Endometriosis is a common women health disorder that occurs when Endometrial-like tissue grows outside the uterus. This may lead to irregular bleeding , pelvic pain, infertility and other complications. Metformin, because of its activity to improve insulin sensitivity, it is used for the treatment of diabetes; it also has a modulatory effect on ovarian steroid production and has anti-inflammatory properties, all may suggest its possible effect in treatment of endometriosis. This study was planned to determine the effect of metformin on serum levels of interleukin- eight(IL-8), Tumor necrosis factor-alpha (TNF –α) and estradiol (E2) production , and related symptomatic changes that accompany with endometriosis (pelvic pain, dysmenorrhea and menorrheaga) after three months of study. Blood samples were obtained from those taking metformin and measure the serum levels of (IL-8) , TNF –α and (E2) were measured before and after three months of taking a metformin .Metformin therapy resulted in a significant reduction in the clinical symptoms of endometriosis (pelvic pain and dysmenorrhea) and insignificant changes in menorrhagia. Metformin therapy resulted in a significant reduction in the serum levels of IL-8, TNF- α while insignificant reduction in estradiol E 2 in the study group after 3 months of treatment .In conclusion the results of this study, demonstrated that metformin may be a well-tolerated treatment for endometriosis that relieved pain and reduces menstrual disorders and serum levels of the inflammatory markers (IL-8 and TNF-α) are decreased in study group treated with metformin after 3 months due to its anti- inflammatory effects.
Keywords: Endometriosis, Metformin, TNF – a ,IL-8, E 2.