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July 19, 2007 — Diabetes drugs often prescribed to women with the common hormone disorder polycystic ovary syndrome (PCOS) may not reduce excessive hair growth on their face and body. Researchers from the Mayo Clinic made this conclusion in a study presented at The Endocrine Society's 89th Annual Meeting in Toronto.
Dr. Mihaela Cosma, a third-year endocrine fellow and a researcher with the Knowledge and Encounter Research Unit at Mayo, and her co-workers performed a meta-analysis — a statistical analysis and integration of results — from 16 female hirsutism studies published through May 2006. Hirsutism, or excess hair growth in areas where hair is usually absent, is a common problem in PCOS, as are irregular or absent menstrual periods, infertility, obesity and diabetes. PCOS affects 7 percent of women of childbearing age, according to The Hormone Foundation.
Some women with PCOS receive therapy for fertility problems and diabetes using a group of diabetes medications called insulin sensitizers. These drugs include metformin and thiazolidinediones (TZDs), such as rosiglitazone and pioglitazone.
Dr. Cosma explained that it is unclear whether insulin-sensitizing medications successfully treat hirsutism, because studies have been small and their results have been contradictory. Therefore, the researchers conducted a systematic review of studies that randomly assigned women with hirsutism to at least six months of therapy with insulin sensitizers or a control. Outcomes were an improved score on a commonly used scale for quantifying excessive hair growth in women.
Insulin sensitizers did not provide a significant benefit for hirsutism in these women, according to Cosma. When studies compared metformin with androgen-lowering medications used to help hirsutism (spironolactone and flutamide), the other drugs were better than metformin at reducing excess hair growth.
Most of the published studies, however, were small (20 to 50 subjects) and did not ask women if they thought their hirsutism had improved, Cosma said. She called for larger trials to answer the question of whether insulin sensitizers should be used to treat hirsutism in women with PCOS.