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This is a combination therapy consisting of an oral contraceptive (typically a combined estrogen-progestin pill) and an insulin sensitizer (most commonly metformin, but sometimes other agents such as pioglitazone). This regimen is primarily used in the management of polycystic ovary syndrome (PCOS) in women not seeking fertility. Oral contraceptives act by suppressing pituitary luteinizing hormone secretion, reducing ovarian androgen production, and preventing endometrial hyperplasia. Insulin sensitizers improve peripheral glucose uptake and reduce hepatic glucose production, thereby addressing the metabolic disturbances associated with PCOS. The combination aims to target both hyperandrogenism and insulin resistance—two key pathophysiological features of PCOS—offering benefits for menstrual regularity, androgen excess symptoms (such as hirsutism), metabolic profile (including fasting glucose/insulin levels), and endometrial protection[1][3][4][7]. Evidence suggests that this combination may be more effective than either agent alone for certain clinical outcomes in PCOS.
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