not readily respond to insulin circulating in the blood. For this reason, the amount of insulin remains high in the blood (called hyperinsulinemia). High levels of insulin can contribute to lack of ovulation, high androgen levels, infertility, and early pregnancy loss. Weight reduction, which may be very difficult, is also very important. For those with polycystic ovaries who are overweight, weight loss can reduce insulin resistance, stimulate ovulation, and improve fertility rates.
Other medications used to treat the symptoms of polycystic ovary disease include birth control pills, spironolactone, flutamide, and clomiphene citrate. Treatment with clomiphene induces the pituitary gland to produce more FSH, which in turn stimulates the maturity and release of the ova. Occasionally, more potent ovulation induction agents (fertility drugs, human menopausal gonadotropins) are needed for pregnancy.