THE EFFECT OF METFORMIN ON ENDOMETRIAL HYPERPLASIA IN PATIENTS WITH POLYCYSTIC OVARIAN SYNDROME (PCOS)
Metformin in Endometrial Hyperplasia in PCOS
Keywords:Endometrial hyperplasia, Metformin, Polycystic ovarian syndrome
Objective: To study the effect of metformin therapy in patients with polycystic ovarian syndrome having irregular heavy menstrual cycle and thickened endometrium (hyperplasia) on transvaginal ultrasound.
Study Design: Quasi – experimental study.
Place and Duration of Study: The study was conducted in Military Hospital Rawalpindi, department of gynae / obs unit- I from January 2009 – June 2010.
Patients and Methods: A total of 100 patients in the age group of 40-47 years who reported to gynae OPD with irregular heavy menstrual cycles with or without clinical features of hyperandrogenism were selected and informed consent was taken. Transvaginal ultrasound (TVS) was performed on them by the same operator and those who had polycystic ovaries (enlarged ovaries with > 8-9 follicles peripherally enlarged) and endometrial thickness > 12 mm in the follicular phase of the cycle were selected. Total 100 patients were included in the study, but 10 patients were dropped out. Metformin was started after explaining the purpose of the study initially in low dose (500-1000 mg/day) and was adjusted to 1500 mg/day over next 4-6 weeks. Patients with abnormal liver or renal functions and those already taking hormonal therapy or on tamoxifen were excluded from the study. The endometrial thickness was assessed on monthly follow up visits and final findings were recorded and presented at the end of one year.
Results: Of 90 patients, mean age of patients was 43.25 years (SD = 1.91), mean pretreatment endometrial thickness was 20.25 mm (SD= 4.85) mean and post treatment endometrial thickness was 16.38mm (SD = 4.72). There was a significant reduction in endometrial thickness after treatment with metformin.
Conclusion: Metformin therapy (1500 mg/day) significantly reduces endometrial thickness (hyperplasia) in patients with PCOS.