ROLE OF METFORMIN AND VITAMIN D3 IN OBESE PCOS PATIENTS

Polycystic ovarian syndrome (PCOS) is a common metabolic and endocrinological disorder affecting women of reproductive age, with a prevalence of 4-20%. It is characterized by symptoms such as oligoamenorrhea/amenorrhea, hyperandrogenism, hyperinsulinemia, and ultrasound (USG) features of polycystic ovaries. Risk factors include excessive weight gain, high BMI, dyslipidemia, stress, and chronic illness. Symptoms such as menstrual irregularity, infertility, male-pattern hair loss, facial hair, and acne are common due to anovulation and androgen excess. The exact cause of PCOS is unknown, but it is believed to be multifactorial, involving environmental and genetic factors. Studies suggest overexpression of LH receptors on theca cells as a potential mechanism. Metformin is recommended in addition to lifestyle interventions (LSI) for women with PCOS and BMI ?25 kg/m², irrespective of glucose disturbances or menstrual irregularity. It is effective for glucose intolerance and may be beneficial for long-term use, though the optimal duration is unclear. Vitamin D deficiency has been associated with insulin resistance and PCOS. Vitamin D enhances insulin synthesis, release, receptor expression, and reduces pro-inflammatory cytokines, improving insulin sensitivity. In conclusion, both metformin and vitamin D play significant roles in managing PCOS by addressing insulin resistance and hormonal imbalances.