Abstract
Author(s): Mustafa Mohammed Albassam*, Yasser Kadhim Hashem Al-Zwaini, Alaa Al-Noori, Mohammed Hasan Kadhim, Hilal Abdulla Younis
Background: One of the most critical parameters to diagnose Polycystic Ovarian Syndrome (PCOS) is prolactin (Pr), Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH) and Luteinizing Hormone/Follicle- Stimulating Hormone (LH/FSH) ratio. Objective: Assess the clinical metabolic outcomes value of LH/FSH ratio, LH, FSH and Pr in productive-age women having polycystic ovarian syndrome after an average treatment period of three months with combined Metformin and Spironolactone. Design: A retrospective pilot study. Setting: Private Gynaecological Clinics, Baghdad, Iraq. Patients and methods: We selected reproductive-aged women with PCOS who underwent enzyme-linked immunosorbent assay tests of FSH, LH, and Pr before and after treatment. Women with hyperprolactinemia, thyroid disease, Cushing’s syndrome, and adrenal hyperplasia were excluded. We investigated patients, Pre-treatment and Post-treatment regarding Metformin (MET) 500 mg q.i.d/day and Spironolactone (SPR) 50 mg/day treatment. Main outcome measure: LH/FSH ratio, LH, FSH, Pr, menstrual cycle, hirsutism and acne. Sample size: Thirty. Results: LH and Pr showed a highly significant decreased after combined treatment with MET and SPR when compared with Pretreatment (P=.0001, .0004), respectively, Menstrual Cycle/Year showed a significant increase in Post-treatment (P=.0001) and no significant change in body mass index and FSH parameter when compared Posttreatment with Pre-treatment (P=.297, .296) respectively, and a highly significant decreased and improvement in hirsutism and acne symptoms in Post-treatment when compared with Pre-treatment (P=.0001, .0073) respectively. Conclusion: LH, LH/FSH ratio, Pr, menstrual irregularity, hirsutism, and acne as metabolic outcomes of PCOS can be reversed to normal by using combined MET and SPR as a complementary effect for three months.