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.

Keywords: Abnormal uterine bleeding; endometrial histology; endometrial hyperplasia; megestrol; metformin; progesterone.