Misbah Malik, Nasira Tasnim, Ghazala Mahmud.
Effect of Metformin Alone Compared with Metformin Plus Simvastatin on Polycystic Ovarian Syndrome in Pakistani Women.
J Coll Physicians Surg Pak Jan ;28(3):184-7.

Objective: To determine the efficacy of metformin alone versus metformin plus simvastatin for treatment of polycystic ovarian syndrome (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.

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