Comparison of spironolactone and spironolactone plus metformin in the treatment of polycystic ovary syndrome

Abstract

The aim of this study was to evaluate and compare the effects of spironolactone and spironolactone plus metformin treatments on body mass index (BMI), hirsutism score, hormone levels, and insulin resistance in women with polycystic ovary syndrome (PCOS). Thirty-seven patients with PCOS were randomly assigned to receive spironolactone 100 mg/d (spironolactone group, 18 patients) or spironolactone 100 mg/d plus metformin 2000 mg/d (combination group, 19 patients) for 12 months. BMI, modified Ferriman–Gallway score (FGS), serum levels of regarding hormones, and homeostasis model assessment of insulin resistance (HOMA-IR) index were assessed before and after the treatments. Six patients in the spironolactone group and four patients in the combination group reported inter-menstrual vaginal bleeding during treatments. In hirsutism scores, the spironolactone therapy resulted in 25.2% reduction, while combination therapy resulted in 28.3% reduction (p > 0.05, between groups). When the groups were compared in terms of percent changes in BMI, FGS, HOMA-IR, and hormone values other than free testosterone, no significant difference was noted. In the present study, FGSs were significantly decreased in both groups; however, combination therapy was not more effective than spironolactone alone in terms of BMI, FGS, hormone levels, or insulin resistance.

Chinese abstract

本研究的目的为评估和比较螺内酯治疗和螺内酯-二甲双胍联合治疗对多囊卵巢综合征(PCOS)患者体质指数(BMI)，多毛评分，激素水平和胰岛素抵抗的影响。 37名PCOS患者被随机分配至接受螺内酯100 mg/d（螺内酯组，18位患者）或螺内酯100 mg/d加二甲双胍2000 mg/d（联合组，19位患者）共12月。在治疗前和治疗结束后分别对BMI，改良的Ferriman–Gallway评分（FGS），血清相关激素水平，稳态模型胰岛素抵抗指数(HOMA-IR)进行评估。螺内酯组中的六位患者和联合治疗组的四名患者报告在治疗期间出现了经期间阴道出血。螺内酯组在多毛评分方面减少了25.2%，而联合治疗减少28.3% (p>0.05，组间)。根据百分比变化比较组间差异时，除游离睾酮水平外，BMI, FGS, HOMA-IR和其他激素水平均无显著差异。根据目前研究，各组治疗后多毛评分（FGSs）均显著降低；然而，联合治疗组在BMI，FGS，激素水平和胰岛素抵抗方面并不比螺内酯单独治疗更加有效。

• Metformin
• PCOS
• spironolactone
• treatment

Declaration of interest

The authors report no conflicts of interest.