|The Effect of Combination of Metformin and Megestrol Acetate with Megestrol Acetate Alone on Endometrial Growth Disorders|
|Manizheh Sayyah- Melli, Sanam Pourazad, Parvin Mostafa Gharebaghi, Elaheh Ouladsahebmadarek, Mehri Jafari-Shobeiri, Vahideh Rahmani|
|Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran|
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Keywords : Endometrial hyperplasia, endometrial proliferative disorders, metformin, megestrol acetate
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Objectives: Endometrial hyperplasia has an affinity for progression toward endometrial carcinoma. This study was conducted to compare the effect of metformin plus megestrol acetate with megestrol acetate alone on endometrial histology in patients with endometrial proliferative and hyperplastic disorders.
Materials and Method: In a single blinded clinical trial study, 96 patients with abnormal uterine bleeding and endometrium with irregular or hyperplastic glands with or without atypical foundations were categorized randomly in two equal groups. Group1 received metformin 500 mg twice a day plus megestrol acetate 40 mg daily for 3 months and group 2 received megestrol acetate 40 mg per day for 3 months. The treatment response was evaluated using pathologic samples of endometrial biopsies 2 weeks after discontinuing the treatment.
Results: In both groups, endometrial hyperplasia was resolved in most cases. Significant decrease was shown within groups in the endometrial thickness before and after the intervention. Comparison of thickness between two groups showed that after intervention megestrol acetate group revealed significant decrease in the endometrial thickness [12.73 ± 6.04 mm (group 1), versus 8.55 ± 3.43 mm (group 2), p<0.001]. Lack of response to treatment was seen in 7% of group 1 and 4.9% of group 2 (p=0.68). None of the groups showed any complications and there was no hysterectomy.
Conclusion: Both treatment modalities were effective in treating proliferative and hyperplastic disorders. However, the response to treatment in the megestrol group was greater than the megestrol plus metformin group.
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