Endometrial hyperplasia is a precancerous condition in women. Progesterone, currently used to treat women with endometrial hyperplasia, is associated with side effects in 84% of women. Intrauterine device with levonorgestrel — an invasive method that is not suitable for all women and is associated with irregular vaginal bleeding in 82% of cases.
Therefore, alternative treatment is needed for women with endometrial hyperplasia. Metformin is often used to treat people with diabetes, but the drug has been found to be effective in treating endometrial hyperplasia. However, the efficacy and safety of metformin for the treatment of endometrial hyperplasia remain uncertain.
In the article estet-portal.com you can read in detail the results of the Cochrane review of research data regarding the justification for prescribing metformin for endometrial hyperplasia.
Niche of metformin use in the treatment of endometrial hyperplasia
Authors searched Cochrane Specialized Gynecology and Fertility Registry, Cochrane Central Controlled Research Registry (CENTRAL), MEDLINE, Embase, and others.
Included randomized controlled trials (RCTs) and crossover trials comparing metformin (used alone or in combination with other medical therapies) with placebo or no treatment, any conventional medical treatment, or any other active intervention for women with histologically confirmed endometrial hyperplasia any type.
Main signs of endometrial hyperplastic processes
The authors analyzed 3 RCTs involving 77 women. The quality of the evidence was rated as very low for all results due to the very high risk of bias and imprecision.
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There is currently insufficient evidence to support or refute the use of metformin alone or in combination with standard therapy, particularly megestrol acetate, versus megestrol acetate alone for the treatment of endometrial hyperplasia.
Randomized controlled trials providing evidence of long-term outcomes are needed to address this clinical issue.
Niche of metformin use in endometrial cancer
A large body of evidence links the incidence of endometrial cancer to metabolic conditions such as obesity and hyperglycemic conditions.
Better understanding of the contribution of the metabolic microenvironment to endometrial cancer tumorigenesis is needed.
There is convincing evidence that the mechanisms of utilization and synthesis of nutrients are significantly impaired in malignant neoplasms, both at the intracellular and intercellular levels. Models such as the inverse Warburg effect particularly emphasize the importance of considering the interaction between cancer epithelial cells and their surrounding stroma. Dysregulation of metabolic pathways may represent an adaptation that promotes cancer cell survival and proliferation.
The incidence of endometrial cancer is on the rise, in part due to rising rates of obesity.
Drugs such as metformin may be uniquely prepared to exploit these defects, perhaps in combination with other treatments that aim to use glucose. Indeed, preclinical and early clinical studies have shown promise for metformin as an adjuvant in the treatment of endometrial cancer, which affects both cancer-specific and patient-specific parameters.
Further research is needed to elucidate the role of metformin as a therapy for endometrial cancer, and several clinical trials are currently underway that will greatly expand our understanding of its potential benefits.
Thank you for staying with estet-portal.com. Read other interesting articles in the "Gynecology" section. You may be interested in Treatment of adenomyosis: possible risks and prognosis
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