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Background and Aim: Metformin, a biguanide antihyperglycemic drug, has been shown to improve ovarian function and glucose metabolism in women with polycystic ovary syndrome (PCOS), but results concerning its effects on insulin sensitivity are controversial. Oral contraceptive pills are commonly used in the treatment of PCOS, but like metformin, their influence on insulin sensitivity is not well known. The aim of this study was to investigate endocrine and metabolic effects of metformin versus Diane in women with polycystic ovary syndrome. Materials and Methods: This research was a prospective randomized clinical Trial study, we randomized 60 women (20-49 years old) with PCOS either to metformin (500mg 3 daily for 6 months) or to oral contraceptive pills (Dian) 35µg ethinyl estradiol 2mg cyproterone acetate for 6 moths. Data were analyzed by Chi-Square، t، Mann-Whitney and Wilcoxon Signed Ranks tests with P<0.05 as a limit of significance. Results: Results showed that metformin significantly decreased serum glucose, insulin concentrations, serum cholesterol, serum testosterone, serum DHEAS (Dehydro epiandrosterone sulfate) and improved menstrual cyclicity and insulin sensitivity. Diane significantly decreased serum testosterone and serum DHEAS but slight effect in carbohydrate metabolism and increase serum glucose. Conclusion: Metformin, probably by way of its effects on adipose tissue, leads to reduction of hyperinsulinemia and concomitant improvement, and therefore, it offers a useful alternative treatment for anovulatory women with PCOS. Despite slight increase in fasting glucose, Diane is an effective for women with hyperandrogenism and hirsutism.

Keywords: Metformin; Diane; Endocrine parameter; Metabolic parameter

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