Comparison of the Effect of Fenugreek and Metformin on Clinical and  Metabolic Status of Cases with Polycystic Ovary Syndrome: A Randomized Trial

Shahla  Mirgaloybayat; Azadeh  Akbari Sene; Fatemeh  Jayervand; Mahdi  Vazirian; Arash  Mohazzab; Mitra  Kazerooni

doi:10.18502/jri.v25i2.16040

Shahla Mirgaloybayat Endometriosis Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Azadeh Akbari Sene Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Fatemeh Jayervand Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Mahdi Vazirian Department of Pharmacognosy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
Arash Mohazzab Epidemiology Department, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
Mitra Kazerooni Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), School of Medicine, Iran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jri.v25i2.16040

Keywords: Cholesterol, Fenugreek, Herbal medicine, Polycystic ovary syndrome, Randomized clinical trial, Triglyceride, Trigonella.

Abstract

Background: It is hypothesized that fenugreek seeds are a rich source of fiber with anti-diabetic effects, which can help to lower blood glucose in patients with polycystic ovary syndrome (PCOS). In this study, the clinical and metabolic effects of fenugreek were compared to those of metformin in women with PCOS aged 16-40 years.

Methods: In a randomized, triple-blind, parallel clinical trial, the efficacy of fenugreek 333 mg (n=55) was compared with metformin 500 mg (n=55), both administered three times a day in women with PCOS of reproductive age. Changes in some clinical outcomes and metabolic laboratory profile outcomes were evaluated at baseline and two months after the study.

Results: By the end of the intervention period, all investigated factors improved significantly in patients of both groups (p<0.05). Reduction in biometric indices (body mass index and waist–hip ratio), fasting blood sugar (FBS), and insulin resistance was significantly higher after metformin consumption (p<0.001). Metformin also significantly improved irregular menstruation (p=0.02). In contrast, fenugreek significantly improved patients' lipid profiles, including low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) compared to metformin (p<0.001). Both interventions improved the patient's hair loss and hirsutism.

Conclusion: Fenugreek cannot substitute metformin in PCOS treatment. However, regarding its lipid-lowering ability and low frequency of adverse effects, it can be used as an adjuvant treatment in PCOS, especially in PCOS patients with hyperlipidemia and severe hair loss.