The use of a combination of metformin and statins in women with polycystic ovary syndrome: a modern view of the problem

The article discusses the effectiveness of the combination of statins and metformin for hyperandrogenism treatment in polycystic ovary syndrome (PCOS). This study aimed to analyze the current scientific data on the effect of the combination of statins and metformin on the clinical and laboratory indicators of hyperandrogenism, ovarian volume, and menstrual cycle regularity and assess their use in the treatment of women with PCOS. Results of retrospective and prospective studies, meta-analyses, and systematic reviews at ClinicalTrials.gov, PROSPERO, among the publications of the International Endocrinological Society, as well as in open electronic databases of scientific literature Google Scholar, PubMed, and Cochrane Library were analyzed. Randomized controlled trials (RCTs), meta-analyses, and systematic reviews that involve women with PCOS who received metformin and statins alone or in combination for androgen level reduction and menstrual cycle regularity improvement were selected. These studies have shown certain effectiveness of statins in reducing the laboratory manifestations of hyperandrogenism. The positive effect of their combination with metformin on insulin resistance and, generally, the high effectiveness of such treatment regimen to reduce laboratory and clinical manifestations of hyperandrogenism in women with PCOS, reduce ovarian volume, and increase menstruation frequency was also demonstrated. Their isolated use cannot be recommended for patients with PCOS due to the possible negative effect of statins on insulin resistance and an increased risk of developing diabetes. Further, given the demonstrated effectiveness of the combination of statins and metformin, further studies should be conducted to determine the dose of drugs and other features of their use.