Metformin Efficiency in Genital Endometriosis Management
Study Objective: To assess clinical efficiency of combination therapy with Metformin and Metformin monotherapy in the management of endometriosis genitalis externa (EGE). Study Design: perspective randomised singe-arm study in parallel groups. Materials and Methods. 146 patients with pain syndrome associated with endometreosis were treated with one therapy option for 6 months: Dienogest 2mg/d (group 1, n = 32); Dienogest 2mg/d + Metformin 1,500mg/d (group 2, n = 61); Dienogest 2mg/d + Metformin 750mg/d (group 3, n = 29); Metformin 1,500 mg/d (group 4, n = 24). The intensity and prevalence of dysmenorrhea, dyspareunea, chronic pelvis pain (CPP) before and after treatment were evaluated. Study Results. In group 2, pain syndrome became less intensive in 85.2% of EGE patients. Dysmenorrhea reduction was statistically more frequent (p = 0.031), CPP was less intensive (p = 0.027), as compared to the standard Dienogest therapy. 75.9% of group 3 patients and 66.7% of group 4 patients had less intensive pain syndrome. There were no statistically significant differences in therapy results between group 3 and group 4 and Dienogest monotherapy. Conclusion. Combination of Dienogest (2mg/day) and Metformin (1,500mg/d) allows boosting the efficiency of therapy of endometreosis-associated pain syndrome. Personification of pathogen-specific EGE management with individualised selection of a drug combination and Metformin dose is a promising option. Keywords: endometreosis, pain syndrome, Dienogest, Metformin