A study to evaluate the effect of metformin, oral contraceptive pills and their combination on anthropometric measurements, lipid profile and hs-CRP levels in Indian women with polycystic ovary syndrome at a tertiary care hospital

Objectives: The study evaluated effect of metformin, oral contraceptive pills (OCP), and their combination on high - sensitivity C- reactive protein (hs-CRP), lipid profile, and anthropometric measurements (body mass index, waist circumference, hip circumference, waist - hip ratio) in Indian women with PCOS (polycystic ovary syndrome). Methods: In this prospective, observational, open-label study, metformin, OCP, and their combination were compared in women with PCOS (Rotterdam criteria). Lipid parameters, hs-CRP, anthropometric measurements, menstrual cycle, and Ferriman - Gallway (FG) score were evaluated at baseline, three and six months after treatment. Results: A total of 88 patients completed study. hs - CRP levels significantly decreased in metformin and combination groups (p <0.001) at 3 and 6 months, while they increased in OCP group (p<0.001). Anthropometric measurements significantly decreased in metformin (p<0.001) and combination groups (p<0.05), whereas an increase in these variables was observed in OCP group (p<0.05). Administration of metformin (p<0.001) and combination (p<0.05) resulted in improvement in lipid profile, whereas treatment with OCP (p<0.05) has led to unfavorable lipid profile. FG score and menstrual irregularity improved in all groups. Conclusion: Metformin may be a better treatment option for OCPs in ameliorating atherogenic profile in Indian women with PCOS. For patients requiring OCP, combination of metformin with OCP can be preferred to OCP alone as metformin has been shown to reduce cardiovascular risk induced by OCP. Combination of metformin and OCP has regularized menstrual cycle better than monotherapy of either drug.