Comparing The Effects of Metformin and Exercise-Based Lifestyle Interventions for Symptom Management of Polycystic Ovary Syndrome (PCOS): A Literature Review

Introduction: Polycystic ovary syndrome (PCOS) is a common hormone problem characterized by androgen excess and typically leads to the development of small cysts in the ovaries, insulin resistance, hirsutism, irregular menstrual cycles, and hyperandrogenism. While there is no cure for PCOS, treatments like metformin and lifestyle modifications work to manage individual symptoms. While studies in the past have compared individual effects of metformin and lifestyle modifications on symptoms of PCOS, a limited number of studies have compared the effects of metformin with lifestyle modifications, specifically aerobic exercise. This review compared the effects of metformin treatment and exercise interventions on metabolic symptoms, such as high blood glucose and insulin levels in PCOS. Methods: A literature search using Pubmed and Google Scholar was conducted. A total of five articles focusing on metformin were included in the review; some focusing inclusively on the drug itself, others comparing lifestyle modifications alone and modifications combined with metformin. In this review, the lifestyle modification was aerobic exercises, taking the form of exercise regimes (walks, marching in place, or supervised fitness sessions). Results: Results show that metformin improves metabolic symptoms, including blood glucose and insulin levels, significantly more than lifestyle interventions alone; however, if both treatments were combined, these effects were more profound. Discussion: Metformin serves as an effective treatment for metabolic and hormonal symptoms, consequently improving PCOS symptomology. Although exercise is shown to be less effective than metformin, the addition of exercise to metformin treatment further ameliorates symptomology. Conclusion: Combining metformin and aerobic exercise demonstrates the greatest impact on managing PCOS symptoms. Future studies should examine the standardization of an aerobic exercise regimen and pharmaceutical treatments for the management of PCOS.