Skip to main content
Top
Published in: The Journal of Obstetrics and Gynecology of India 5/2017

01-10-2017 | Original Article

Efficacy of Combined Cabergoline and Metformin Compared to Metformin Alone on Cycle Regularity in Patients with Polycystic Ovarian Disease with Hyperprolactinemia: A Randomized Clinical Trial

Author: Mervat Ali Mohamed Elsersy

Published in: The Journal of Obstetrics and Gynecology of India | Issue 5/2017

Login to get access

Abstract

Purpose

Polycystic ovarian syndrome (PCOS) is a common reproductive disorder. Increasing serum prolactin in these patients could be detected in both follicular and luteal phase of the normal and stimulated cycles. Hyperprolactinemia affects the hypothalamic–pituitary–ovarian axis causing anovulation and abnormal uterine bleeding. In this study, the efficacy of combined cabergoline and metformin therapy was compared to metformin therapy alone in patients with PCOS on the body mass index, androgen profile and menstrual cycle regulation.

Methods

Two hundred and fifty patients with polycystic ovarian syndrome (PCOS) with increased serum prolactin were randomly allocated into two groups: group (1) received oral metformin tablet 1000 mg per day and cabergoline 0.5 g tablet weekly for 3 months as a case group, and group (2) received oral metformin tablet 1000 mg per day and a placebo tablet weekly for 3 months as the control group (n = 123). Body mass index (BMI), menstrual cycle regularity, serum testosterone, serum prolactin and dehydroepiandrosterone sulfate (DHEAS) level were compared before and after treatment in both groups.

Results

There was significant decrease in body mass index and improvement of androgenic profile in both groups after treatment. In group (1), there was significant improvement in cycle regularity and significant decrease in serum prolactin level post-treatment.

Conclusions

The use of cabergoline in addition to metformin had more favorable effect on cycle regularity and prolactin level in patients with polycystic ovarian syndrome with hyperprolactinemia than the use of metformin alone.
Literature
1.
go back to reference Bachelot A. Polycystic ovarian syndrome: clinical and biological diagnosis. Ann Biol Clin (Paris). 2016;74(6):661–7. Bachelot A. Polycystic ovarian syndrome: clinical and biological diagnosis. Ann Biol Clin (Paris). 2016;74(6):661–7.
2.
go back to reference Melgar V, Espinosa E, Sosa E, et al. Current diagnosis and treatment of hyperprolactinemia. Rev Med Inst Mex Seguro Soc. 2016;54(1):111–21.PubMed Melgar V, Espinosa E, Sosa E, et al. Current diagnosis and treatment of hyperprolactinemia. Rev Med Inst Mex Seguro Soc. 2016;54(1):111–21.PubMed
3.
go back to reference Kurina AU, Pronina TS, Dilmukhametova LK, et al. Cooperative synthesis of dopamine in rat mediobasal hypothalamus as a compensatory mechanism in hyperprolactinemia. Biochem (Mosc). 2017;82(3):366–72.CrossRef Kurina AU, Pronina TS, Dilmukhametova LK, et al. Cooperative synthesis of dopamine in rat mediobasal hypothalamus as a compensatory mechanism in hyperprolactinemia. Biochem (Mosc). 2017;82(3):366–72.CrossRef
4.
go back to reference Lee DY, Oh YK, Yoon BK, et al. Prevalence of hyperprolactinemia in adolescents and young women with menstruation-related problems. Am J Obstet Gynecol. 2012;206(3):213.e1–5.CrossRef Lee DY, Oh YK, Yoon BK, et al. Prevalence of hyperprolactinemia in adolescents and young women with menstruation-related problems. Am J Obstet Gynecol. 2012;206(3):213.e1–5.CrossRef
5.
go back to reference Paepegaey AC, Veron L, Wimmer MC, et al. Misleading diagnosis of hyperprolactinemia in women. Gynecol Obstet Fertil. 2016;44(3):181–6.CrossRefPubMed Paepegaey AC, Veron L, Wimmer MC, et al. Misleading diagnosis of hyperprolactinemia in women. Gynecol Obstet Fertil. 2016;44(3):181–6.CrossRefPubMed
6.
go back to reference Huang T, Chen PC, Wu MH, et al. Metformin improved health-related quality of life in ethnic Chinese women with polycystic ovary syndrome. Health Qual Life Outcomes. 2016;14(1):119.CrossRef Huang T, Chen PC, Wu MH, et al. Metformin improved health-related quality of life in ethnic Chinese women with polycystic ovary syndrome. Health Qual Life Outcomes. 2016;14(1):119.CrossRef
8.
go back to reference Matthews ML. Abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol Clin N Am. 2015;42(1):103–15.CrossRef Matthews ML. Abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol Clin N Am. 2015;42(1):103–15.CrossRef
9.
go back to reference Capozzi A, Scambia G, Pontecorvi A, et al. Hyperprolactinemia: pathophysiology and therapeutic approach. Gynecol Endocrinol. 2015;31(7):506–10.CrossRefPubMed Capozzi A, Scambia G, Pontecorvi A, et al. Hyperprolactinemia: pathophysiology and therapeutic approach. Gynecol Endocrinol. 2015;31(7):506–10.CrossRefPubMed
10.
go back to reference Ghaneei A, Jowkar A, Hasani Ghavam MR, et al. Cabergoline plus metformin therapy effects on menstrual irregularity and androgen system in polycystic ovary syndrome women with hyperprolactinemia. Iran J Reprod Med. 2015;13(2):93–100.PubMedPubMedCentral Ghaneei A, Jowkar A, Hasani Ghavam MR, et al. Cabergoline plus metformin therapy effects on menstrual irregularity and androgen system in polycystic ovary syndrome women with hyperprolactinemia. Iran J Reprod Med. 2015;13(2):93–100.PubMedPubMedCentral
11.
go back to reference Ferrero H, Garcia-Pascual CM, Pellicer N, et al. Dopamine agonist inhibits vascular endothelial growth factor protein production and secretion in granulosa cells. Reprod Biol Endocrinol. 2015;13:104.CrossRefPubMedPubMedCentral Ferrero H, Garcia-Pascual CM, Pellicer N, et al. Dopamine agonist inhibits vascular endothelial growth factor protein production and secretion in granulosa cells. Reprod Biol Endocrinol. 2015;13:104.CrossRefPubMedPubMedCentral
12.
go back to reference Chen H, Fu J, Huang W. Dopamine agonists for preventing future miscarriage in women with idiopathic hyperprolactinemia and recurrent miscarriage history. Cochrane Database Syst Rev. 2016;7:CD008883.PubMed Chen H, Fu J, Huang W. Dopamine agonists for preventing future miscarriage in women with idiopathic hyperprolactinemia and recurrent miscarriage history. Cochrane Database Syst Rev. 2016;7:CD008883.PubMed
13.
go back to reference Pala NA, Laway BA, Misgar RA, et al. Metabolic abnormalities in patients with prolactinoma: response to treatment with cabergoline. Diabetol Metab Syndr. 2015;7:99.CrossRefPubMedPubMedCentral Pala NA, Laway BA, Misgar RA, et al. Metabolic abnormalities in patients with prolactinoma: response to treatment with cabergoline. Diabetol Metab Syndr. 2015;7:99.CrossRefPubMedPubMedCentral
14.
go back to reference Krysiak R, Okrzesik J, Okopien B. Different effects of metformin on the hypothalamic-pituitary-thyroid axis in bromocriptine- and cabergoline-treated patients with hashimoto’s thyroiditis and glucose metabolism abnormalities. Exp Clin Endocrinol Diabetes. 2015;123(9):561–6.CrossRefPubMed Krysiak R, Okrzesik J, Okopien B. Different effects of metformin on the hypothalamic-pituitary-thyroid axis in bromocriptine- and cabergoline-treated patients with hashimoto’s thyroiditis and glucose metabolism abnormalities. Exp Clin Endocrinol Diabetes. 2015;123(9):561–6.CrossRefPubMed
15.
go back to reference Mohammadbygi R, Yousefi SR, Shahghaybi S, et al. Effects of Cabergoline administration on uterine perfusion in women with polycystic ovary syndrome. Pak J Med Sci. 2013;29(4):919–22.CrossRefPubMedPubMedCentral Mohammadbygi R, Yousefi SR, Shahghaybi S, et al. Effects of Cabergoline administration on uterine perfusion in women with polycystic ovary syndrome. Pak J Med Sci. 2013;29(4):919–22.CrossRefPubMedPubMedCentral
16.
go back to reference Corbett S, Shmorgun D, Claman P, et al. The prevention of ovarian hyperstimulation syndrome. J Obstet Gynaecol Can. 2014;36(11):1024–33.CrossRefPubMed Corbett S, Shmorgun D, Claman P, et al. The prevention of ovarian hyperstimulation syndrome. J Obstet Gynaecol Can. 2014;36(11):1024–33.CrossRefPubMed
Metadata
Title
Efficacy of Combined Cabergoline and Metformin Compared to Metformin Alone on Cycle Regularity in Patients with Polycystic Ovarian Disease with Hyperprolactinemia: A Randomized Clinical Trial
Author
Mervat Ali Mohamed Elsersy
Publication date
01-10-2017
Publisher
Springer India
Published in
The Journal of Obstetrics and Gynecology of India / Issue 5/2017
Print ISSN: 0971-9202
Electronic ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-017-1022-3

Other articles of this Issue 5/2017

The Journal of Obstetrics and Gynecology of India 5/2017 Go to the issue