Effect Of Metformin Alone Compared With Metformin Plus Simvastatin on Polycystic Ovarian Syndrome In Pakistani Women

OBJECTIVE: To determine the efficacy of metformin alone versus metformin plus simvastatin for treatment of polycystic ovariansyndrome (PCOS). STUDY DESIGN: Randomized controlled trial. PLACE AND DURATION OF STUDY: Maternal and Child Health Centre, Unit II, Pakistan Institute of Medical Sciences (PIMS), from November 2014 to April 2015. METHODOLOGY: One hundred and eight patients (108) were randomly divided into metformin group (n=54) and metformin plus simvastatin group (n=54), detailed clinical history, including menstrual details, was taken with thorough examination performed. Baseline ultrasound was performed to evaluate ovarian size and these were considered enlarged with volume >10cc or with >12 follicles in any one ovary. Blood samples were taken at baseline and after three months of therapy to determine the LH/FSH ratio and lipid profile. Efficacy was defined as >15% decrease in the baseline values. RESULTS: The mean age of patients was 28.82 ±7.18 years. Mean BMI of the patients was 22.41 ±1.55 Kg/m2. Efficacy was achieved in 66.7% patients with metformin alone, while in 92.6% with combination medication (p=0.001). CONCLUSION: The combination of metformin plus simvastatin is more efficacious as compared to metformin alone for management of females with PCOS.