Role of metformin in polycystic ovarian syndrome

ABSTRACT

To assess the role of Metformin in Polycystic ovarian syndrome [PCOS]. This interventional, quasi-experimental study was conducted at Department of Obstetrics and Gynaecology, Lady Reading Hospital Peshawar from October 2004 to October 2006. A total of 35 patients with PCOS were included fulfilling Rotterdam Criteria. Metformin was given in a dose of 850 mg twice a day. Patients' reassessment was done clinically on a three monthly basis while laboratory investigations and Transvaginal scan was done after two years. Data was analysed using SPSS v. 16. The mean age of the sample was 27 +/- 5.2 years. Out of 35, 29[82.8%] had primary infertility while 6[17.2%] had secondary and only 7[20%] of those conceived. Menstrual irregularities were present in30[85.7%] patients, 27[55.5%] with oligomenorrhea, 2[5.7%] with amenorrhea and 1[2.86%] with polymenorrhea. Out of these 15, 2 and 1 showed improvement, respectively. Regarding hyperandrogenism,22[62.8%] patients were with hirsutism, 3[9.4%] had acne and 10[28.5%] had hair loss. Out of these 0, 2and 3 improved, respectively. Transvaginal scan showed polycystic ovaries in all patients at baseline while the cysts dissolved in 15[42.8%] patients. Biochemical investigations like Leutinizing Hormone Follicle Stimulating Hormone[LHFSH], Serum Testosterone, Serum Prolactin, Random Blood Sugar[RBS] and Serum Insulin was raised in 32[91.4%], 24[68.5%], 9[25.7%], 3[8.5%] and 10[28.5%] patients respectively and 17[53.1%], 13[54.2%], 4[44.4%], 1[33.3%] and 4[40%] patients improved respectively. Metformin is an effective drug to improve the menstrual irregularities, LHFSH and serum testosterone but it does not show improvement in clinical signs and symptoms of hyperandrogensim