Diabetes drug may help women with PCOS ovulate

A drug commonly prescribed to help treat diabetes can also help
improve symptoms of a hormonal disorder that can make women infertile.

The drug rosiglitazone (Avandia) helped women with polycystic ovary
syndrome - which is marked by infertility, acne, excess weight and
excess hair - to ovulate more frequently, said Dr. Nicholas Cataldo,
adjunct clinical instructor of obstetrics and gynecology at Stanford
University and lead author of the study.

The drug also helped improve insulin resistance, another problem
with the disorder, in which the normal amount of insulin secreted by
the pancreas cannot get to cells.

Cataldo presented the findings at the annual meeting of the
Endocrine Society that runs from June 16-19 in New Orleans.

One in 15 women suffer from polycystic ovary syndrome, making it the
most common endocrine disorder of reproductive-aged women in the
United States.

"We picked a particularly insulin-resistant group," said Cataldo.
His team treated 42 women for 12 weeks with either 2 milligrams, 4
or 8 milligrams of the drug.

"What we found is, as expected, the drug improved insulin
resistance," said Cataldo. But it also helped with ovulation
problems. "Fifty-five percent of the women ovulated at least once
during the 12-week study."

"So the good news is, it can be used in an infertility clinic
setting to promote ovulation without going to injectable drugs with
the risk of multiple births," Cataldo said.

Symptoms of PCOS become apparent at or around puberty, and the
symptoms vary greatly in severity. Women may have many symptoms or a
few of them, such as acne, excess hair that grows in a male-like
pattern on the chest, upper lip, chin and other areas, and excess
weight. The ovulatory problems can lead to infertility. And the
insulin resistance boosts the risk of type 2 diabetes. Women with
untreated PCOS also have a higher risk of heart disease.

The idea to use a diabetes drugs to treat PCOS isn't new, Cataldo
said, but rosiglitazone hasn't been studied extensively for PCOS.
Another diabetes drug, metformin (Glucophage), has been found
effective in reducing excess circulating male hormones and promoting
ovulation, but not without side effects such as stomach problems.

In his study, the same side effects weren't reported, Cataldo said.

Dr. Guy Ringler, a reproductive endocrinologist in Los Angeles, and
staff physician at Santa Monica UCLA Medical Center, lauded the new
study. "I think this study is impressive and it shows
[rosiglitazone] is a promising new agent for treatment of women with
PCOS," he said.

"One of the problems with metformin is, it's not well-tolerated,"
Ringler said. "At least half will complain of GI complaints such as
bloating, severe enough that they stop taking the medicine."

Despite the promising findings from the new study, Ringler said, a
lot is yet to be learned.

"What we don't know is, should we be treating every woman with PCOS
long-term with these insulin-sensitizing agents? And the question is
can they prevent the long-term health complications such as
development of type 2 diabetes and cardiovascular complications? And
that has not been shown."

"If we could find a good agent that is safe in correcting some of
the abnormalities and is well-tolerated, perhaps it will have
usefulness in preventing long-term health problems associated with
PCOS," Ringler said.

Dr. Tracey McLaughlin, a clinical instructor in the division of
endocrinology at Stanford University and a co-author of the study,
added that the new research "is showing there is another therapeutic
option of fertility in women with PCOS."

-- Kathleen Doheny, HealthDayNews

Source: Nicholas A. Cataldo, M.D., adjunct clinical instructor of
obstetrics and gynecology, Stanford University Medical Center, Palo
Alto, Calif.; Tracey McLaughlin, M.D., clinical instructor, division
of endocrinology, Stanford University Medical Center, Palo Alto,
Calif.; Guy Ringler, M.D., reproductive endocrinologist, California
Fertility Partners, Los Angeles; June 16, 2004, presentation,
Endocrine Society annual meeting, New Orleans
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