Antiproliferative Effect of Metformin on the Endometrium - a Clinical Trial

Abstract

Background: Unopposed estrogen has a central role in development of endometrial benign, premalignant and malignant lesions. The aim of this study was to evaluate the anti-estrogenic effect of metformin on endometrial histology in comparison with progesterone. Materials and Methods: A total of 43 patients who were referred to our center for abnormal uterine bleeding and had a histologic diagnosis were disordered proliferative endometrium or simple endometrial hyperplasia were included and randomly distributed in two groups treated with metformin (500mg Bid) or megestrol (40mg daily), respectively, for three months. After this period the patients were evaluated by another endometrial biopsy to assess the impact of the two drugs in restoring normal endometrial histology. Results: Our findings revealed that metformin could induce endometrial atrophy in 21 out of 22 patients (95.5%) while this positive response was achieved in only 13 out of 21 patients (61.9%) in the megstrol group. In addition two low grade endometrial carcinomas in the metformin group responded very well. Conclusions: We conclude that metformin could be used as an effective antiestrogenic agent in control of abnormal endometrial proliferative disorders.

The Comparative Effect of Combination of Metformin and Megestrol Acetate With Megestrol Acetate Alone on Endometrial Growth Disorders

“…In this study, we reported more responses in both groups compared to the results of other studies (95.1% and 93%). As with the study of Shan et al (11) and Dastranj et al (14), we had no complication in any of the groups.…”

“…Continuous treatment with megestrol acetate was effective in improving proliferative and hyperplastic disorders of endometrium but its effect on atypical cases was lower (13). Dastranj et al compared the effect of megestrol acetate with metformin and found a higher effect in the metformin group (95.5%) than the megestrol group (63.6%) (14). In comparison to this study, we investigated the comparative effect of combination of megestrol acetate and metformin with megestrol acetate alone on proliferative and hyperplastic endometrial disorders.…”

Effects of Metformin on Cell Kinetic Parameters of MCF-7 Breast Cancer Cells in Vitro

“…In addition two low grade endometrial carcinomas in the metformin group responded very well (Tabrizi et al, 2014).…”

Proliferation and metastatic potential of endometrial cancer cells in response to metformin treatment in a high versus normal glucose environment

“…However, the majority of these previous studies possessed methodological weaknesses and/or insufficient data. Additionally, experimental studies revealed that metformin is an effective antiestrogenic agent, inhibiting cell proliferation and leading to growth arrest, as well as inducing apoptosis in EC (17,(20)(21)(22). Furthermore, recent findings have suggested that metformin is important in suppressing the migration and invasion of cancer cells, which could prevent metastasis (23)(24)(25).…”