Effects of metformin and compound cyproterone acetate on patients with polycystic ovarian syndrome

Objective: To study the clinical and endocrinologic effects of Metformin and compound cyproterone acetate (CPA, Schering AG, Germany) on patients with polycystic ovarian syndrome (PCOS).Design: A prospect and randomized studyMaterials and Methods: Our study involved total 65 patients, 45 PCOS patents and 20 non-PCOS infertility patients. Forty-five PCOS patients were randomly assigned to three groups (A1, A2, and A3) and the non-PCOS patients were as control (B). Complete baseline work-up including body mass index (BMI), waist: hip ratio (WHR), Ferriman-Gallwey score (FGS), serum inhibin B, LH, free testosterone (T), sex hormone binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), fasting glucose (FG) and insulin (FI), FG/FI ratio, glucose tolerance test (GTT), were performed in all patients. Patients in groups A1, A2, and A3, were treated with CPA alone, metformin alone, or combination of CPA with Metformin, respectively. At the end of 12-week therapy, all patients were re-evaluated and above parameters were measured.Results: Compare with the control group (B), all three A groups had significant higher baseline BMI, WHR, FGS, LH, T, and FI (P<0.01). No significant difference among A1, A2, and A3 were found (P>0.05). Every patients in group A1 and A3 achieved regular menses following the treatment, but only 4/15 (27%) in group A2 had regular menses after the therapy. In addition, FT and DHEAS were significantly decreased in all treatment groups (P<0.05). Most importantly, decreased LH and increased SHBG were observed in both A1 and A3 (P<0.001). Although some improvement of FI and FG/FI ratio was noticed in A3, the difference was not statistically significant (P>0.05). Inhibin B levels were not altered following these treatments.Conclusion: The patients treated with CPA alone or combination with Metformin had improved menses and androgen profiles. The combination therapy may further suppress the hyperandrogenaemia and improve insulin sensitivity. Objective: To study the clinical and endocrinologic effects of Metformin and compound cyproterone acetate (CPA, Schering AG, Germany) on patients with polycystic ovarian syndrome (PCOS). Design: A prospect and randomized study Materials and Methods: Our study involved total 65 patients, 45 PCOS patents and 20 non-PCOS infertility patients. Forty-five PCOS patients were randomly assigned to three groups (A1, A2, and A3) and the non-PCOS patients were as control (B). Complete baseline work-up including body mass index (BMI), waist: hip ratio (WHR), Ferriman-Gallwey score (FGS), serum inhibin B, LH, free testosterone (T), sex hormone binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), fasting glucose (FG) and insulin (FI), FG/FI ratio, glucose tolerance test (GTT), were performed in all patients. Patients in groups A1, A2, and A3, were treated with CPA alone, metformin alone, or combination of CPA with Metformin, respectively. At the end of 12-week therapy, all patients were re-evaluated and above parameters were measured. Results: Compare with the control group (B), all three A groups had significant higher baseline BMI, WHR, FGS, LH, T, and FI (P<0.01). No significant difference among A1, A2, and A3 were found (P>0.05). Every patients in group A1 and A3 achieved regular menses following the treatment, but only 4/15 (27%) in group A2 had regular menses after the therapy. In addition, FT and DHEAS were significantly decreased in all treatment groups (P<0.05). Most importantly, decreased LH and increased SHBG were observed in both A1 and A3 (P<0.001). Although some improvement of FI and FG/FI ratio was noticed in A3, the difference was not statistically significant (P>0.05). Inhibin B levels were not altered following these treatments. Conclusion: The patients treated with CPA alone or combination with Metformin had improved menses and androgen profiles. The combination therapy may further suppress the hyperandrogenaemia and improve insulin sensitivity.