THE EFFECT OF METFORMIN ON ENDOMETRIAL HYPERPLASIA IN PATIENTS WITH PCOS IN PAKISTANI WOMEN. AN OBSERVATIONAL STUDY.

Abstract

Objective: To compare the effects of metformin therapy in patients with polycystic ovarian syndrome having irregular heavy menstrual cycle and thickened endometrium (hyperplasia) on transvaginal ultrasound
Design: observational study.
Setting: Tertiary care hospitals of Gujranwala, Pakistan.
Patient(s): The study comprised a total of 100 women with PCOS taking the metformin therapy.
Intervention(s): metformin was started initially in low dose (500-100 mg/day)and was adjusted to 1500 mg/day over next 4-6weeks..
Main Outcome Measure(s): endometrial thickness, menstrual cycle regulation
Result(s): The mean age of the studied group was 32.1 ± 5.7 years, mean BMI was 26.3 ± 0.27 kg/m2 and parity ranged from 0 to 2. A significant decrease of BMI of the investigated cases after metformin therapy was observed. A significant decrease of LH level from 9.17 ± 2.84 Miu/ml to 6.18 ± 3.6 Miu/ml and also a significant decrease in fasting insulin level after metformin therapy were also observed. There was a significant decrease of LH/FSH ratio in the studied cases after metformin administration as compared to before therapy. Pretreatment mean endometrial thickness was 23.25mm(SD=3.85)while after treatment with metformin mean endometrial thickness was 18.38mm(SD=3.72). Paired sample t-test was applied for the comparison of pre and post endometrial thickness. A p-value < 0.05 was considered as significant.
Conclusion: Metformin therapy in patients with PCOS restores normal menstrual cycle, induces ovulation and showing decrease in LH level and reduce the endometrial thickness.
Key words: Endometrial hyperplasia, Metformin, Polycystic ovarian syndrome