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[This article belongs to Volume - 26, Issue - 02]

The short-term effects of metformin and myoinositol on menstrual normalization among women with polycystic ovary syndrome: A meta-analysis

Polycystic ovary syndrome (PCOS) is the most common endocrine disease among women in the reproductive age group. Metformin has the used to mitigate insulin resistance and normalize menstrual periods in PCOS for decades. Inositol was found to be effective in the treatment of the same. however, face-to-face comparisons between the two drugs are scarce. This meta-analysis aimed to compare metformin and myoinositol for the menstrual cycle among women with PCOS. We searched PubMed MEDLINE, Web of Science, SCOPUS, and Cochrane Library from inception up to December 2023. The keywords inositol, metformin, polycystic ovary syndrome, Stein-Leventhal syndrome, amenorrhea, anovulation, menstrual regulation, oligomenorrhea, "Inositol/therapeutic use" (MeSH), "Polycystic Ovary Syndrome/drug therapy" (MeSH), "Polycystic Ovary Syndrome/prevention and control" (MeSH), and "Metformin/therapeutic use" (MeSH), were used. We identified 790 studies and 583 stands after the removal of duplication, from them, 48 full texts were screened and only eight studies were included in the final meta-analysis. No significant statistical difference was found between inositol and metformin regarding menstrual normalization among women with polycystic ovary syndrome, odd ratio, 0.59, 95% CI, O.31-1.11. The P-value for the overall effect was 0.10. Myoinositol was not inferior to metformin regarding menstrual cycle normalization among women with PCOS. Larger randomized trials investigating the side effects of metformin and myoinositol and assessing for their effects on hyperandrogenism and cardiovascular risk factors are suggested.