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

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 polycys-tic ovary syndrome (pcos). in this study, the clinical and metabolic effects of fenu-greek 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 fenu-greek 333 mg (n=55) was compared with metformin 500 mg (n=55), both adminis-tered three times a day in women with pcos of reproductive age. changes in some clinical outcomes and metabolic laboratory profile outcomes were evaluated at base-line and two months after the study. results: by the end of the intervention period, all investigated factors improved sig-nificantly 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 signif-icantly 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 hyper-lipidemia and severe hair loss.