A comparison between the effects of metformin and megestrol on simple endometrial hyperplasia

Abstract

Introduction: Endometrial hyperplasia is one of the most serious causes of severe abnormal bleeding and also can be a precursor of endometrial carcinoma.

Objective: The purpose of the present study was to compare the effects of metformin and megestrol on the endometrial hyperplasia.

Methods: The study was performed as a randomized clinical trial on 42 cases of histopathologically confirmed simple endometrial hyperplasia without atypia. The eligible women were randomly assigned into two groups. In metformin group, metformin was prescribed, 500 mg twice a day (1000 mg daily), for a duration of 4 weeks, and then, followed by 1500 mg daily, for 8 more weeks. In the megestrol group, megestrol was prescribed 40 mg daily for 12 weeks. At the end of the duration of the treatment, endometrial sampling was performed and the results were compared between the two groups.

Results: The women of the two groups did not have significant difference according to age, BMI and gravidity, parity and history of abortion. Overall, 18 women (81.8%) in metformin group and 12 women (60%) in the megestrol group had normal endometrial histology, after 12 weeks of treatment (p = 0.11).

Conclusion: Metformin is comparable with megestrol for the treatment of simple endometrial hyperplasia.

Chinese abstract

前言: 子宫内膜增生是子宫异常出血最重要的原因之一, 也是子宫内膜癌的癌前病变。

目的: 本研究的目的是比较二甲双胍和甲地孕酮对子宫内膜增生的疗效。

方法: 本研究是一项基于42例病理组织学确诊为无异型性的单纯子宫内膜增生的随机临床试验。将符合条件的受试者随机分为两组。在二甲双胍组中, 二甲双胍口服剂量为500mg, 每日两次 (每日1000mg) , 持续4周, 然后每日1500mg, 再持续8周。在甲地孕酮组中, 甲地孕酮口服剂量为每日40mg, 持续12周。在治疗结束时, 进行子宫内膜取样, 并比较两组结果。

结果: 两组女性在年龄、体重指数、妊娠次数、分娩次数和流产史方面不存在显著差异。总体而言, 经过12周的治疗后 (p = 0.11) , 二甲双胍组中的18名女性 (81.8％) 和甲地孕酮组中的12名女性 (60％) 的子宫内膜均恢复正常的组织学结构。

结论: 治疗单纯子宫内膜增生, 二甲双胍与甲地孕酮疗效相当。

Keywords:

• Abnormal uterine bleeding
• endometrial histology
• endometrial hyperplasia
• megestrol
• metformin
• progesterone

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.