Insulin resistance appears to be the fundamental common pathway to disease amongst women with PCOS. Polycystic ovary syndrome (PCOS) is the commonest endocrinopathy amongst young women, with approximately one in five women having ovaries with a polycystic appearance on ultrasound ( 1) and almost half of those with polycystic ovaries fulfilling the diagnostic criteria for PCOS (see below) ( 2). Keywords: Anovulation hirsutism hyperandrogenism infertility insulin resistance metformin polycystic ovary syndrome (PCOS) randomized controlled trials (RCTs) More research is required to define whether metformin has a role in improving long term health outcomes for women with PCOS, including the prevention of diabetes, cardiovascular disease and endometrial cancer. Limited evidence suggests that metformin may be a suitable alternative to the oral contraceptive pill (OCP) for treating hyperandrogenic symptoms of PCOS including hirsutism and acne. Women with PCOS undergoing in vitro fertilisation should be offered metformin to reduce their risk of ovarian hyperstimulation syndrome.
For clomiphene-resistant women, metformin alone or in combination with clomiphene is an effective next step. Metformin is an effective ovulation induction agent for non-obese women with PCOS and offers some advantages over other first line treatments for anovulatory infertility such as clomiphene. However, in the past two decades, its properties as an insulin sensitising agent have been explored in relation to its applicability for women with PCOS. For decades its use was restricted to management of type 2 diabetes. Metformin is one of the longest established oral insulin sensitising agents. The list also indicates the extent of foreign equity participation in specific investment activities.Abstract: Polycystic ovary syndrome (PCOS) is an endocrinopathy characterised by increased resistance to insulin. 7042, also known as the “Foreign Investments Act of 1991,” which provides for the formulation of a Regular FINL covering investment areas/activities open to foreign investors and/or reserved to Filipino nationals. The foreign investment negative list (FINL) was formulated by virtue of Republic Act (RA) No. 184 issued in 2015, in accordance with the objectives of the order. This move aims to amend the Tenth Regular Foreign Investment Negative List under Executive Order (EO) No. The NEDA Board is likewise directed to immediately advise the President regarding restrictions on foreign participation, which may already be lifted or eased without the need of legislation.
Members of the NEDA Board are called to support legislative efforts that may be necessary to eliminate the said restrictions, including a pending legislation seeking to clarify the definition of public utilities. It likewise calls for the easing of government restriction for culture, production, milling, processing, and trading except retailing, of rice and corn and acquiring by barter, purchase or otherwise, rice, corn, and other by-products.Īpart from promoting the country’s competitiveness, the order seeks to foster higher economic growth in the Association of Southeast Asian Nations (ASEAN) region and beyond through joint endeavors and partnerships with other countries. The memorandum order also covers public services, except activities and systems recognized as public utilities such as transmission and distribution of electricity, water, pipeline distribution system, and sewerage pipeline system. These areas include private recruitment for local and overseas employments practice of particular professions, where allowing foreign participation will redound to the public benefit contracts for the construction and repair of locally-funded public works teaching at higher education levels retail trade enterprises and domestic market enterprises. 16, ordering the concerned agencies to take immediate steps to lift or ease existing restrictions on foreign participation in eight investment areas. In a bid to raise the Philippines’ level of competitiveness, the Palace issued Memorandum Order No. Malacañang on Tuesday, November 21, directed the National Economic and Development Authority (NEDA) Board and its member agencies to “exert utmost efforts” in easing or lifting restrictions on the government’s investment activities that have limited foreign participation.