Efficacy of Metformin and Combination of Metformin and Myo-Inositol on Clinical and Hormonal Profile of Polycystic Ovarian Disease Patient
DOI:
https://doi.org/10.70749/ijbr.v3i3.933Keywords:
Polycystic Ovary Syndrome (PCOS), Metformin, Myo-Inositol, Insulin ResistanceAbstract
Background: The widespread endocrine condition known as polycystic ovarian syndrome (PCOS) is typified by hyperandrogenism, insulin resistance, and reproductive failure. Metformin, a commonly used insulin sensitizer, has showed benefits in controlling PCOS but is often linked with gastrointestinal adverse effects. Another insulin-sensitizing drug that has drawn interest is myo-inositol because of its superior tolerability and comparable effectiveness. The purpose of this study is to compare the clinical and hormonal effects of metformin monotherapy against myo-inositol combination treatment in patients with PCOS. Methods: At a Combined Military Hospital CMH, Lahore, 150 women with PCOS diagnoses based on the Rotterdam criteria were enrolled. Subjects were randomized to either the combination therapy group (metformin + myo-inositol, n = 75) or the metformin monotherapy group (n = 75). Pregnancy outcomes, ovulation rates, hormonal profiles, metabolic indicators, and clinical parameters were evaluated both before and after treatment. Additionally, adverse consequences were noted. Results: Combination therapy produced better results in raising SHBG levels and decreasing BMI, fasting insulin, HOMA-IR, and total testosterone levels. The combination group saw higher rates of ovulation (78% vs. 65%), menstrual regularity (85% vs. 72%), and pregnancy (30% vs. 22%) than the metformin monotherapy group. The combined medication group saw considerably less gastrointestinal side effects, which improved patient adherence. Conclusion: In PCOS patients, metformin and myo-inositol work better together to improve metabolic, hormonal, and reproductive results while lowering side effects. According to these results, combined medication might be a better and more palatable option for treating PCOS than metformin by itself.
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References
Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19:41–47. https://doi.org/10.1093/humrep/deh098
Goodarzi MO, Korenman SG. The importance of insulin resistance in polycystic ovary syndrome. Fertil Steril. 2003;80:255–258. https://doi.org/10.1016/s0015-0282(03)00734-9
Franks S, Stark J, Hardy K. Follicle dynamics and anovulation in polycystic ovary syndrome. Hum Reprod Update. 2008;14:367–378. https://doi.org/10.1093/humupd/dmn015
Kahn BB, Flier JS. Obesity and insulin resistance. J Clin Invest. 2000; 106:473–481. https://doi.org/10.1172/jci10842
Kirpichnikov D, McFarlane SI, Sowers JR. Metformin: an update. Ann Intern Med. 2002;137:25–33. https://doi.org/10.7326/0003-4819-137-1-200207020-00009
Bargiota A, Diamanti-Kandarakis E. The effects of old, new and emerging medicines on metabolic aberrations in PCOS. Ther Adv Endocrinol Endocrinol. 2012;3:27–47. https://doi.org/10.1177/2042018812437355
Baptiste CG, Battista M-C, Trottier A, Baillargeon J-P. Insulin and hyperandrogenism in women with polycystic ovary syndrome. J Steroid Biochem Mol Biol 2010; 122: 42-52. https://doi.org/10.1016/j.jsbmb.2009.12.010
Copeland, W. E., Keeler, G., Angold, A., & Costello, E. J. (2007). Traumatic events and posttraumatic stress in childhood. Archives of general psychiatry, 64(5), 577-584. https://doi.org/10.1001/archpsyc.64.5.577
Fleming, R., Hopkinson, Z. E., Wallace, A. M., Greer, I. A., & Sattar, N. (2002). Ovarian function and metabolic factors in women with oligomenorrhea treated with metformin in a randomized double blind placebo-controlled trial. The Journal of Clinical Endocrinology & Metabolism, 87(2), 569-574. https://doi.org/10.1210/jcem.87.2.8261
Fulghesu AM, Romualdi D, Di Florio C, et al. Is there a dose–res ponse relationship of metformin treatment in patients with polycystic ovary syndrome? Results from a multicentric study. Hum Reprod. 2012;27:3057–3066. https://doi.org/10.1093/humrep/des262
Genazzani AD. Inositol as putative integrative treatment for PCOS. Reprod Biomed Online 2016; 33: 770-780. https://doi.org/10.1016/j.rbmo.2016.08.024
Palomba S, Falbo A, Zullo F, et al. Evidence-based and potential benefits of metformin in the polycystic ovary syndrome: a comprehensive review. Endocr Rev. 2009;30:1–50. https://doi.org/10.1210/er.2008-0030
Palomba S, Falbo A, Zullo F, Orio Jr F. Evidence-based and potential benefits of metformin in the polycystic ovary syndrome: a comprehensive review. Endocr Rev 2008; 30: 1-50. https://doi.org/10.1210/er.2008-0030
Teede H, Deeks A, Moran L. Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med 2010; 8: 41. https://doi.org/10.1186/1741-7015-8-41
Tso LO, Costello MF, Albuquerque LET, Andrio lo RB, Marjoribanks J, MacEdo CR. Metformin treatment before and during in vitro fertilization or intracytoplasmic sperm injection in women with polycystic ovary syndrome: Summary of a Cochrane review. Fertil Steril 2015; 104: 542-544. https://doi.org/10.1016/j.fertnstert.2015.05.038
Unfer V, Facchinetti F, Orru B, et al. Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocr Connect. 2017;6:647–658. https://doi.org/10.1530/ec-17-0243
Unfer V, Nestler JE, Kamenov ZA, et al. Effects of inositol(s) in women with PCOS: a systematic review of randomized controlled tri als. Int J Endocrinol. 2016;2016:1. https://doi.org/10.1155/2016/1849162
Facchinetti, F., Bizzarri, M., Benvenga, S., D'Anna, R., Lanzone, A., Soulage, C., ... & Unfer, V. (2020). Results from the international consensus conference on myo-inositol and D-chiro-inositol in obstetrics and gynecology: The link between metabolic syndrome and PCOS. European Journal of Obstetrics & Gynecology and Reproductive Biology, 247, 173-178. https://doi.org/10.1016/j.ejogrb.2015.09.024
Giordano, D., Corrado, F., Santamaria, A., Quattrone, S., Pintaudi, B., Di Benedetto, A., & D'Anna, R. (2019). Effects of myo-inositol supplementation in postmenopausal women with metabolic syndrome. Menopause, 26(2), 295-299. https://doi.org/10.1097/gme.0b013e3181e8e1b1
Zheng X, Lin D, Zhang Y, Lin Y, Song J, Li S, Sun Y. Inositol supplement improves clinical pregnancy rate in infertile women undergoing ovulation induction for ICSI or IVF-ET. Med 2017; 96: e8842. https://doi.org/10.1097/md.0000000000008842
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