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REVIEW article

Front. Pharmacol.

Sec. Pharmacoepidemiology

Volume 16 - 2025 | doi: 10.3389/fphar.2025.1654372

Metformin in Polycystic Ovary Syndrome: Unraveling Multi-Stage Therapeutic Mechanisms from Puberty to Long-Term Health Outcomes

Provisionally accepted
  • 1Shenzhen Longgang Second People’s Hospital, Shenzhen, China
  • 2Sun Yat-Sen University, Guangzhou, China
  • 3Macau University of Science and Technology, Taipa, Macao, SAR China

The final, formatted version of the article will be published soon.

Polycystic ovary syndrome (PCOS) represents a prevalent endocrine disorder affecting reproductiveaged 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 stagesfrom pubertal development through pregnancy to long-term health outcomes, thereby providing valuable insights into the clinical application of metformin in the treatment of PCOS.

Keywords: Metformin, Polycystic Ovary Syndrome, Infertility, Mechanism, Drug Therapy

Received: 26 Jun 2025; Accepted: 05 Aug 2025.

Copyright: © 2025 Zeng, Luo, Ou, Gan, Huang, Tomlinson and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Brian Tomlinson, Macau University of Science and Technology, Taipa, Macao, SAR China
Yiming Jiang, Sun Yat-Sen University, Guangzhou, China

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