Thiazolidinedines
The alternative insulin sensitisers, the thiazolidinedines (Actos or Pioglitazone and Avandia or Rosiglitazone) have been tested in clinical trials and been found to be effective in the treatment of PCOS. We reserve them for severely recalcitrant patients in view of their potential side effects on liver function. We would then use them in combination with metformin, or instead of metformin in women with who cannot tolerate metformin. They also have a tendency to initially put on weight.