title: Comparison of efficacy of metformin and oral contraceptive combination of ethinyl estradiol and drospirenone in polycystic ovary syndrome.
abstract: OBJECTIVE
  The 2013 Endocrine Society guidelines state that hormonal contraceptives should be used for treating both menstrual irregularity and hirsutism in patients with polycystic ovary syndrome (PCOS). Metformin should be reserved for the treatment of women presenting with only menstrual irregularity because it has limited benefits in treating hyperandrogenism associated with PCOS. A high prevalence of insulin resistance is noted among the South Asians, and these guidelines may not hold good for this population. Thus, this study was conducted to investigate and compare the effects of metformin and an oral contraceptive containing drospirenone on menstrual pattern, body mass index, serum testosterone levels, and dehydroepiandrosterone sulfate (DHEAS) levels at baseline to 6 months of therapy in the treatment groups.
  
  
  METHODS
  This was a prospective observational study that was conducted over a year in patients visiting the Endocrinology outpatient department at a tertiary care center in a south Indian city. Forty-six subjects diagnosed with PCOS as per the Rotterdam criteria were included. They received either metformin twice daily or an oral contraceptive containing drospirenone once daily as a monthly regimen for 6 months.
  
  
  RESULTS
  Metformin regularized menstrual cycles in 72% of patients who were followed up at 6 months. No significant difference was observed between the two treatment groups with respect to decreasing the body mass index, serum testosterone levels, and DHEAS levels (p=0.40, p=0.65, and p=0.22, respectively).
  
  
  CONCLUSIONS
  Metformin is effective in regularizing menstrual cycles, decreasing body mass index, and treating hyperandrogenism in Indian women diagnosed with PCOS.
authors.affiliation: Department of Pharmacology, M.S. Ramaiah Medical College and Hospitals, Karnataka, India.
authors.forename: Yashasvi
authors.initials: Y
authors.lastname: Suvarna
authors.affiliation: Department of Pharmacology, M.S. Ramaiah Medical College and Hospitals, Karnataka, India.
authors.forename: Nivedita
authors.initials: N
authors.lastname: Maity
authors.affiliation: Department of Endocrinology, M.S. Ramaiah Medical College and Hospitals, Karnataka, India.
authors.forename: Pramila
authors.initials: P
authors.lastname: Kalra
authors.affiliation: Department of Pharmacology, M.S. Ramaiah Medical College and Hospitals, Karnataka, India.
authors.forename: M C
authors.initials: MC
authors.lastname: Shivamurthy
keywords: Polycystic ovary syndrome; menstrual cycle; metformin; oral contraceptive containing drospirenone; testosterone