Metformin’s therapeutic potential in adenomyosis: insights from interleukin 8 level

Adenomyosis is a gynecological disorder characterized by the invasion of endometrial tissue into the myometrium, leading to chronic inflammation and pelvic pain. Interleukin 8 (IL-8) plays a key role in inflammation and pain sensitization in adenomyosis. Metformin, an antidiabetic agent, exerts anti-inflammatory effects by activating adenosine monophosphate-activated protein kinase, inhibiting IL-8 production, and reducing inflammatory cell infiltration. This cohort-prospective study evaluates the effects of metformin on IL-8 levels and pain in adenomyosis patients. This cohort-prospective study in Makassar, Indonesia, included 40 women diagnosed with adenomyosis via physical examination and ultrasound examination in a polyclinic at Hasanuddin University Teaching Hospital. Participants were divided into two groups: 20 received metformin 500 mg and ibuprofen 400 mg every 8 hours for 30 days, while 20 only received ibuprofen. All statistical analyses were conducted using the Statistical Program for Social Sciences (IBM, Chicago, IL, USA). IL-8 levels increased in both groups (p=0.45). Visual Analog Scale (VAS) significantly decreased in the metformin group (p<0.001) but was not significant in the control group (p=0.06). Comparison of changes in IL-8 (p=0.13) and VAS (p=0.09) levels between the metformin and control groups was not statistically significant. This study suggests that the anti-diabetic drug metformin can also be used as an anti-inflammatory drug in adenomyosis patients as an adjunctive therapy. Further clinical trials need to be done on metformin drugs.