Metformin in polycystic ovary syndrome: unraveling multi-stage therapeutic mechanisms from puberty to long-term health outcomes

Polycystic ovary syndrome (PCOS) represents a prevalent endocrine disorder affecting reproductive-aged women worldwide, characterized by a variety of reproductive, metabolic, and psychological manifestations. This condition disrupts menstrual cycles and fertility, and significantly compromises quali...

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Main Authors: Weiwei Zeng, Yuning Luo, Juanfeng Ou, Dali Gan, Min Huang, Brian Tomlinson, Yiming Jiang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1654372/full
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author Weiwei Zeng
Yuning Luo
Juanfeng Ou
Dali Gan
Min Huang
Brian Tomlinson
Yiming Jiang
author_facet Weiwei Zeng
Yuning Luo
Juanfeng Ou
Dali Gan
Min Huang
Brian Tomlinson
Yiming Jiang
author_sort Weiwei Zeng
collection DOAJ
description Polycystic ovary syndrome (PCOS) represents a prevalent endocrine disorder affecting reproductive-aged women worldwide, characterized by a variety of reproductive, metabolic, and psychological manifestations. This condition disrupts menstrual cycles and fertility, and significantly compromises quality of life, while increasing the risk of severe health consequences, including cardiovascular diseases and endometrial carcinoma. Although the precise etiology of PCOS remains elusive, genetic and environmental factors are thought to contribute to its pathogenesis. In recent years, the escalating global prevalence of PCOS has been observed, and pharmacological intervention has become the primary treatment approach. Metformin, an insulin sensitizer, has emerged as a valuable treatment option in PCOS management. Multiple studies have suggested that metformin have a positive impact on puberty problems, pregnancy complications, and long-term health outcomes in women with PCOS. However, persistent controversies surround its therapeutic efficacy and underlying molecular mechanisms. This review systematically examines the mechanisms of metformin in ameliorating PCOS-associated infertility, with particular emphasis on its pleiotropic effects across critical life stages—from pubertal development through pregnancy to long-term health outcomes, thereby providing valuable insights into the clinical application of metformin in the treatment of PCOS.
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publishDate 2025-08-01
publisher Frontiers Media S.A.
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spelling doaj-art-2fc2e8c3331945d28b088e1e8a4cb44d2025-08-20T03:07:00ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-08-011610.3389/fphar.2025.16543721654372Metformin in polycystic ovary syndrome: unraveling multi-stage therapeutic mechanisms from puberty to long-term health outcomesWeiwei Zeng0Yuning Luo1Juanfeng Ou2Dali Gan3Min Huang4Brian Tomlinson5Yiming Jiang6Department of Pharmacy, Shenzhen Longgang Second People’s Hospital, Shenzhen, Guangdong, ChinaDepartment of Pharmacy, Shenzhen Longgang Second People’s Hospital, Shenzhen, Guangdong, ChinaDepartment of Pharmacy, Shenzhen Longgang Second People’s Hospital, Shenzhen, Guangdong, ChinaDepartment of Pharmacy, Shenzhen Longgang Second People’s Hospital, Shenzhen, Guangdong, ChinaInstitute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, ChinaFaculty of Medicine, Macau University of Science and Technology, Macau, ChinaSchool of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, ChinaPolycystic ovary syndrome (PCOS) represents a prevalent endocrine disorder affecting reproductive-aged women worldwide, characterized by a variety of reproductive, metabolic, and psychological manifestations. This condition disrupts menstrual cycles and fertility, and significantly compromises quality of life, while increasing the risk of severe health consequences, including cardiovascular diseases and endometrial carcinoma. Although the precise etiology of PCOS remains elusive, genetic and environmental factors are thought to contribute to its pathogenesis. In recent years, the escalating global prevalence of PCOS has been observed, and pharmacological intervention has become the primary treatment approach. Metformin, an insulin sensitizer, has emerged as a valuable treatment option in PCOS management. Multiple studies have suggested that metformin have a positive impact on puberty problems, pregnancy complications, and long-term health outcomes in women with PCOS. However, persistent controversies surround its therapeutic efficacy and underlying molecular mechanisms. This review systematically examines the mechanisms of metformin in ameliorating PCOS-associated infertility, with particular emphasis on its pleiotropic effects across critical life stages—from pubertal development through pregnancy to long-term health outcomes, thereby providing valuable insights into the clinical application of metformin in the treatment of PCOS.https://www.frontiersin.org/articles/10.3389/fphar.2025.1654372/fullmetforminpolycystic ovary syndromeinfertilitymechanismdrug therapy
spellingShingle Weiwei Zeng
Yuning Luo
Juanfeng Ou
Dali Gan
Min Huang
Brian Tomlinson
Yiming Jiang
Metformin in polycystic ovary syndrome: unraveling multi-stage therapeutic mechanisms from puberty to long-term health outcomes
Frontiers in Pharmacology
metformin
polycystic ovary syndrome
infertility
mechanism
drug therapy
title Metformin in polycystic ovary syndrome: unraveling multi-stage therapeutic mechanisms from puberty to long-term health outcomes
title_full Metformin in polycystic ovary syndrome: unraveling multi-stage therapeutic mechanisms from puberty to long-term health outcomes
title_fullStr Metformin in polycystic ovary syndrome: unraveling multi-stage therapeutic mechanisms from puberty to long-term health outcomes
title_full_unstemmed Metformin in polycystic ovary syndrome: unraveling multi-stage therapeutic mechanisms from puberty to long-term health outcomes
title_short Metformin in polycystic ovary syndrome: unraveling multi-stage therapeutic mechanisms from puberty to long-term health outcomes
title_sort metformin in polycystic ovary syndrome unraveling multi stage therapeutic mechanisms from puberty to long term health outcomes
topic metformin
polycystic ovary syndrome
infertility
mechanism
drug therapy
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1654372/full
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