The oral contraceptive pill is more effective than metformin monotherapy for treating hirsutism in women with polycystic ovary syndrome (PCOS) who are overweight, according to an Australian review.

However, the oral contraceptive pill (OCP) or metformin alone are less effective than combining the two treatments for improving hirsutism, says lead author Dr Michael Costello of the University of NSW and Royal Hospital for Women in Sydney.

But some studies have suggested that metformin may be safer and more effective long-term than the pill, Dr Costello and colleagues note in the Cochrane Database of Systematic Reviews.

The team included 44 randomised controlled trials of 2047 adult women (39 trials) and 206 adolescent women (five trials) in their analysis.