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Alternatives to Metformin for Patients with PCOS.

Compared with placebo, thiazolidinediones (TZDs) decrease systolic blood pressure and fasting blood glucose and insulin levels while improving menstrual irregularities in women with PCOS. Metformin and TZDs have similar effects on pregnancy rates, ovulation, and menstrual frequency, but TZDs can cause weight gain and lower free testosterone and dehydroepiandrosterone (DHEA) levels to a greater degree, whereas metformin reduces body mass index (BMI) and serum triglyceride levels to a greater degree.