Physiological Effects of Metformin on Hirsuitism, Ovarian Volume and Insulin Resistance in Patients With PCOS
Background: Polycystic Ovary Syndrome (PCOS) commonly encountered by gynaecologist, is reflected by menstrual irregularity, infertility, hirsutism, increased androgen levels and insulin resistance. Use of metformin can significantly affect the outcome in these patients.
Objectives: This Study demonstrates the effect of metformin on hirsutism, ovarian volume and insulin resistance in females having PCOS.
Methods: 40 women with PCOS were included. Women with chronic oligomenorrhea or amenorrhea, hirsutism and classic look of polycystic ovaries on ultrasound were labelled PCOS according to ESHRE guidelines. Those taking other medication and not agreed for next visit were excluded and then randomly grouped into two. After history and examination anthropometric measurements and hirsutism assessment was done. Base line Investigations including blood for fasting glucose, insulin levels and pelvic ultrasounds were done. The intervention group and placebo took metformin and placebo tablets respectively for 3 months at the end of which clinical assessment and investigations were done.
Results: Hirsutism dropped from 12.5% to 7.5% in metformin group at post intervention (p < 0.05). The mean volume of right ovary reduced significantly in the group taking metformin vs. placebo (p < 0.05). The mean insulin levels fell from baseline of 17.1 IU/l to 14.1 IU/l in metformin group. The mean level of glucose in fasting state did not change in the metformin intervention group. On the other hand, the level of glucose in fasting state increased from baseline of 100.6 (mg/dl) to 105.6 (mg/ dl) at post intervention in placebo group trending towards statistical significance (p = 0.06).
Conclusion: Metformin significantly reduced hirsutism, ovarian volume and insulin resistance in females with polycystic ovary disease.
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