Materials and Methods: In a pre- and post-interventional study, 31 patients with abnormal uterine bleeding (AUB) were participated to receive 5 mg letrozole and 500 mg metformin daily for 3 months after pathology report of disordered proliferative endometrium. The effect of this combination therapy on endometrial histology was evaluated through comparing the endometrial histology results before and after the intervention.

Results: After treatment with letrozole and metformin, 77.4% of patients showed significant response to therapy in the form of inactive and atrophic endometrium (P < 0.001). The clinical response to treatment was observed in 18 (58.1%) women as complete relief from bleeding and decreased hemorrhage in 6 (19.4%) women.

Conclusions: Based on the results of this study, letrozole and metformin can be successfully used for treatment of disordered proliferative endometrium. Hence, the effects of these medications deserve to be noticed for careful treatment of the patients with AUB.